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 02, 2022

Weekly Overseas Health IT Links – 2nd April, 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.

-----

https://ehrintelligence.com/news/epic-healthy-planet-increased-patient-adherence-to-preventive-care

Epic Healthy Planet Increased Patient Adherence to Preventive Care

Epic Healthy Planet used EHR data to determine care gaps for older high-risk patients, resulting in greater patient adherence to preventive care services such as cancer screening and vaccinations.

By Sarai Rodriguez

March 25, 2022 - After piloting the population health tool, Epic Healthy Planet, primary care providers at UC Davis Health were able to directly address care gaps through personalized EHR data reports to significantly upend patient adherence to preventive care.

The study examined how EHR optimizations like population health tools impacted healthcare delivery and decreased the adverse outcomes preventable diseases have on older patients.

“Unfortunately, primary care physicians are inundated with numerous patient health concerns throughout the day, and some screening tests can be forgotten,” Eric Chak, associate professor of gastroenterology and hepatology and lead investigator on the study, stated in the press release. “In California there is currently just a lung cancer screening rate of 1 percent of eligible adults.”

Prior to a patient visit, patient data was used to create custom reports and bundle orders based on patient care gaps for several healthcare maintenance areas such as colon cancer screening, lung cancer screening, tobacco and obesity counseling, age-appropriate vaccines, and hepatitis C screening.

-----

https://mhealthintelligence.com/news/vendor-affiliated-telehealth-providers-prescribe-antibiotics-more-often

Vendor-Affiliated Telehealth Providers Prescribe Antibiotics More Often

Patients who received virtual care from vendor-supplied physicians had 2.3 higher odds of being prescribed antibiotics than those seen by health system-employed physicians, a study shows.

By Anuja Vaidya

March 25, 2022 - Physicians affiliated with direct-to-consumer telemedicine platforms prescribed antibiotics more frequently than health system-employed physicians who provide virtual care, raising concerns about fueling antibiotic resistance, according to a recent study.

Published in the Journal of Telemedicine and Telecare, the study examined on-demand telehealth visits available to health system employees and their dependents at a large urban academic health system from March 2018 to July 2019. Researchers performed multivariable logistic regression to determine the effect of physician affiliation on antibiotic prescribing patterns for acute respiratory infections.

There were 716 virtual visits over the study period, of which 257 (36 percent) involved a diagnosis related to acute respiratory infections. Overall, antibiotics were prescribed in 23 percent of these visits.

A total of 16 health system-employed and 25 vendor-supplied physicians participated in an acute respiratory infection virtual visit. While system-employed physicians prescribed antibiotics in 18 percent of visits, vendor-supplied physicians prescribed antibiotics in 37 percent of visits.

------

https://patientengagementhit.com/news/google-pitches-search-engine-for-medical-appointments-self-scheduling

Google Pitches Search Engine for Medical Appointments, Self-Scheduling

The search tool is still in its early phases, but Google indicated patients will be able to see available medical appointments with providers like MinuteClinic.

By Sara Heath

March 25, 2022 - Omnipresent tech giant Google has announced plans for enhancing its search engine feature by adding information about available medical appointments, something Chief Health Officer and former ONC head Karen DeSalvo said will improve patient self-scheduling and healthcare navigation.

The search engine feature isn’t live yet, DeSalvo added, but as it rolls out Google said the function will let patients see available times when participating providers are able to book an appointment slot.

This comes as the medical industry increasingly acknowledges the role the internet and search engines play in patient health. Recent data from patient experience consulting firm Press Ganey found that patients look at an average of three websites to learn more about their health, and one of those is Google. When patients need medical appointments, they turn to the search engine.

This latest feature is set to streamline that search, DeSalvo indicated, and quickly produce the available times a patient’s preferred provider is available for booking.

-----

https://www.digitalhealth.net/2022/03/maternity-digitisation-is-long-overdue/

Maternity digitisation is long overdue

In a piece for Digital Health, Ted Reynolds, a healthcare specialist at Restore Digital, explores the progress in making the maternity records of all expectant mothers electronic by 2024, and why he believes retrospective records should be the next priority for the NHS.

DHI News Team – 17 March 2022

The digitisation of maternity records has been long overdue. During pregnancy, women navigate their way through a complex care route of midwives, GPs, health visitors, obstetricians – the list, depending on the pregnancy and the patient, can stretch far and wide across the whole NHS. The one constant is the burden of sharing maternity information is placed predominately on the patient.

Mothers-to-be are asked to take to each of their appointments, a hardcopy of their maternity information. They will be asked repeatedly to share information about their medical and maternity history. Unsurprisingly, things get lost – paper goes missing, women forget or don’t recognise the clinical significance of some information.

All of this creates greater risk to the patient’s care and safety – but digitisation of maternity records, a key element of The Maternity Transformation Programme, aims to change that.

------

https://www.healio.com/news/neurology/20220318/va-hospital-telestroke-networks-improve-treatment-lower-ed-transfer-rate

March 18, 2022

VA hospital telestroke networks improve treatment, lower ED transfer rate

Telestroke networks improve acute stroke treatment for veterans and positively affect the efficiency of interhospital networks by avoiding unnecessary ED transfers, according to a study published in Neurology.

“Interhospital transfer for stroke has increased over the past two decades, particularly with the expansion of eligibility for endovascular thrombectomy,” Michael J. Lyerly, MD, associate professor of neurology at the University of Alabama at Birmingham, and colleagues wrote. “This has the potential to overburden tertiary centers with stroke mimics or thrombectomy-ineligible patients, as well as to increase health care expenditures.”

Researchers sought to examine the impact and effectiveness of the VA National Telestroke Program on hospital transfers among U.S. military veterans diagnosed with acute ischemic stroke (AIS).

The study analyzed 3,488 stroke encounters from 3,289 patients across 21 VA hospitals before (n = 1,056) and after (n = 2,432) implementation of the program. Researchers assessed transfer rates through administrative data and chart review and documented patient and facility-level characteristics to identify potential transfer predictors.

-----

https://www.radiologybusiness.com/topics/health-it/imaging-informatics/specialty-female-physicians-more-time-ehr-men

Regardless of specialty, female physicians spend more time in the EHR than men

Marty Stempniak | March 25, 2022 | Imaging Informatics

Regardless of specialty, female physicians appear to spend more time in the electronic health record than men, according to research published Thursday in JAMA Network Open.

While such systems have helped transform the practice of medicine, they have also contributed to burnout. Previous studies have unearthed higher rates of such workplace fatigue among women, and researchers recently set out to determine whether EHRs are part of the problem.

Lead author Lisa Rotenstein, MD, MBA, and colleagues found a potential connection, with women spending an average of 41 minutes more in daily total time on EHR work. Same for time spent after hours (nearly 10 minutes more per day) and on EHR-based clinical documentation (31 minutes), after adjusting for various factors such as age and specialty.

“Our findings provide a potential mechanism for the gender gap in burnout, which has implications for workforce mental health and physician retention,” Rotenstein, with Brigham and Women’s Hospital’s Department of Medicine, and co-authors wrote March 24. “They suggest that women physicians may benefit from policy changes, workflows, and technologies that reduce documentation burden, including scribes, team documentation, and artificial intelligence-powered solutions.”

-----

https://www.healthcareitnews.com/news/why-does-big-tech-often-fail-healthcare

Why does Big Tech often fail in healthcare?

An IT veteran spells out why so many giants have found the healthcare industry harder to crack than they reckoned, and describes what Big Tech must do to succeed. He also discusses Oracle's pending acquisition of Cerner.

By Bill Siwicki

March 25, 2022 10:57 AM

If there were a graveyard for failed health IT projects, it would be cluttered with the tombstones of initiatives first launched with fanfare by Big Tech companies such as IBM, Google, Microsoft and Amazon.

The question has been asked: Is healthcare too hard for Big Tech firms?

That's the perspective of industry veteran Kyle Silvestro, who over the years has seen numerous tech companies spend billions to build healthcare projects, only to shutter them years later with little to show for it. Silvestro is president, CEO and chairman of SyTrue, a healthcare artificial intelligence/natural language processing company.

Big Tech firms continue to seek a seat at the healthcare table. And while some have been making inroads in recent years, especially with cloud offerings – it was hard to miss the big booths of AWS, IBM, Microsoft and others on the HIMSS22 show floor this past week – that progress has come after lots of trial and error. 

-----

https://www.healthcareittoday.com/2022/03/25/how-to-reduce-manual-data-entry-risks-in-the-healthcare-sector-in-2022/

How To Reduce Manual Data Entry Risks In The Healthcare Sector In 2022

March 25, 2022

Guest Author

The volume and variety of healthcare data is on the rise. Underpinned by pandemic pressures, the adoption of telehealth services grew to 38 times pre-COVID levels over the past two years, in turn, creating a need for patients and physicians to access critical medical information on demand.

Despite this technological shift, however, many medical staff members are still doing manual data entry. Recent research found that between 26% and 39% of healthcare workers are entering data manually. Further, 32% to 40% believe this is partly due to challenges in locating the data they need, when they need it.

That’s not all. In addition to wasted time, manual processes also increase the risk of data entry errors. Here’s a look at what this means for healthcare organizations — and what steps they can take to reduce total risk.

-----

https://www.healthleadersmedia.com/payer/physicians-still-keen-telehealth-despite-challenges

Physicians Still Keen on Telehealth Despite Challenges

Analysis  |  By Laura Beerman  |   March 24, 2022

A recent survey captures physician telehealth utilization.

New survey results indicate that "telehealth use will outlive the pandemic," reported by Optum, UnitedHealth Group’s health services division, conducted fall 2021, which captured physician telehealth utilization including opportunities and frustrations. Below are four highlights from the survey.

1. Very few providers plan to stop using telehealth post pandemic.

In a survey of 240 providers, mostly primary care physicians (PCP), 93% intend to keep using telehealth. Most common uses include primary and chronic care visits as well as prescription refill needs (75%, 72%, and 64%, respectively). Urgent and post-procedure care represented 38% and 28% of visits. PCPs also used telehealth to support patient mental health needs (36%).

2. Telehealth preferences vary.

Provider responses indicated that older technologies have given way to new telehealth preferences when it comes to visits and communication, but not scheduling. Video was used in 88% of visits while pre-pandemic communication channels such as secure messaging (30%), email (12%), text messaging (7%), and chatbots (3%) lagged. The telephone remained highly favored for both visits and scheduling at 80% and 86%, respectively.

https://www.healthleadersmedia.com/technology/groups-offer-5-recommendations-protecting-patient-data-third-party-apps

Groups Offer 5 Recommendations for Protecting Patient Data on Third-Party Apps

Analysis  |  By Eric Wicklund  |   March 25, 2022

The Workgroup for Electronic Data Interchange and the Confidentiality Coalition have written a letter to federal officials calling for more protections for patient information accessed through third-party mHealth apps.

Two organizations focused on protecting patient data are urging federal officials to take several steps to protect that data from unsafe third part mHealth apps.

The Workgroup for Electronic Data Interchange (WEDI) and Confidentiality Coalition have written a letter to Health and Human Services Secretary Xavier Becerra and Commerce Secretary Gina Raimondo offering five recommendations for protecting patient information on third party apps, much of which isn’t covered by the Health Insurance Portability and Accountability Act (HIPAA).

“Some CEs, including health plans, physician practices and inpatient facilities have already built or have contracted with business associates to develop patient access APIs and apps and are actively promoting their use,” the letter points out. “Specifically, these apps deployed by providers and health plans are typically covered under HIPAA and therefore the individual’s accessing data have assurances that their information is being kept private and secure. We are concerned, however, regarding the lack of robust privacy standards applicable to the large percentage of third-party app developers not associated with CEs and therefore not covered under HIPAA and the fact that there currently is no federally recognized certification or accreditation for these apps.”

“The potential exists for PHI gained via the apps to be inappropriately disclosed to the detriment of patients and their families,” the letter states. “While we strongly support patient access to their PHI via apps, we assert that a national framework is required to ensure that health care data obtained by third-party apps is held to high privacy and security standards.”

-----

https://ehrintelligence.com/news/clinical-note-assessment-tool-boosts-student-ehr-documentation-quality

Clinical Note Assessment Tool Boosts Student EHR Documentation Quality

Clerkship director feedback using a clinical note assessment tool helped enhance student EHR documentation quality.

By Hannah Nelson

March 24, 2022 - Clerkship director feedback was more effective than ward resident feedback in improving student EHR documentation quality through the use of a clinical note assessment tool, according to a study published by Cureus.

Researchers reviewed the quality of student inpatient progress notes before and after structured feedback using the Responsible Electronic Documentation (RED) checklist during a third-year internal medicine clerkship.

The first intervention group received feedback from clerkship directors in the 2017-2018 academic year. The second group received input from ward residents/attendings in the 2018-2019 academic year.

The study found that feedback from clerkship directors yielded a more significant increase in students’ total note scores from pre- to post-intervention.

-----

https://ehrintelligence.com/news/va-looking-forward-to-ehr-implementation-despite-legislators-concerns

VA ‘Looking Forward’ to EHR Implementation Despite Legislators’ Concerns

Despite several legislators’ concerns, a VA official said that he is confident the VA medical center in Walla Walla is ready for its EHR implementation.

By Hannah Nelson

March 24, 2022 - A Department of Veterans Affairs (VA) official said that he is confident the VA medical center in Walla Walla is ready for its planned March 26th EHR implementation, according to reporting from The Union-Bulletin.

The department launched the Cerner EHR in October 2020 at a VA hospital in Spokane, kicking off its EHR Modernization (EHRM) project.

"We're looking forward to that go-live at Walla Walla on Saturday," Donald Remy, VA deputy secretary, said in a briefing Tuesday. "Everything we're doing is shaped by the lessons we've learned since go-live in Spokane and lessons that we keep learning along the way, because the veterans have earned and deserve our very best, and we'll never settle for anything less than that."

The VA Office of Inspector General (OIG) recently released a trio of reports that found "serious deficiencies and failures" with the Cerner EHR at the VA EHR Modernization (EHRM) pilot site in Spokane.

-----

https://mhealthintelligence.com/news/ama-69-of-physicians-use-audio-only-telehealth

AMA: 69% of Physicians Use Audio-Only Telehealth

Audio-video synchronous platforms are still the most used telehealth modality, but a large proportion of physicians are also using phone-only modalities, a new AMA survey shows.  

By Anuja Vaidya

March 24, 2022 - More than two-thirds of telehealth providers said they use audio-only modalities to offer telehealth services, according to a recent survey conducted by the American Medical Association.

The survey polled 2,232 physicians between Nov. 1 and Dec. 31, 2021.

The popularity of telehealth among physicians is apparent, with 85 percent saying they still use it. But 52 percent agreed that their telehealth usage has decreased since they first started offering the services. The top reason for the decrease was that they moved to a hybrid model of care with both in-person and virtual care services.

Nearly half of the respondents (46.8 percent) said they conduct 1 percent to 20 percent of their patient visits via telehealth each week. On the other end of the spectrum, 21.3 percent of respondents said they conduct more than 80 percent of their visits virtually every week.

Though the number of telehealth modalities is growing, physicians are partial to live interactive audio-visual platforms, with 93 percent of survey respondents indicating that they use this modality. Audio-only phone-based telehealth is also popular, with 69 percent of respondents saying they used this technology for virtual care, followed by asynchronous telehealth, a distant third with only 12 percent of physicians saying they used asynchronous platforms.

-----

https://www.cancertherapyadvisor.com/home/cancer-topics/general-oncology/lack-digital-health-literacy-linked-overall-survival-adults-cancer-treatment/

March 23, 2022

Lack of Digital Health Literacy Linked to Overall Survival in Adults With Cancer

Vicki Moore, PhD

Overall survival (OS) was poorer among patients with cancer who had limited digital health literacy, according to study results published in JCO Clinical Cancer Informatics.

Health literacy is the ability to access and understand health information and services to participate in decisions related to one’s own health. Digital health literacy involves being able to retrieve and understand health information electronically. Limited digital health literacy was defined in this study as the lack of an email address in the patient’s electronic patient record (EPR).

“The negative impact of limited health literacy on the survival of patients with diabetes or chronic heart failure has already been demonstrated, but to our knowledge, it has never been discussed in patients with cancer,” the investigators wrote.

The study was a noninterventional analysis of adults treated at Centre Léon Bérard in Lyon, France, who had received a cancer diagnosis between 2015 and 2017. The investigators obtained data on patients’ sex and age, certain cancer characteristics and outcomes, the presence or absence of an email address in the patient’s EPR, and whether or not the patient opened an account on the online patient portal. OS was the primary endpoint.

-----

https://healthitanalytics.com/news/machine-learning-model-helped-streamline-22-of-pediatric-ed-visits

Machine-Learning Model Helped Streamline 22% of Pediatric ED Visits

Machine learning and novel workflows enhanced test ordering processes within a pediatric emergency department, thereby streamlining care, a new study shows.

By Mark Melchionna

March 23, 2022 - While exploring the possibilities of integrating machine learning into clinical decision-making, a JAMA Network study found that novel machine learning-driven workflows helped improve test ordering within pediatric emergency departments (EDs).

The study included 42,238 boys up to the age of 18, all of whom came from the emergency department of the Hospital for Sick Children in Toronto, Canada. There were 77,219 patient visits, all of which took place between July 1, 2018, and June 30, 2019.

Machine-learning models predicted the need for services such as urinary dipstick testing, electrocardiogram, abdominal ultrasonography, bilirubin level testing, and forearm radiographs.

Using a variety of statistical analyses, researchers evaluated the models to determine the time between completing patient triage and test use.

-----

https://www.beckershospitalreview.com/healthcare-information-technology/americans-without-internet-more-likely-to-die-from-covid-19-study-finds.html

Americans without internet more likely to die from COVID-19, study finds

Katie Adams -  

The lack of reliable internet access is a factor consistently associated with high risk of death from COVID-19, according to a study published March 4 in JAMA Network Open.

University of Chicago researchers analyzed data on social determinants of health and COVID-19 mortality across 3,142 counties in 50 states from Jan. 22, 2020-Feb. 28, 2021. They found the lack of internet access was consistently linked to high COVID-19 mortality risk, regardless of other demographic factors such as age, education and insurance status.

For every additional 1 percent of residents in a county who have internet access, it is estimated that between 2.4 and six COVID-19 deaths per 100,000 people could be prevented, according to the study.

-----

https://www.healthdatamanagement.com/articles/digital-data-exchange-is-foundational-part-of-virtual-care?id=129660

Digital data exchange is ‘foundational’ part of virtual care

Despite the benefits of virtual care, there’s a risk that technology could interrupt communication; however, new tools can restore dialogues and aid patient engagement.

Mar 24 2022


Fred Bazzoli

Editor-in-Chief, HDM

Physicians saw the COVID-19 pandemic as a disruptive influence to traditional care delivery. Like any disruptive event, they’ve experienced a mix of positives and negatives.

The cataclysmic virus upended traditional healthcare delivery, causing clinicians and patients to rely on digital health technology to support virtual encounters. That’s demonstrated the ability of healthcare to adopt new processes and workflows faster than anyone had expected. However, it’s heaped new pressure on providers and patients alike – while technology has enabled change, it’s also disassociated the relationships, connections, and communications that are so critical to keeping patients happy and on the road to recovery.


“The ability to connect one human to another is going to be foundational."


Increased digital connections, all the while needing more personalized interactions, will be the conflicting challenges for healthcare in the years ahead, says Rodrigo Martinez, MD, chief medical officer for PerfectServe, a technology solution provider.

-----

https://www.healthdatamanagement.com/articles/variety-of-factors-affect-physicians-use-of-ehrs-burnout-potential?id=129663

Variety of factors affect physicians’ use of EHRs, burnout potential

Research suggests that organizational culture affects documentation requirements and patient loads, and the pandemic has amplified the stresses of documenting care.

Mar 24 2022


Fred Bazzoli

Editor-in-Chief, HDM

As the nation’s healthcare system gets a temporary breather from the COVID-19 pandemic, it’s time to take a fresh look at how best to address clinician burnout.

A great deal of attention has shifted to the toll the pandemic has taken on healthcare professionals, a recent study brings fresh analysis of the stress that electronic health records systems impose on clinicians.


Study shows female clinicians spend a higher percentage of their EHR time outside of patient appointment hours compared to their male counterparts.


Research by athenahealth, the Watertown, Mass.-based systems provider, suggests that EHR systems still are consuming a large percentage of physicians’ time. It also shows that records systems are still not fully embraced by clinicians and not perceived to be a benefit to patient care, says Nele Jessel, M.D., chief medical officer for the company.

Workload requirements a concern

Healthcare administrators need to reexamine the current workload placed on physicians, particularly documentation and patient visit requirements, she says. “These are some of the things that the C-suite needs to be thinking about in terms of mitigating burnout,” Jessel adds.

-----

https://www.healthcareitnews.com/news/anz/nz-based-orion-health-build-worlds-largest-hie-saudi-arabia

NZ-based Orion Health to build 'world's largest' HIE for Saudi Arabia

The system is expected to house the health data of over 50 million people in the Kingdom.

By Adam Ang

March 24, 2022 02:08 AM

Health IT provider Orion Health from New Zealand has been appointed to build a health information exchange for the Kingdom of Saudi Arabia.

According to a press statement, the system will provide a single, holistic view of medical and care information of around 32 million people at launch, with capacity to cover more than 50 million people. What is expected to be the "world's largest" HIE will take data feeds from over 5,000 government and private healthcare providers.

WHY IT MATTERS

Orion Health, which provides population health solutions across 15 countries, said the Kingdom wanted them to set up a data ecosystem that will enable it to analyse and manage large scale disease outbreaks, pandemics, and growing chronic conditions like diabetes by applying machine learning and AI. It also needs a system "that allows clinicians to make informed decisions and help keep people healthier, happier and out of hospital".

"Heading into a post-pandemic world, Saudi Arabia is the first country to revolutionise the delivery of healthcare for their citizens through technology and many others will follow," said Orion Health founder and CEO Ian McCrae.

-----

https://www.healthcareitnews.com/news/report-90-nurses-considering-leaving-profession-next-year

Report: 90% of nurses considering leaving the profession in the next year

Does that stat catch your attention? Good. Shawn Sefton, RN, talks about the results of a new survey of RNs, the key problems it identified – and how technology can help lessen burnout.

Bill Siwicki

March 24, 2022

Shawn Sefton, RN, has experienced first-hand the operational, staffing and scheduling challenges that plague the U.S. nurse workforce, having worked as a nurse and in various nurse leader roles for decades.

She spent her early career as a frontline ED and perianesthesia nurse in various hospitals. Then she served as manager of presurgical services and anesthesia at Boston Medical Center, and as clinical specialist nurse (perioperative projects) and clinical director at Beth Israel Deaconess Hospital-Needham.

Sefton followed those years up as a director at PriceWaterhouseCoopers' health advisory practice, where she led operational and financial improvement engagements at a number of health systems. Today she serves as chief nursing officer and vice president of client services at Hospital IQ, a vendor of predictive hospital operations automation software.

Healthcare IT News sat down with Sefton to get her expert and insider views on the findings of a recent Hospital IQ survey of U.S. hospital nurses. 

-----

https://www.healthcareittoday.com/2022/03/24/google-health-adds-condition-focused-feature-to-its-clinical-data-sorting-tool/

Google Health Adds Condition-Focused Feature To Its Clinical Data Sorting Tool

March 24, 2022

Anne Zieger

About a year ago, Google gave the world a look at a pilot version of a new tool designed to give clinicians harmonized health data from different sources. The tool, Care Studio, is software designed to offer a comprehensive view of patient records and help clinicians find and review results in context.

This week, at the ViVE Conference, Google added a piece to the puzzle. At the show, Google offered a preview of Conditions, a new Care Studio feature offering clinicians additional insight into patient records.

In a recent blog post, Paul Muret, VP and GM of Care Studio, explained what makes this latest development important to the Google Health product line.

As he noted, too often key clinical insights into a patient’s condition are often buried in unstructured notes and data silos.

-----

https://healthitsecurity.com/news/cisa-fbi-warn-critical-infrastructure-of-satcom-cyber-threats

CISA, FBI Warn Critical Infrastructure of SATCOM Cyber Threats

CISA and the FBI released a joint advisory warning critical infrastructure organizations of satellite communication (SATCOM) cyber risks.

By Jill McKeon

March 23, 2022 - The Cybersecurity and Infrastructure Security Agency (CISA) and the Federal Bureau of Investigation (FBI) released a joint advisory to warn critical infrastructure organizations of cyber risks associated with satellite communication (SATCOM) networks.

Entities across all sectors, including healthcare, use SATCOM networks for voice and data communication. CISA and the FBI urged SATCOM network providers and customers to remain vigilant against SATCOM cyberattacks, which could disrupt network environments.

In late February, hackers targeted SATCOM provider Viasat and disrupted network access across Ukraine. The attack coincided with Russia’s initial invasion of Ukraine, Reuters reported. Viasat is also a defense contractor for the US and some of its allies and is used across US critical infrastructure.

“Given the current geopolitical situation, CISA’s Shields Up initiative requests that all organizations significantly lower their threshold for reporting and sharing indications of malicious cyber activity,” the advisory stated.

-----

https://www.medscape.com/viewarticle/970764

Pneumonia Decision Tool Reduces Death in ED Patients

Pam Harrison

March 22, 2022

The use of an electronic clinical decision support tool called "ePNa" reduced severity-adjusted, 30-day, all-cause mortality by 38% across 16 community hospitals in Utah compared with predeployment levels, a 3-year, pragmatic, cluster-controlled study shows.

"We designed the ePNa specifically to require minimal input from the clinician so everything it does is already in the electronic medical record (EMR)," Nathan Dean, MD, University of Utah School of Medicine, Salt Lake City, told Medscape Medical News.

"So it's actually putting the guideline recommendations into effect for physicians so that they can make better decisions by having all this information — it's a comprehensive best practice kind of tool where best practices are likely to make the biggest difference for patients with a high severity of illness," he added.

The study was published online in the American Journal of Respiratory and Critical Care Medicine.

-----

https://www.healthcareitnews.com/news/telehealth-can-effectively-manage-covid-19-home-study-finds

Telehealth can effectively manage COVID-19 at home, study finds

University of Iowa researchers found that a telemonitoring program could help to reduce hospital resource utilization while allowing timely identification of disease progression.

By Kat Jercich

March 23, 2022 04:16 PM

A University of Iowa study published this month in the Journal of Telemedicine and Telecare found that an at-home telemonitoring program was an effective and sustainable way to manage COVID-19 for patients.  

The goals of the program, as outlined in the study, were to avoid unnecessary hospitalizations, identify declining patients, escalate care when needed and provide support to patients and families.  

"Despite the low intensity of the intervention, our results support the use of telehealth to effectively monitor patients with COVID-19 at home," wrote researchers.  

WHY IT MATTERS

As researchers explained, 1,128 University of Iowa Hospitals and Clinics patients who had been diagnosed with COVID-19 met the criteria for the home monitoring program, known as HMP.  

-----

https://www.healthcareitnews.com/news/emea/nhs-work-australian-healthcare-tech-firm-beamtree

NHS to work with Australian healthcare tech firm Beamtree

The company has scored contracts with four hospital trusts in England.

By Tammy Lovell

March 23, 2022 12:50 PM

Australian health data firm, Beamtree, has landed its first NHS contracts with four hospital trusts in England.

Milton Keynes University Hospitals, Lancashire Teaching Hospitals, Southern Health NHS Foundation Trust, and University Hospitals Coventry and Warwickshire (UHCW) will implement Beamtree’s proprietary RippleDown decision support technology to help drive improvements in patient care.

The NHS trusts are Beamtree’s first international clients in hospital-based care. It is also the first time the firm’s coding and analytic services have been contracted in England. 

Beamtree is building a strategic pipeline of international partners to implement its services in Europe, the Middle East, US and Asia. 

-----

https://www.healthcareitnews.com/blog/top-takeaways-himss22-what-cios-need-know

Top takeaways from HIMSS22: What CIOs need to know

Health system IT leaders need to be ready to enable care delivery anywhere, anytime, to any patient. New advances in cloud and telehealth/remote monitoring are forcing the issue.

By David Chou

March 22, 2022 03:44 PM

Healthcare chief information officers had a lot to take in at HIMSS22 this past week. There were many new product and partnership announcements and insightful panels and discussions, but here are two critical takeaway themes from HIMSS22 relevant to healthcare decision-makers like you!

Healthcare cloud is everywhere

It feels like every company has a health cloud offering these days.

Microsoft's Azure health cloud includes a data service that brings together clinical, imaging, medical devices, and other datasets. Microsoft has made additional enhancements focused on clinical workflow integration with the Teams product and Dynamics CRM. Examples include using Teams for virtual care visits, Teams integration with Cerner electronic health record, and additional enhancements on the Azure Health Data Services using AI.

Salesforce has announced that it will improve its Salesforce Customer 360 for Health product, adding new features. Teladoc Health and Ovation Medical are among the organizations that will utilize these new capabilities. Staff members, clinicians, and administrative staff can access patient health information and social circumstances while observing the patient from all angles to arrange appropriate treatment while empowering front-line support teams to communicate with and provide an excellent experience for patients.

-----

https://www.healthcarefinancenews.com/news/early-warning-system-sepsis-saves-lives-university-missouri-health-care

Mar 23 2022

Early-warning system for sepsis saves lives at University of Missouri Health Care

Algorithms on pulse rate and other indicators are tied into the EHR to alert rapid-response teams.

Susan Morse, Executive Editor

The use of algorithms has saved lives at the University of Missouri Health Care.

The health system put in place an early-warning system tied to the EHR to alert rapid-response teams of a patient's risk for developing sepsis, a life-threatening infection.

One of every three patients who dies in the hospital has sepsis, according to information given at the HIMSS22 session, "Saving Lives with the NEWS Algorithm: Using Early Detection and Rapid Response." Every hour, the condition goes untreated increases a patient's mortality risk by 4%. 

The move to faster response started when the hospital system received unacceptable star ratings, said Bryan Bliven, CIO, University of Missouri Health Care. Teams looked at the metrics and drivers, and then, made changes. 

-----

https://www.healthcareitnews.com/news/scotus-denies-epics-attempt-preserve-full-trade-secrets-payout

SCOTUS denies Epic's attempt to preserve full trade-secrets payout

The Supreme Court rebuffed the electronic health record vendor's petition after a Seventh Circuit decision to reduce the damages from the Tata case.

By Kat Jercich

March 23, 2022 12:09 PM

The U.S. Supreme Court denied a petition from Epic this week regarding an appeals court's decision to cut the electronic health record vendor's total damages in a trade secrets case involving Tata Consultancy Services.   

After initially being awarded $940 million – $700 million in punitive damages – by a U.S. district court jury, Epic has seen that number steadily whittled down by both state and federal courts.

"TCS’s conduct, while reprehensible, was not egregious, and multiplying the substantial compensatory award – calculated on the basis of TCS’s benefit rather than Epic’s loss – is unnecessary to reflect Epic’s uncertain economic harm," said a three-judge panel of the Seventh Circuit Court of Appeals in its 2020 decision.

Epic declined to respond to requests for comment.  

-----

https://www.healthleadersmedia.com/pharma/internet-things-becomes-greater-focus-pharma

Internet of Things Becomes Greater Focus for Pharma

Analysis  |  By Ana Mulero  |   March 23, 2022

Large pharma players are approaching IoT to embrace what is happening in the digital health space.


KEY TAKEAWAYS

·         Internet of Things (IoT) can be used for collecting real-world data on medications as well as personalizing treatments.

·         Use of the technology allows for significant time and cost savings across the lifespan of a medication.

As Thomas B. Cueni of the IFPMA recently stated, voluntary "technology transfer partnerships have been the cornerstone in the fight against COVID-19" in ways that offer new and exciting opportunities for pharma. The need for the adoption of connected technologies that was exacerbated by the pandemic is expected to complete a shared vision.

The vision is centered on using the Internet of Things (IoT), a concept coined several decades ago, to provide improved and personalized healthcare to patients. IoT describes a system of computing devices interconnected via the internet that enables sending and receiving data. The ongoing push for the IoT hype to become reality as part of the digitization of healthcare got a second wind after the pandemic began in 2020. Major pharma players are working to harness the potential of IoT for time and cost savings that ultimately benefit patients and providers.

IoT encompasses every organization from providers and payers to developers and vendors. But pharma is in an advantageous position to connect the dots across the entire life cycle of a medication. The advantages of IoT are focused not only on medical intervention and medication errors, but also personalized medicine.

What perhaps is the most interesting is the way that large pharma players are approaching IoT to embrace the entirety of what is happening in the digital space and through connected devices. Bayer, for example, has invested into a business unit that is focused on trying to create revenue out of this.

-----

https://www.nejm.org/doi/full/10.1056/NEJMp2115646?query=featured_home

Digital Inclusion as Health Care — Supporting Health Care Equity with Digital-Infrastructure Initiatives

  • Jorge A. Rodriguez, M.D.,
  • Carmel Shachar, J.D., M.P.H.,
  • and David W. Bates, M.D.

As health care has shifted to increasingly rely on digital tools for patient care, digital inclusion has become critical to promoting health care equity. The recently enacted Infrastructure Investment and Jobs Act (IIJA) makes investments that could foster sustainable digital inclusion. Although the law isn’t focused on health care, it addresses long-standing drivers of digital health disparities, presents new opportunities for community-based digital inclusion, and could be a critical lever for improving access to care. We believe it’s important for health care organizations to understand the opportunities the law presents, to advocate for its effective and equitable implementation, and to take advantage of improvements to digital infrastructure (see table).

With digital health tools such as telehealth and patient portals becoming prominent components of care delivery, the barriers to digital inclusion have grown increasingly apparent.1 For example, more than 100 studies have revealed disparities in portal use based on age, race, socioeconomic status, English-language proficiency, and other factors.2 Digital inclusion refers to “the activities necessary to ensure that all individuals and communities, including the most disadvantaged, have access to and use of [digital tools].”3 Structural barriers to digital inclusion, such as digital redlining, have limited the reach of digital health tools. Digital redlining entails “discrimination by Internet service providers in the deployment, maintenance, or upgrade of infrastructure or delivery of services.”3 Communities affected by digital redlining are generally the same ones that already have poor health outcomes. Health care systems have, by necessity, implemented digital tools in communities affected by digital redlining to reach underserved patients and combat health disparities.

-----

https://ehrintelligence.com/news/wa-senator-demands-va-halt-ehr-implementation-for-patient-safety

WA Senator Demands VA Halt EHR Implementation for Patient Safety

After an OIG report found patient safety issues with the VA EHR implementation, Sen. Patty Murray (D-Wash.) called on the VA to stop the rollout.

By Hannah Nelson

March 22, 2022 - A Washington senator has demanded that the Department of Veterans Affairs (VA) delay its planned March 26th EHR implementation in Walla Walla after an Office of Inspector General (OIG) report revealed dozens of unresolved patient safety problems with the new Cerner system.

The OIG report found that the EHR implementation launched in October 2020 at the Mann-Grandstaff VA Medical Center in Spokane, Washington, has created difficulties for end-users in critical areas such as clinical documentation and referral management.

“After hearing from the VA Office of Inspector General, it’s clear to me that VA is not ready for go-live of the EHR system at the VA Medical Center in Walla Walla, and we need to put a pause on this rollout right now,” Sen. Patty Murray (D-Wash.) said in a statement.

“It’s absolutely unacceptable to me that VA knew about widespread, egregious patient safety risks associated with its ongoing rollout of its Cerner Electronic Health Record System—but in conversations with my office, VA has been expressing confidence and readiness for the go-live date at the Walla Walla VA,” she said. “This was simply not the case.”

-----

https://www.healthcareitnews.com/news/biden-urges-immediately-hardened-cyber-defenses-citing-russia

Biden urges 'immediately' hardened cyber defenses, citing Russia

The warnings followed an alert from federal security agencies about Russian state-sponsored threat actors exploiting default protocols and known vulnerabilities.

By Kat Jercich

March 22, 2022 01:37 PM

President Joe Biden released a statement on Monday doubling down on the potential for Russia to conduct malicious cyber activity against the United States.  

The president noted that Russia could perpetrate attacks as a response to the United States' economic sanctions on the country amidst its continued assault on Ukraine.  

"It’s part of Russia’s playbook," said Biden in the memo.  "Today, my Administration is reiterating those warnings based on evolving intelligence that the Russian Government is exploring options for potential cyberattacks," the memo continued.  

WHY IT MATTERS

As Biden's memo noted, the administration and Congress have worked to shore up funding for cyber defense, particularly among critical infrastructure entities such as healthcare.  

-----

https://www.healthcarefinancenews.com/news/biggest-trends-healthcare-are-hospital-care-home-and-widening-labor-gap

2022

The biggest trends in healthcare are hospital care at home and the widening labor gap

Over the next three years, 40% of providers will shift 20% of hospital beds to the home, says Philips.

Susan Morse, Executive Editor

During HIMSS22, Philips gave its top predictions for the future of healthcare systems over the next three years based on labor market trends and the expansion of hospital-at-home services.

Roy Jakobs, chief business leader of Connected Care at Philips, offered the following predictions:

  • Over the next three years, 40% of providers will shift 20% of hospital beds to the home.
  • By 2025, a common marketplace will connect all consumers, payers and providers.
  • By 2025, 10 major national employers will go to direct contracting.
  • Three-quarters of health systems will suffer from cybersecurity risks.

The big theme is serving patients at home, Jakobs said.

"We can't just serve patients in hospitals," he said. "Virtual visits, remote monitoring are going into the home."

-----

https://www.statnews.com/2022/03/21/health-algorithm-lung-northwestern/

When AI takes a human touch: How a team effort to improve patient care in hospitals paid off

By Casey Ross March 21, 2022

The project began with a vexing problem. Imaging tests that turned up unexpected issues — such as suspicious lung nodules — were being overlooked by busy caregivers, and patients who needed prompt follow-up weren’t getting it.

After months of discussion, the leaders of Northwestern Medicine coalesced around a heady solution: Artificial intelligence could be used to identify these cases and quickly ping providers.

If only it were that easy.

It took three years to embed AI models to flag lung and adrenal nodules into clinical practice, requiring thousands of work hours by employees who spanned the organization — from radiologists, to human resources specialists, to nurses, primary care doctors, and IT experts. Developing accurate models was the least of their problems. The real challenge was building trust in their conclusions and designing a system to ensure the tool’s warnings didn’t just lead providers to click past a pop-up, and instead translated to effective, real-world care.

-----

https://ehrintelligence.com/news/ehr-optimization-doubles-hcv-screening-cuts-clinician-burden

EHR Optimization Doubles HCV Screening, Cuts Clinician Burden

An EHR optimization that made HCV screening a default order mitigated clinician burden and significantly increased screening rates.

By Hannah Nelson

March 21, 2022 - An EHR optimization doubled completion rates of hepatitis C virus (HCV) screening while cutting down on clinician burden, according to a study published in JAMA Network Open.

HCV attacks the liver and is a leading cause of cirrhosis, cancer, and the need for liver transplants. While national guidelines recommend HCV screening for all adults, screening rates remain low.

A University of Pennsylvania research team made HCV screening a default order for patients who met guidelines at two different hospitals.

They then compared screening rates to a pre-existing alert system that required doctors to respond to a pop-up to make a screening order. Under the new system, a patient recommended for screening already had the screening order in their EHR admission order-set, and the physician only needed to click if they disagreed.

-----

https://healthitsecurity.com/news/ehnac-hitrust-partner-to-promote-security-privacy-standards

EHNAC, HITRUST Partner to Promote Security, Privacy Standards

EHNAC and HITRUST announced a partnership to promote the security and privacy of trusted networks while aligning with TEFCA requirements.

By Jill McKeon

March 21, 2022 - The Electronic Healthcare Network Accreditation Commission (EHNAC) and HITRUST announced a partnership to enhance security and privacy requirements under the Trusted Network Accreditation Program (TNAP).

EHNAC assesses organizations through TNAP with the goal of promoting interoperability and ensuring alignment with the Trusted Exchange Framework and Common Agreement (TEFCA). The Office of the National Coordinator for Health Information Technology (ONC) published TEFCA in January 2022 to support health information exchange.

EHNAC and HITRUST will leverage the HITRUST CSF to ensure that TNAP’s privacy and security requirements align with TEFCA requirements.

"EHNAC and HITRUST are committed to ensuring that all organizations are able to adhere to the latest best practices and standards in privacy and security while meeting federal and state compliance mandates," Lee Barrett, executive director and CEO of EHNAC said in the announcement.

-----

https://www.jdsupra.com/legalnews/considerations-for-remote-patient-7597935/

Considerations for Remote Patient Monitoring Vendors and Providers

Saul Ewing Arnstein & Lehr LLP

Remote patient monitoring (“RPM”) refers to the use of digital technologies to monitor and capture medical and other health data from an individual. This data is electronically stored for an individual’s personal use or transmitted to health care providers for assessment. RPM requires a device to digitally record and transmit the recorded physiologic data. The data collected cannot be self-recorded, self-reported, or entered manually by the individual. RPM may also be called telemetry, remote physiologic monitoring, remote monitoring, or remote therapeutic monitoring. ​

What You Need to Know:

  • The use of Remote Patient Monitoring – the use of digital technologies to monitor and capture medical and other health data from patients – is rapidly growing.
  • RPM vendors and providers using RPM technology are subject to specialized government regulations and guidelines.​

Use of RPM was on the rise prior to the COVID-19 pandemic, but the value of providing patient care without additional travel or direct contact with others has been solidified during the pandemic and has propelled RPM to the forefront of care management tools. Better technologies and infrastructure to improve consistent monitoring, coupled with expanded Medicare coverage of RPM services to include both chronic and acute conditions, has dramatically increased the adoption of RPM.

With the growth of RPM, there are several considerations RPM vendors and health care providers using RPM services should understand. This article outlines security, compliance, and integration considerations that should be top of mind for vendors in the RPM industry and health care providers implementing RPM technologies.

-----

https://www.healthcareitnews.com/news/former-onc-chief-describes-2-things-make-fhir-utterly-powerful

Former ONC chief describes the 2 things that make FHIR ‘utterly powerful’

Dr. Donald Rucker sat down at HIMSS22 to discuss how the healthcare industry's transformation could affect patients and what's needed to achieve FHIR's full potential.

By Kat Jercich

March 21, 2022 03:40 PM

The importance of data-sharing and interoperability were two dominant themes at HIMSS22, with leadership repeatedly emphasizing how the COVID-19 pandemic shined a light on the consequences of siloed information. 

Dr. Donald Rucker, former National Coordinator for Health Information Technology, says the ability to represent data uniformly is arguably a bigger win than the ability to transmit it – and he says FHIR will be a key way of doing so.

Rucker spoke to Healthcare IT News in Orlando before his HIMSS22 panel about what he sees as the promises of FHIR, how the transformation it enables will affect patients and what next steps look like to achieve its potential. 

Q. What do you see as the main promise of FHIR?

A. I would say there's two of them.

One is, you have a relatively standardized way of representing clinical data – and notice I said "representing," not just interoperating. The ability to represent things uniformly is a bigger win than just, "I can move it from here to there." 

-----

https://www.healthcareittoday.com/2022/03/21/is-your-fax-infrastructure-costing-you-money-and-putting-patients-at-risk/

Is Your Fax Infrastructure Costing You Money and Putting Patients At Risk?

March 21, 2022

John Lynn

While many are still calling to #axthefax, the reality is that fax is here to stay in healthcare for the foreseeable future.  If there was a better solution, we’d have moved there already.  However, fax is the most interoperable part of healthcare and healthcare organizations send and receive thousands of faxes every day.

What does need to disappear is legacy fax infrastructure and poorly implemented and maintained digital fax that is costing healthcare organizations money and putting patients at risk.  While at the ViVE conference, I sat down with Barry Clark, President at WestFax, to discuss this and to learn about the launch of the new WestFax Comprehend product.

In the interview, Clark highlights how many healthcare organizations fax infrastructure is built on unreliable technology that can often fail which leads to fax servicer providers charging multiple times for the same fax.  Even worse, this unreliable infrastructure can lead to misses faxes which leads to important patient safety and continuity of care issues.

-----

Enjoy!

David.

No comments: