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, April 23, 2022

Weekly Overseas Health IT Links – 23rd , 2022.

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/2022/04/rethinking-the-architecture-of-health-it-to-unlock-potential/

Rethinking the architecture of health IT to unlock potential

Tomaz Gornik, CEO of Better, explores why we need to rethink the architecture of health IT in order to unlock the potential of a patient-centric approach to care.  

DHI News Team 12 April 2022

In just a few years, conversations surrounding the importance of data in healthcare have changed dramatically. And although it took a pandemic for the market to shift, it is encouraging to know that accessible and quality data is now considered paramount to improving health and care.

Providers are finally starting to think about data first and applications second, and we are seeing fundamental changes being made to NHS procurement process, with tenders less likely to give vendors responsibility for data formats. Instead, they are requesting solutions based on open, published, vendor-neutral data standards.

Healthcare systems are evolving too, with patients demanding greater responsibility to manage their own care, and healthcare providers recognising the benefits of making them active participants, particularly in terms of reducing elective care backlogs.

As a result, we are seeing more attention being paid to holistic care models across the sector, which focus on bringing care closer to the citizen and coordinating care activities between different providers. This is a positive step, and a sign that the future of health and care does not revolve around provider organisations, but around the patient.

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https://www.forbes.com/sites/forbestechcouncil/2022/04/14/why-ransomware-on-hospitals-is-one-of-the-greatest-dangers-of-our-time/?sh=3537f7057ca3

Why Ransomware On Hospitals Is One Of The Greatest Dangers Of Our Time

Galina Antova

Apr 14, 2022,06:15am EDT

Galina Antova is the Co-Founder of Claroty, cybersecurity company focusing on protecting the world's critical infrastructure.

Recently, I unfortunately needed to spend some time in a hospital, attending to a family member. I was shocked to see firsthand how much Covid-19 has impacted healthcare processes. As reflected in various reports, the availability of personnel and level of care have been negatively affected, and so many non-urgent procedures have had to be postponed, ultimately leading to worse patient outcomes. Across the board, we’re just starting to realize the impact Covid-19 has had on healthcare outcomes, beyond Covid-related illness and deaths.

I think a similar parallel can be drawn to the dangers of ransomware on healthcare organizations.

Over the last couple of years, cybercriminals have increasingly targeted critical infrastructure organizations with ransomware attacks since time pressures and the vital services they provide compel these entities to pay more quickly. In 2021, 80% of these organizations surveyed experienced an attack, and 62% paid the ransom, according to my company’s research. One critical infrastructure sector is healthcare delivery organizations (HDOs). Just like any other enterprise, HDOs are increasingly interconnected, and technology controls are relied upon in nearly every step along the delivery process.

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https://mytechdecisions.com/compliance/healthcare-data-security/

Why Healthcare Needs Better Data Security

A staggering 44,993,618 healthcare records were exposed or stolen in 2021, organizations must be more proactive in securing patient data.

April 12, 2022 Brian Foy

As the healthcare industry accelerates into an increasingly digitized world, cyber breaches exposing confidential patient data are becoming more commonplace. In fact, according to the Department of Health and Human Services’ Office for Civil Rights’ breach portal, a staggering 44,993,618 healthcare records were exposed or stolen in 2021.

The implications of these security breaches are significant; they threaten not only health data integrity, but patient confidence in the healthcare system overall. One survey found that about half of consumer respondents were more likely to trust companies that reacted quickly to breaches or disclosed hacks of data to the public.

As a result, healthcare systems and companies becoming more proactive in safeguarding the data of their patients will be vital to the future of healthcare.

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https://www.healthcarefinancenews.com/news/patients-increasingly-suing-hospitals-over-data-breaches

Apr 13 2022

Patients increasingly suing hospitals over data breaches

Fifty-eight lawsuits were filed in 2021, with 43 of them filed against healthcare organizations, the largest percentage among all industries.

Jeff Lagasse, Associate Editor

Industries are increasingly being sued by consumers for data breaches, but the sector with the biggest litigation increase is healthcare, according to new findings from the law firm BakerHostetler.

In fact, healthcare comprises 23% of lawsuits due to data breaches. The next highest after that is business and professional services at 17%, followed by finance and insurance (15%), education (12%) and manufacturing (10%).

In all, 23 data breach incidents resulted in one or more lawsuits; 58 lawsuits were filed overall, with 43 of them filed against healthcare organizations.

Of all industries, healthcare also logged the highest initial ransom demand from hackers and bad actors, at more than $8.3 million. The average ransom that was actually paid was far lower, at about $876,000, but that was still the highest average amount paid across all industries. 

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https://www.mobihealthnews.com/news/little-bit-sci-fi-how-robots-can-make-dent-nurses-workloads

'A little bit sci-fi': How robots can make a dent in nurses' workloads

Diligent Robotics CEO and cofounder Andrea Thomaz explains how her company's clinical support robot Moxi works and how its design informs its interactions with humans.

By Emily Olsen

April 15, 2022 11:11 am

Frontline healthcare workers are stretched thin in the wake of the COVID-19 pandemic as many hospitals contend with nursing shortages and provider burnout.

Diligent Robotics, which earlier this week announced a $30 million Series B funding round, aims to lessen some of that staffing burden by automating routine delivery tasks with its Moxi robot. The company's CEO and cofounder, Andrea Thomaz, sat down with MobiHealthNews to discuss how Moxi works, what it takes to onboard a robot hospital worker and how Moxi's design informs its interactions with humans. (This interview has been edited for clarity and length.)

MobiHealthNews: Can you tell me a bit about how Moxi works and how it assists healthcare providers in hospitals?

Andrea Thomaz: Moxi is what's called in robotics a mobile manipulation robot. That just means it's got a mobile base, an arm that can manipulate things in the environment and a socially expressive head that lets people know what Moxi is doing. 

Moxi is doing fetch-and-deliver tasks for hospital staff. We like to say that Moxi can be installed to be pretty flexible and go point-to-point in the hospital. And we end up saving people a lot of time by taking over all of the ad hoc delivery tasks that happen throughout the day.

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https://www.healthleadersmedia.com/payer/5-challenges-facing-digital-quality-measurement

5 Challenges Facing Digital Quality Measurement

Analysis  |  By Laura Beerman  |   April 14, 2022

The National Association of ACOs is the latest to respond to CMS electronic quality measure goals.


KEY TAKEAWAYS

·         CMS' Meaningful Measures 2.0 initiative continues to draw industry support and response, most recently from the National Association of ACOs.

·         The organization cites unique ACO challenges related to digital quality measurement, including how new goals upend long-standing ones.

·         ACO financial and operational challenges join those common to all stakeholders, including interoperability and measure standardization and streamlining.

Which challenge to tackle first in digital quality reporting?

The National Association of ACOs (NAACOS) is one of many posing the question as CMS aims to "[t]ransform measures to fully digital by 2025." NAACOS announced that it "has launched a new task force, aimed at developing recommendations for how to successfully collect and electronically report on ACOs' quality of care through disparate health information technology (IT) systems."

In its press release, NAACOS noted the following digital quality measure challenges for the Medicare Shared Savings Program (MSSP) and other stakeholders:

  1. Interoperability. An abiding industry challenge requiring the collection, integration, and analysis of data from dozens of disparate EHR systems.
     
  1. Standardization. A key part of interoperability applies not only to data but quality measures themselves. Electronic clinical quality measures (eCQM) were a component of CMS' final Rate Announcement.
     
  1. Streamlining. CMS' Meaningful Measures program, now in Phase 2.0, will continue to target measure reduction and consolidation. Some ACOs have already done this work. A consolidated value-based care Star Rating from one MSSP—the Baylor Scott & White Quality Alliance—spans 50+ multipayer contracts and was featured in a January 2022 NAACO webinar.
     
  1. Unique ACO challenges. NAACOS reports that more than 75% of ACOs must navigate at least six EHR systems, with 37% managing 15 or more. NAACOS also cited the "unintended implications and consequences of mandating data reporting on total patient populations instead of just the MSSP," which has been the decade-long standard.
     
  1. Financial and operational changes. Achieving all the above by 2025 will require time, resources, and money, what NAACOS terms "significant investment by vendors, practices, and ACOs."

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https://healthitsecurity.com/news/nist-highlights-enterprise-patch-management-in-latest-guidance

NIST Highlights Enterprise Patch Management in Latest Guidance

NIST’s National Cybersecurity Center of Excellence (NCCoE) released final guidance for enterprise patch management.

By Jill McKeon

April 14, 2022 - The National Institute of Standards and Technology’s (NIST) National Cybersecurity Center of Excellence (NCCoE) released final guidance regarding enterprise patch management to help organizations prevent vulnerabilities and exploitation within their IT systems.

The two publications (SP-800-40 and SP 1800-31) emphasized the need to prioritize patching and preventive maintenance in order to avoid data breaches and operational disruptions. SP-800-40 acts as a guide to enterprise patch management planning, while SP-1800-31 explores use cases and approaches for improving enterprise patching practices for general IT systems.

Although the guidance is not healthcare-specific, the sector should take note of enterprise patch management best practices. Unpatched devices and systems can serve as an easy network entry point for threat actors. Medical devices in particular can be difficult to patch due to their portability and the fact that organizations may not know how many devices are on their networks at any given time.

NCCoE directed its guidance toward chief information officers, cybersecurity directors and managers, chief information security officers (CISOs), and anyone else who might be responsible for managing software risks.

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https://www.healthdatamanagement.com/articles/interoperability-consensus-the-pipes-are-built-data-can-flow?id=129884

Interoperability consensus – the pipes are built; data CAN flow.  

Easier data exchange can help solve major pain points for healthcare organizations, and that will sustain momentum, say presenters at the HDM KLASroom.

Apr 14 2022


Fred Bazzoli

Editor-in-Chief, HDM

Interoperability has always seemed like a long distant goal, but the reality appears now that all the technology pieces are in place to make it a reality. 

Two major hurdles remain – bringing those pieces together into a finely integrated picture, and having clinicians find ways to utilize it to solve their day-to-day data access problems. 

Facilitating the exchange of clinical information was the theme of this week’s HDM KLASroom, which focused on using data to strengthen the clinician-patient relationship. In addition to improving care, interoperability-aided data access has the potential to lighten clinicians’ burdens and give them the tools to improve the care they provide, presenters said on Wednesday. 


The pipes are in place 

Interoperability has come a long way in the past 15 years, noted Steven Lane, MD, clinical informatics director for privacy, security and interoperability at Sutter Health. Early efforts used standards to move data between partners, but now standards such as the Fast Healthcare Interoperability Resource (FHIR) and APIs can support exchange between providers, payers and patients. 

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https://healthitanalytics.com/news/research-challenges-limit-machine-learning-use-in-medical-imaging

Research Challenges Limit Machine Learning Use in Medical Imaging

Data limitations, evaluation issues, and publishing incentives may be slowing the clinical progress of machine learning in medical imaging, a new study finds.

By Shania Kennedy

April 13, 2022 - Though research on machine learning use in medical imaging has grown significantly in recent years, improvements in the clinical use of such data remain limited, according to a study published in npj Digital Medicine.

Machine learning (ML) is a promising but controversial tool for healthcare providers. Studies suggest heightened enthusiasm around the potential application of ML in clinical settings, but they also note that appropriate regulations must be implemented to ensure that it is effectively implemented. Recent studies have shown that biases within artificial intelligence (AI) algorithms can create health disparities.

The current study's authors found that at each step of the research process, potential challenges and biases can be introduced that limit the clinical use of ML in medical imaging. Issues can arise from the beginning, depending on how data for this research are collected, how datasets are created and distributed, and what biases may exist in the datasets themselves.

When the data are evaluated, further challenges present themselves in selecting meaningful evaluation targets, preventing improper evaluation procedures, choosing suitable metrics, and adopting other statistical best practices, the researchers pointed out.

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https://www.beckershospitalreview.com/cybersecurity/how-email-warnings-can-stop-snooping-hospital-employees.html

How email warnings can stop snooping hospital employees

Naomi Diaz -13 April, 2022

Email warnings were 95 percent effective in preventing healthcare employees from inappropriately accessing patient health information, according to an April 13 study published in JAMA.

Researchers conducted a nonrandomized controlled trial at a large academic medical center to understand the effectiveness of email warnings on reducing repeated unauthorized access to patient health information. Here's what they found:

  • In the intervention group, who had email warnings, 4 out of 219 employees' repeated offenses occurred between 20 and 70 days after the initial unauthorized access.
     
  • In the control group, who didn't have access to email warnings, 90 out of the 225 employees accessed protected health information for a second time, between 20 and 70 days after their initial unauthorized access. 
  • Email warnings were 95 percent effective for reducing repeated offenses.
  • The nonrandomized controlled trial found that when left unchecked, hospital employees repeatedly committed unauthorized access to patient health information.

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https://www.cbinsights.com/research/report/digital-health-trends-q1-2022/

State of Digital Health Q1’22 Report

April 14, 2022

After a record-breaking 2021, global digital health investment cools in Q1’22.

Global digital health funding reached $10.4B in Q1’22, down 36% from the previous quarter. 

In our State Of Digital Health 2021 Report, we dig into global investment trends to spotlight takeaways like:

  • How digital health’s funding slowdown compares to fintech and retail tech
  • The record unicorn count, unicorn birth trends, and new digital health unicorns of Q1’22
  • Which investors completed the most healthcare investments in Q1’22, and other top-ranked firms
  • The digital health sector that saw a 60% decline in funding QoQ
  • The median valuation increase of digital health startups compared to their prior financing round
  • How Q1’22’s M&A, IPO, and SPAC exits compare to previous quarters — including the exit type that saw activity plummet 96% QoQ
  • And much more

Below, check out just a few highlights from our 164-page, data-driven State Of Digital Health Q1’22 Report. For deeper insights, all the record figures, and a boatload of private market data, download the full report.

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https://www.healthcarefinancenews.com/news/hhs-extends-public-health-emergency-another-90-days

2022

HHS extends public health emergency for another 90 days

HHS and the Biden Administration say they will give 60 days prior notice before ending the PHE.

Susan Morse, Executive Editor

Health and Human Services Secretary Xavier Becerra has announced a 90-day extension of the public health emergency that was due to expire on April 16. 

The PHE is being extended for the ninth time since January 2020 due to the COVID-19 pandemic. Cases are again surging in some areas with mask mandates being implemented in certain regions.

WHY THIS MATTERS

The PHE has allowed hospitals and providers to use waivers for innovation in such areas as telehealth and acute hospital care at home.

HHS and the Biden Administration have said they would give 60 days prior notice before ending the PHE.

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https://www.healthcareitnews.com/news/hhs-secretary-cures-act-enforcement-long-overdue

HHS Secretary: Cures Act enforcement 'long overdue'

Xavier Becerra said at the ONC annual meeting this week that establishing consequences for providers found to engage in information blocking is a "top HHS priority."

By Kat Jercich

April 14, 2022 09:09 AM

U.S. Department of Health and Human Services Secretary Xavier Becerra said that the federal government has made "extraordinary progress" over the past year when it comes to advancing health technology.  

Becerra pointed to the launch of TEFCA, enforcement of Cures Act provisions and the launch of Helios FHIR Accelerator as just a few examples.  

At the same time, he said at the Office of the National Coordinator for Health IT Annual Meeting this week, the agency has several goals that have yet to be fulfilled. 

Among them are what he referred to as the Cures Act penalty enforcement gap.   

Namely, as Becerra explained, civil monetary penalties for not complying with information-sharing requirements have only been established for technology developers and health information networks.  

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https://www.healthcareittoday.com/2022/04/14/healthcare-ai-bias-reasons-and-resolutions/

Healthcare AI Bias: Reasons and Resolutions

April 14, 2022

The following is a guest article by Anand Shroff, President at Verantos.

Artificial intelligence (AI) holds great promise to dramatically improve clinical outcomes for patients, but in a perverse twist, AI algorithms that are used to improve drug development and support healthcare don’t just highlight social inequities — they may ultimately exacerbate them. A lingering shortcoming of AI use in the life sciences and healthcare sectors is that both the underlying patient data and the rules that are established to develop and train the algorithm often have built-in biases.

AI algorithms are first developed and trained using real-world data (RWD) from typical sources like patient records and are then used to recognize patterns in broader data sets. AI algorithms are trained to find patterns in massive amounts of data, so when bias exists in the underlying RWD itself, or in the rules and assumptions used to develop the AI algorithms, then any patterns that are later identified by the AI algorithm in larger data sets will perpetuate that bias in the findings.

Similarly, AI may be inadvertently applied in inappropriate contexts, or used to evaluate RWD sets that were not necessarily the target of the underlying algorithm development, and this too can lead to results that perpetuate underlying biases in the system. Such bias reflects existing inequities found within the real world — biases related to socioeconomic status, race, ethnicity, religion, gender, disability or sexual orientation.

Unfortunately, people of privilege — those of a certain socio-economic status, race, ethnic background, religion, gender, and even sexual orientation — tend to receive better care and thus have better outcomes. In recent years, as financial incentives have begun to align with society’s collective moral compass, hospitals and health systems have sought to actively remedy systemic disparities in the quality of care.

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https://healthitanalytics.com/news/research-challenges-limit-machine-learning-use-in-medical-imaging

Research Challenges Limit Machine Learning Use in Medical Imaging

Data limitations, evaluation issues, and publishing incentives may be slowing the clinical progress of machine learning in medical imaging, a new study finds.

By Shania Kennedy

April 13, 2022 - Though research on machine learning use in medical imaging has grown significantly in recent years, improvements in the clinical use of such data remain limited, according to a study published in npj Digital Medicine.

Machine learning (ML) is a promising but controversial tool for healthcare providers. Studies suggest heightened enthusiasm around the potential application of ML in clinical settings, but they also note that appropriate regulations must be implemented to ensure that it is effectively implemented. Recent studies have shown that biases within artificial intelligence (AI) algorithms can create health disparities.

The current study's authors found that at each step of the research process, potential challenges and biases can be introduced that limit the clinical use of ML in medical imaging. Issues can arise from the beginning, depending on how data for this research are collected, how datasets are created and distributed, and what biases may exist in the datasets themselves.

When the data are evaluated, further challenges present themselves in selecting meaningful evaluation targets, preventing improper evaluation procedures, choosing suitable metrics, and adopting other statistical best practices, the researchers pointed out.

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https://mhealthintelligence.com/news/anxiety-disorder-patients-used-telehealth-more-during-pandemic

Anxiety Disorder Patients Used Telehealth More During Pandemic

A greater proportion of people with anxiety and fear-based mental health disorders received care through telehealth rather than in-person in 2020, a new study shows.  

Source: Getty Images

By Anuja Vaidya

April 13, 2022 - People with anxiety and fear-related disorders tended to use telehealth more than in-person visits when seeking mental healthcare in the first year of the COVID-19 pandemic, according to a recent study.

Conducted by researchers at the Oregon Health & Science University, the study was published in Health Affairs. The retrospective analysis used data from claims clearinghouse Office Ally to compare outpatient mental health services from March 2016 to December 2018 with services during the same period in 2020.

Researchers studied 101.7 million outpatient mental health visits in total. The visits involved people 12 years and older with primary diagnosis codes corresponding to mental health conditions and encounters categorized as in-person or telehealth.

In the early months of the pandemic, in-person mental health visits fell by 21.9 percent. But they rebounded, with nearly half (47.9 percent) transitioning to telehealth by the end of December 2020.

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https://mhealthintelligence.com/news/pulse-oximeters-offer-no-added-benefits-for-remote-covid-19-monitoring

Pulse Oximeters Offer No Added Benefits for Remote COVID-19 Monitoring

Researchers found that using pulse oximeters to monitor patients with COVID-19 produced the same results as monitoring programs that did not involve the device.

By Mark Melchionna

April 13, 2022 - Researchers from the Perelman School of Medicine of the University of Pennsylvania found that programs using pulse oximeters to monitor patients with COVID-19 at home produced similar benefits to programs that did not.  

In March 2020, Penn Medicine launched a program known as COVID Watch, which intended to provide COVID-infected patients with remote care. The program consisted of check-ins two times daily and asking questions relating to shortness of breath.

The health system eventually decided to implement pulse oximeter devices in this program that monitored oxygen content rather than asking patients questions.

In a study, researchers evaluated over 2,000 COVID-19 watch patients enrolled between Nov. 29, 2020, and Feb. 5, 2021 to compare those that received standard care or care that included the pulse oximeter device.

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https://patientengagementhit.com/news/smoking-trumps-other-social-determinants-of-health-impacting-mortality

Smoking Trumps Other Social Determinants of Health Impacting Mortality

Income was another key social determinant of health affecting mortality, but smoking even as a high-income person can reduce life expectancy.

By Sara Heath

April 13, 2022 - Smoking was the leading social determinant of health affecting mortality and life expectancy, although income was another strong SDOH predictor, according to researchers from the Center for Population Health at Georgetown University and the Department of Sociology at UC Riverside.

The study, published in JAMA Network Open, revealed that people who had never smoked were 37 percentage points more likely to live until at least age 85 than those who had smoked in their lifetime. In contrast, folks with more than $300,000 in assets were 19 percentage points more likely to live until age 85 compared to those with no assets at all.

Even a rich person couldn’t shake the detrimental effects of smoking, the researchers pointed out.

“Our results suggest that even if wealth has a causal effect on mortality, it cannot compete with the impact of smoking. If you want to live longer, you better avoid the cancer sticks,” corresponding author Dana Glei, a senior research investigator at Georgetown University’s Center for Population and Health, said in a press release about the study.

Factors like smoking and income join a long list of social determinants that can affect health. Previous research has shown that income, in particular, can improve an individual’s overall health across her lifetime. And although this research confirms that, it also shows the detrimental impact smoking, another key SDOH, can also have.

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https://www.healthdatamanagement.com/articles/4-strategies-for-engaging-clinicians-in-ai?id=129859

4 strategies for engaging clinicians in AI

What does it take to ensure models work from the perspective of clinicians? AI experts describe four steps to help get our heads out of the sand.

Apr 12 2022


Maggie Van Dyke

Contributing Editor, HDM

John Lee, MD, vice president and CMIO at Allegheny Health Network, says many clinicians have one of three attitudes about artificial intelligence:

“It’s magic and you should trust it.”

 “It’s voodoo and you should distrust it.”

 “You should stick you head in the sand and not think about it.”

Lee, however, sees machine-learning models as an extension of the risk-scoring tools and mnemonics that physicians have used for decades to help them in clinical decision-making.

One example is the HEART score, which helps emergency department physicians determine if patients presenting with chest pain need aggressive management. The HEART score looks at a small number of criteria, including age and electrocardiogram findings. 

By comparison, machine learning enables many more diagnostic criteria to be considered in a rapid fashion. “We’re able to add hundreds to thousands of additional data features and make those scoring tools more precise without adding to the physician’s cognitive load,” Lee says.

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https://www.healthdatamanagement.com/articles/technology-do-no-harm-do-good-things-instead?id=129831

‘Tech, do no harm.’ Do good things instead

How is technology impacting care team experiences – positives and negatives? HDM’s Fred Bazzoli recaps some highlights from the openning sessions of The HDM KLASroom.

Apr 11 2022


Fred Bazzoli

Editor-in-Chief, HDM

Good in theory, not in practice. A lot of clinician frustration with IT can be defined just like that.


As an industry, we have to get to the point where technology isn’t a burden, but delivers value at the clinical workplace.


It’s the mismatch that happens when idealism meets cold, hard reality. That feeling you get when you transition from something tried and true to something brand new.

Our first session of the HDM KLASroom on the topic of Improving Clinician and Care Team Experiences illustrated both the challenges and the hope-inspiring solutions that provider organizations are putting into place.

Here’s a challenge, summarized: The average electronic patient record covering five years has almost 16,000 words in it. Hamlet, Shakespeare’s longest piece, has 30,000 words. So we expect clinicians to fully grasp half of Hamlet every 20 minutes for each patient encounter they have – an impossibility, notes Eve Bloomgarden, MD, director of thyroid care and director of endocrine innovation and education in the division of endocrinology at NorthShore University Health Systems.

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https://www.healthdatamanagement.com/articles/creating-an-ai-ecosystem?id=129857

Creating an AI ‘Ecosystem’

Key steps include developing AI models, establishing governance processes and creating workflows.

Apr 12 2022


Maggie Van Dyke

Contributing Editor, HDM

The healthcare sector needs to create an “ecosystem” that enables artificial intelligence to flourish, says Suresh Balu, program director at the Duke Institute for Health Innovation.

“Right now, AI is in the nascent stages. A lot more needs to be developed so we can realize the full potential,” he says.

Balu compares the current stage in AI development to the time when the first automobiles were built. “Back then, there was no network of roads or bridges. You also did not have a lot of options to consider when parts failed.”


Because machine-learning models are continually changing, regulators also need to provide ongoing monitoring to ensure continued performance and safety.

Suresh Balu, program director at the Duke Institute for Health Innovation


Today, healthcare needs to build a vast AI ecosystem that enables a variety of capabilities and best practices, Balu says. Key steps include creating trustworthy and adaptable AI models, establishing data governance processes, educating the healthcare workforce on how to use AI and creating workflows for monitoring AI to ensure continued accuracy. 

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https://www.statnews.com/2022/04/11/ransomware-hospitals-rural-cyberattack/

At small and rural hospitals, ransomware attacks are causing unprecedented crises

By Marion Renault April 11, 2022

At 12:08 p.m. on a Monday, a Sky Lakes Medical Center employee tapped an email link.

Within minutes, that click cracked open the Oregon hospital’s digital infrastructure for cybercriminals to infiltrate. By the time IT staff started looking into it, “everything was being encrypted,” said John Gaede, director of information services. On a note discovered in a server, the attackers announced the 100-bed Klamath Falls hospital had been hit with ransomware.

“None of us have ever experienced anything like this,” Gaede said. The ramifications were sweeping. Sky Lakes serves a 10,000-square-mile area in rural southern Oregon; the next closest hospital is 72 miles to the west, 140 miles to the north, 100 miles to the east or 100 miles south. In other words, Gaede said, “We are the sole provider of care.”

And at the time of the attack, October 2020, the hospital was battling its first local surge of Covid-19. Hospital officials quickly decided on the most extreme counter-response: powering down about 2,500 devices and more than 600 servers, Gaede said. “Anything that had a computer in it, we shut it off.” For the next 23 days, clinicians and nurses used pen and paper for note-taking, struggling to care for patients without access to their medical histories, lab results and imaging scans, appointment calendars, or emergency contacts. Cancer patients faced a choice between driving an hour or more for radiation elsewhere, or holding off on treatment until Sky Lakes recovered.

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https://mhealthintelligence.com/news/assistance-with-connecting-to-virtual-visits-can-help-close-care-gaps

Assistance With Connecting to Virtual Visits Can Help Close Care Gaps

An initiative that included medical assistants helping patients connect to video visits helped increase access for marginalized patients, a Kaiser Permanente study shows.

By Anuja Vaidya

April 12, 2022 - Having medical assistants work with patients to connect to video visits could help narrow the digital divide, according to a new study conducted by Kaiser Permanente.

Published in JAMA Internal Medicine, the research assessed an initiative developed by the Permanente Medical Group to support video-based telehealth. The initiative included 'virtual rooming,' which involves a medical assistant calling the patient 15 minutes before the telehealth appointment to help connect them to the video visit.

Researchers examined data on telehealth visits from Oct. 1 through Oct. 31, 2020. They compared video visits in medical offices that used virtual rooming more often with those that did not use it as often.

Of the 136,699 video visits studied, 83.6 percent involved a successful connection to the video visit. The use of virtual rooming in medical offices varied, ranging from 4.6 percent to 97.2 percent.

Overall, patients receiving care at medical offices with high virtual rooming rates were 7 percent more likely to have a successful connection to the video visit.

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https://www.beckershospitalreview.com/innovation/how-this-ai-solution-saves-7-minutes-per-patient-encounter-3-takeaways.html

How this AI solution saves 7 minutes per patient encounter — 3 takeaways

In Collaboration with Nuance -12 April, 2022

During the COVID-19 pandemic, physician burnout has reached an all-time high. Meanwhile, patients are not getting the kind of healthcare experiences they want. But artificial intelligence provides a solution that helps both patients and providers while dramatically improving operational efficiency.

In a webinar held in March, hosted by Becker's Hospital Review and sponsored by Nuance Communications, Jared Pelo, MD, chief clinical product officer for Nuance Communications, and Alexia Gillen, DO, ambulatory medical information officer for Monument Health — the largest health system in western South Dakota — discussed Nuance's AI solution.

Three takeaways:

Major barriers exist to achieving a good experience for healthcare organizations, providers and patients. Despite widespread adoption of EHRs along with the Affordable Care Act, the Health Information Technology for Economic and Clinical Health Act and other policies, healthcare continues to endure operational inefficiencies. A major part of these inefficiencies is physicians report spending about 50 percent of their time on documentation, contributing to ever greater burnout. One study estimated the cost of physician burnout at $4.6 billion, according to research cited during the webinar.
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https://www.healthcareitnews.com/news/video-enabled-tablets-could-help-prevent-veteran-suicides

Video-enabled tablets could help prevent veteran suicides

A new study found that the receipt of video-enabled tablets during the pandemic was associated with more psychotherapy visits and reduced emergency department use, among other benefits.

By Kat Jercich

April 13, 2022 02:52 PM

A study published this past week in the Journal of the American Medical Association Network Open found that receipt of video-enabled tablets during the COVID-19 pandemic was associated with more psychotherapy visits and reduced emergency department use among veterans.  

The study, which was led by researchers from VA Palo Alto Healthcare System in Menlo Park, California, examined nearly 500,000 rural veterans who had a history of mental healthcare use.  

"To our knowledge, this study was the largest evaluation of a health system intervention to distribute video-enabled telehealth tablets to patients with access barriers and mental health needs," wrote researchers.  

WHY IT MATTERS  

As the researchers noted in their piece, U.S. veterans are experiencing a mental health crisis, with a suicide rate 1.5 times higher than non-veterans.  

Veterans in rural areas are also more likely to die by suicide than those in urban areas.  

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https://www.healthcareitnews.com/news/nurses-most-likely-clinicians-leave-jobs-new-klas-survey-shows

Nurses most likely clinicians to leave jobs, new KLAS survey shows

Researchers for the Arch Collaborative report found that clinical end users who are satisfied with their organization's electronic health record are more likely to stay.

By Kat Jercich

April 13, 2022 10:48 AM

Research from KLAS this week found that compared to other clinical backgrounds, nurses are the most likely to have plans to leave their organizations in the next two years – but workers more satisfied with the electronic health record are more likely to stay.  

"Clinician turnover is high, staffing costs have risen, and even when organizations are able to hire new providers and staff, the need to train them can strain existing employees," said researchers in the report published Tuesday.  

"These challenges result in overburdened clinicians, millions of additional dollars spent by healthcare organizations, and, ultimately, a diminished capacity for patient care," they said.  

WHY IT MATTERS

As with other issues in healthcare, the COVID-19 pandemic exacerbated existing problems with clinician burnout.  

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https://www.healthcareittoday.com/2022/04/13/addressing-staff-burnout-with-the-right-workstation-setup/

Addressing Staff Burnout with the Right Workstation Setup

April 13, 2022

John Lynn

Burnout is at an all time high in healthcare and the world.  Doctors and nurses are overwhelmed and many are to the point that they are literally leaving their jobs.  Even on the health IT side of things, burnout is real and remote work options means that people can more easily switch jobs.  Addressing staff burnout (clinical and IT) is one of the most important topics in healthcare today.

An area I hadn’t thought much about when it came to it’s impact on the healthcare staff experience is how a healthcare organization approaches its workstation setup.  As I think about it now, it’s obvious that staff not being able to access a workstation, batteries running out on a workstation, and workstations not designed for complex clinical tasks each can contribute to staff burnout.  The good news is that this is a problem that can be solved.  The bad news is that many haven’t taken the time to address it.

In order to understand how much the EHR workstation space has changed and how the right strategy can help reduce burnout in a healthcare organization, I sat down with Kevin Bridges, VP of Marketing and Business Development at Enovate Medical and Doug Gallacher, VP of Sales at Enovate Medical.  Having been in the workstation-on-wheels business for 22 years, Enovate Medical knows the ins and outs of optimizing your workstations for your clinical and IT teams in a way that few can replicate.

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https://www.healthleadersmedia.com/technology/study-highlights-potential-integrating-ehrs-birth-records-manage-disease

Study Highlights Potential of Integrating EHRs With Birth Records to Manage Disease

Analysis  |  By Scott Mace  |   April 13, 2022

EHR data reveals that 1 in 5 Indiana county pregnancies are not screened for syphilis


KEY TAKEAWAYS

·         Recent research has linked birth certificates with maternal health data from EHRs.

·         Siloed information systems across different healthcare settings continue to stymie population health initiatives in public health.

·         There’s a renewed commitment to public health at the federal level, but that commitment may be lagging at the state level.

The analysis of electronic health records is one of public health's newest tools to reduce preventable diseases.

A recent study from the Regenstrief Institute and Indiana University, analyzing EHR data, found that one in five women in an Indiana county do not receive a test for syphilis during pregnancy. The Centers for Disease Control and Prevention (CDC) recommends screening all pregnant women for syphilis during their first prenatal visit.

The study was conducted by a research team looking at live births in Marion County, Indiana, from 2014 through 2016. Researchers were able to link birth certificates from the health department with maternal health data from EHRs in the Indiana Network for Patient Care, created by the Regenstrief Institute and managed by the Indiana Health Information Exchange.

During National Public Health Week last week, HealthLeaders spoke to study co-author Brian Dixon, PhD, MPA, about the study and the state of public health in 2022. Dixon is the director of public health informatics at the Regenstrief Institute and the Indiana University Fairbanks School of Public Health. This interview has been edited for brevity and clarity.

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https://www.healthleadersmedia.com/innovation/northwell-health-launches-ai-incubator-tackles-maternal-health-issues

Northwell Health Launches AI Incubator, tackles Maternal Health Issues

Analysis  |  By Eric Wicklund  |   April 13, 2022

The New York health system has launched Ascertain, an incubator backed with $100 million in seed funding to help innovative start-ups develop and commercialize AI platforms

Northwell Health has joined the growing number of health systems to launch an incubator for innovative start-ups.

New York’s largest healthcare organization is partnering with start-up studio Aegis Ventures to unveil Ascertain, a “joint company creation platform” aimed at developing and commercializing promising AI platforms. The new venture includes $100 million in seed-stage capital.

“Ascertain brings a unique structure, an innovative approach, and a compelling vision to create breakthrough healthcare AI companies that are set up for success,” Michael Dowling, Northwell Health’s president and CEO, said in a press release issued during the health system’s first-ever Healthcare AI Innovation Summit this week. “We are all driven by the idea that everyone deserves access to high-quality, affordable healthcare. Our aim is clear: to find new, cost-efficient ways to create and accelerate companies that deliver real, equitable solutions.” 

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https://healthitanalytics.com/news/artificial-intelligence-enhanced-heart-disease-diagnosis-in-ultrasounds

Artificial Intelligence Enhanced Heart Disease Diagnosis in Ultrasounds

Fellows and residents noticed a 7 and 13 percent increase in accuracy using artificial intelligence for heart disease diagnoses.

By Mark Melchionna

April 08, 2022 - Following the implementation of an artificial intelligence system into ultrasound procedures, researchers from the RIKEN Center for Advanced Intelligence Project (AIP) noticed a sharp increase in the accuracy of heart disease diagnoses.

Although it is a tedious procedure, early diagnosis of the fetus is highly critical to increasing the chances of survival. The reasons for newborn death can vary. However, congenital heart problems make up about 20 percent of cases.

Masaaki Komatsu at RIKEN AIP and a group of researchers developed an AI model that can define a healthy fetal heart in response to those high mortality rates.

Initially, the model was exposed to thousands of ultrasound images and defined each as healthy or unhealthy. The decisions of the AI model then engaged in another round of deep learning, which further enhanced accuracy. Providers used the tool to view the statistics on a chart, allowing them to distinguish differences between cases relating to the heart or blood vessels.

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https://mhealthintelligence.com/news/assistance-with-connecting-to-virtual-visits-can-help-close-care-gaps

Assistance With Connecting to Virtual Visits Can Help Close Care Gaps

An initiative that included medical assistants helping patients connect to video visits helped increase access for marginalized patients, a Kaiser Permanente study shows.

By Anuja Vaidya

April 12, 2022 - Having medical assistants work with patients to connect to video visits could help narrow the digital divide, according to a new study conducted by Kaiser Permanente.

Published in JAMA Internal Medicine, the research assessed an initiative developed by the Permanente Medical Group to support video-based telehealth. The initiative included 'virtual rooming,' which involves a medical assistant calling the patient 15 minutes before the telehealth appointment to help connect them to the video visit.

Researchers examined data on telehealth visits from Oct. 1 through Oct. 31, 2020. They compared video visits in medical offices that used virtual rooming more often with those that did not use it as often.

Of the 136,699 video visits studied, 83.6 percent involved a successful connection to the video visit. The use of virtual rooming in medical offices varied, ranging from 4.6 percent to 97.2 percent.

Overall, patients receiving care at medical offices with high virtual rooming rates were 7 percent more likely to have a successful connection to the video visit.

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https://www.healthcareitnews.com/news/emea/are-european-healthcare-systems-ready-cyber-threat

Are European healthcare systems ready for the cyber threat?

Experts say preparedness is stymied by funding gaps and complexity, according to Brussels-based Frieda Klotz.

April 11, 2022 05:39 AM

The war in Ukraine has been accompanied by talk of a growing cybersecurity threat. Electronic health records (EHRs), data sharing, telehealth and ICT have become common in healthcare, making the field more interdependent, and hackers have increasingly targeted healthcare organisations.

In February, one day after the invasion of Ukraine, the American Hospital Association issued a warning about potential cyber threats from Russia, stating that hospitals could be directly targeted or become collateral damage in a malware attack. For Dr Sabina Magalini, a senior surgeon of emergency trauma at the Gemelli University Hospital in Rome, the nature of the threat has changed, moving away from individuals seeking financial gain. “The intent now is not to do ransomware but it is to do harm,” she said.

Magalini, who was recently involved in an EU-funded cybersecurity project called Panacea, says that healthcare professionals are busy, and IT departments work in different siloes from their medical colleagues. While medicine increasingly relies on digitisation and AI, cyber-hygiene is uneven, she explained. “I always say, if you were working in a nuclear power plant, maybe you would be more compliant with the requirements. Working in healthcare, cybersecurity is not your chief focus.”

Putting patient lives at risk

A system failure in healthcare can be catastrophic. The Irish healthcare system lost access to phone and email communications after a ransomware attack last May, when a staff member opened a malicious MS Excel file. In 2020, a cyber-attack in Germany led to the death of a patient when treatment was delayed.

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https://www.healthcarefinancenews.com/news/hhs-giving-clear-signals-wind-down-public-health-emergency

2022

HHS is giving clear signals of wind down of public health emergency

The current public health emergency ends on April 16, but HHS has promised providers 60 days notice.

Susan Morse, Executive Editor

The current public health emergency ends on April 16, with the federal government giving all indication of the coming end of the PHE, according to Michael P. Strazzella, head of Federal Government Relations at Buchanan Ingersoll and Rooney.

Since the Department of Health and Human Services has said it would give 60 days' notice prior to announcing the end of the PHE, most providers and others are looking for another 90-day extension that would end the PHE in July, or at least give an extension past the April deadline.

Sixty days is not a long notice period for hospitals to prepare for the end of waivers and flexibilities the government has granted under the PHE, Strazzella said. 

But HHS Secretary Xavier Becerra has given clear indication during budget hearings that the country is getting close to the end of this public health emergency, he said. 

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https://www.healthcareitnews.com/news/fda-releases-medical-device-cybersecurity-draft-guidance

FDA releases medical device cybersecurity draft guidance

The agency is seeking stakeholder feedback on the guidance, which seeks to clearly outline its recommendations for premarket submission content when it comes to cybersecurity concerns.

By Kat Jercich

April 12, 2022 03:32 PM

The U.S. Food and Drug Administration published a draft guidance this past week with regard to medical device cybersecurity.

The draft guidance, "Cybersecurity in Medical Devices: Quality System Considerations and Content of Premarket Submissions," seeks to emphasize the importance of safeguarding medical devices throughout a product's life cycle. 

The guidance would replace one issued by the agency in 2018.  

"These recommendations can facilitate an efficient premarket review process and help ensure that marketed medical devices are sufficiently resilient to cybersecurity threats," said FDA in the Federal Register notice about the guidance.  

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https://www.healthcareitnews.com/news/va-study-shows-benefits-telestroke-program-patients

VA study shows benefits of telestroke program for patients

The initiative allows a remote specialist to evaluate individuals via a mobile device and provide a treatment plan for on-site staff to carry out.

By Kat Jercich

April 12, 2022 08:30 AM

A Department of Veterans Affairs-funded study published in Neurology found that a telestroke program helped prevent unnecessary hospital transfers for patients.  

The research, published in conjunction with the Regenstrief Institute and Indiana University School of Medicine, examined the VHA National Telestroke Program, which provides acute stroke care at facilities without an available neurologist.  

The research team found the chance of being transferred to another facility decreased by 60% after the program’s implementation and increased the likelihood of timely stroke treatment.

"This analysis suggests that telestroke provides additional benefits for both patients and health systems," said senior author Dr. Linda S. Williams, research scientist for the Regenstrief Institute and professor of neurology at Indiana University School of Medicine, in a statement.  

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https://www.healthleadersmedia.com/innovation/making-remote-patient-monitoring-scalable-and-sustainable

Making Remote Patient Monitoring Scalable and Sustainable

Analysis  |  By Eric Wicklund  |   April 08, 2022

Complex federal and state regulations, confusing reimbursement rules pose challenges to RPM, hospital at home growth.


KEY TAKEAWAYS

·         The Centers for Medicare & Medicaid Services only began reimbursing for remote patient monitoring - which it currently calls 'remote physiological monitoring' and 'remote therapeutic monitoring' - in 2019, and only with a limited number of CPT codes.

·         CMS unveiled the Acute Hospital at Home payment model in 2020, giving health systems an avenue for developing RPM programs that include in-person care and mimic the ICU environment at home.

·         These services will continue to evolve and grow, though it may take a while for CMS to figure out the landscape.

Editor's note: This article appears in the March/April 2022 edition of HealthLeaders magazine. It is a sidebar to the cover story: “Home Sweet Home: Healthcare Moves Away From the Hospital

Partly in response to the pandemic, healthcare organizations have been launching remote patient monitoring (RPM) and hospital at home programs as a means of providing more services to patients at home and reducing hospital crowding. But federal and state governments have long had a heavy hand in regulating how healthcare can be delivered to the home.

Both federal and state regulators have kept firm control on telehealth by enforcing where it can be used and who can use it, to the point that advocates have long argued that government is hindering telehealth adoption. Only certain types of healthcare providers are allowed to use the technology to deliver healthcare services, and those services often must come from and go to specified healthcare settings, like a hospital, doctor's office, or clinic.

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https://healthitsecurity.com/news/healthcare-data-breach-lawsuits-on-the-rise-report-shows

Healthcare Data Breach Lawsuits On the Rise, Report Shows

BakerHostetler saw an uptick in data breach lawsuits in the weeks following incident notification, especially against healthcare organizations.

By Jill McKeon

April 11, 2022 - As healthcare data breaches continue to impact small and large organizations across the country, accompanying data breach lawsuits are becoming increasingly common. Law firm BakerHostetler’s latest data security incident report showed an increase in duplicative lawsuits, often resulting in steep defense and settlement costs.

BakerHostetler analyzed more than 1,200 data security incidents from 2021 that its Digital Assets and Data Management Practice Group members helped clients manage. The incidents spanned a variety of sectors, but the results showed that healthcare was the most impacted industry, with 23 percent of the analyzed incidents affecting the sector.

The report revealed that 23 of the incidents resulted in one or more lawsuits. While this may not seem like a big number, over 58 lawsuits stemmed from those 23 incidents.

“Previously, there was always a risk of multidistrict litigation following large data incidents. However, now we are seeing multiple lawsuits following an incident notification in the same federal forum. Or, in the alternative, we see a handful of cases in one federal forum and another handful of cases in a state venue,” the report noted.

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https://www.fastcompany.com/90738820/how-tech-can-help-address-the-black-maternal-health-crisis

04-11-22 6:00 am

How tech can help address the Black maternal health crisis

Digital health has the potential to be defined by its intuitiveness and accessibility.

By Kimberly Seals Allers and Neel Shah

America is in the midst of a Black maternal health crisis, and it is getting worse, not better. According to the most recent data from the CDC, in 2020, Black maternal mortality increased a shocking 26% and has persisted at a rate of at least three-times that of white women for decades.

Let’s be clear: It’s racism, not race, that is putting Black women at risk. These data belong to a damning body of research showing how Black women and birthing people go unseen and unheard as they navigate the healthcare system, for the simple reason that it was never built with them in mind. (This is precisely why Chidiebere Ibe‘s medical illustrations went viral earlier this year: Black bodies have never been treated as standard.)

This history of exclusion, bias, and even outright harm has had a devastating impact on Black women and families. And as we have seen over the past two years of the pandemic, it has exacerbated deeply rooted mistrust in historically marginalized communities. Today, more than half of Black adults say they don’t trust the healthcare industry, the lasting legacy of generational neglect.

But as much as the pandemic has reinforced the shortcomings of our system, it’s also accelerated the use of digital technology to drive better care. It’s no secret as to why. The devices that most people carry in their pockets have become increasingly powerful tools to share information, create community, and access services—and they are only becoming more ubiquitous, expected to outnumber humans 3 to 1 by next year. And where traditional healthcare is synonymous with complexity and cost, digital health has the potential to be defined by its intuitiveness and accessibility, making it a powerful new competency for healthcare as a whole.

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https://www.healthcareitnews.com/news/emea/nhs-england-announces-plans-240m-federated-data-platform

NHS England announces plans for £240M federated data platform

The platform is intended to be “an ecosystem of technologies and services”.

By Tammy Lovell

April 11, 2022 02:03 AM

NHS England has unveiled plans to develop a federated data platform (FDP), with an estimated procurement value of £240 million.

It has published a prior information notice for potential suppliers ahead of an open procurement. 

According to the notice, the FDP will be “an ecosystem of technologies and services” and “an essential enabler to transformational improvements across the NHS”. It will be built around five major use cases: population health and person insight, care co-ordination, elective recovery, vaccines and immunisation, and the supply chain.

The notice says the scope of the procurement will comprise two lots: one for the FDP itself, with integrated care system (ICS) integration and consultancy and communications support for ICS implementation and adoption​, the other for privacy-enhancing technology.

A supplier briefing will take place on 13 April 2022, with the publication of the contract notice planned for 6 June 2022.

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https://www.healthcareitnews.com/news/hhs-cyber-arm-warns-teen-criminals

HHS cyber arm warns of teen criminals

"They have already compromised healthcare organizations and have no reason to stop," said the Health Sector Cybersecurity Coordination Center about the group known as Lapsus$.

By Kat Jercich

April 11, 2022 02:56 PM

The Health Sector Cybersecurity Coordination Center released a threat brief on Thursday about a recently discovered cyber threat group known as Lapsus$.  

The group, described as "effective, but also unprofessional and careless," is possibly composed of teenagers and young adults, said HC3.  

"They have successfully targeted several high-profile organizations to completion," said the agency. "Due to the diversity of their techniques, there is no single set of effective defenses or mitigations."  

WHY IT MATTERS  

According to the agency brief, Lapsus$ was first identified around April 2020.  

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Enjoy!

David.

 

1 comment:

Anonymous said...

"Rethinking the architecture of health IT to unlock potential"

After decades and decades of failed promises, don't you think someone should stand up and point out that so many broken promises might just indicate that all these folk making such promises are little more than snake oil merchants?

All they are doing is predicting what they want to happen. The reality is that they have no idea how to deliver on their promises.

The usual claim is that great things have been done in finance and other industries therefore the same must be possible in healthcare.