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, May 21, 2022

Weekly Overseas Health IT Links – 21st May 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://ehrintelligence.com/news/supportive-health-it-structure-linked-to-global-ehr-satisfaction

Supportive Health IT Structure Linked to Global EHR Satisfaction

A KLAS Arch Collaborative report found that sufficient ongoing health IT training is linked to EHR satisfaction in global health systems.

By Hannah Nelson

May 13, 2022 - Supportive health IT structure is the factor most associated with EHR satisfaction, according to a KLAS Arch Collaborative report.

In global health systems, clinicians who strongly agree that their organization supports the EHR well are 132 times more likely to report EHR satisfaction than those who strongly disagree.

Those who disagree or strongly disagree that their organization provides sufficient support for the EHR account for 26 percent of all respondents from global health systems.

According to an Arch Collaborative webinar hosted by King Faisal Specialist Hospital & Research Centre in Saudi Arabia, healthcare organizations should create a high-trust environment by engaging clinicians in EHR governance.

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https://healthitsecurity.com/news/nations-warn-of-cyber-threats-to-managed-service-providers

Nations Warn of Cyber Threats to Managed Service Providers

Five nations came together to warn critical infrastructure of increased cyber threats toward managed service providers (MSPs), and AHA echoed the warning for healthcare.

By Jill McKeon

May 12, 2022 - Cybersecurity authorities from the United States, United Kingdom, New Zealand, Canada, and Australia issued a joint alert warning critical infrastructure entities of increased cyber threats to managed service providers (MSPs) and their customers.

The alert defined MSPs as “entities that deliver, operate, or manage [information and communications technology (ICT)] services and functions for their customers via a contractual arrangement, such as a service level agreement.”

The five nations have observed an increase in malicious cyber activity against MSPs and expect the trend to continue.

“MSPs provide services that usually require both trusted network connectivity and privileged access to and from customer systems. Many organizations—ranging from large critical infrastructure organizations to small- and mid-sized businesses—use MSPs to manage ICT systems, store data, or support sensitive processes,” the alert continued.

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https://www.digitalhealth.net/2022/05/after-ockenden-we-need-better-data-to-prevent-further-harm/

After Ockenden, we need better data to prevent further harm

Maternity services shouldn’t be waiting for whistle-blowers or inquiries to alert them to problems, says Dr Mark Ratnarajah, a practising paediatrician and managing director of C2-Ai. Instead systematic transdisciplinary reviews and real-time data should support a culture of shared learning, that helps ensure patient safety is everybody’s responsibility.

5 May, 2022

Like so many people, I was saddened to read the final report of the Independent Review of Maternity Services at The Shrewsbury and Telford Hospital NHS Trust.

The Ockenden report (named after Donna Ockenden, the midwife who led it) found that more than 200 babies died after “repeated failures” between 2000 and 2019 and documented many more cases of harm. It made more than 60 recommendations for the trust and another 15 for maternity services across the country.

However, I took two things away from the report. First, the trust had systemic problems and had them for a long time; so whatever processes were being used internally and externally to identify harm and support patients and staff had not been working.

Second, when failings occurred, voices of people within the multi-disciplinary team and families were not heard; which suggests a failure of leadership and a culture of denial. If we are going to deliver better, safer maternity services now and in the future, we need to address both issues.

Are maternity services safe?

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https://www.digitalhealth.net/2022/05/ahps-and-pharmacists-the-untapped-potential-in-digital-health/

AHPs and pharmacists: The untapped potential in digital health

In a joint piece for Digital Health, Melissa Andison (occupational therapist and associate chief clinical information officer, Surrey and Borders Partnership NHS Foundation Trust), Euan McComiskie (health informatics lead, Chartered Society of Physiotherapy) and Ramandeep Kaur (lead electronic prescribing and medicines administration pharmacist, Barking, Havering and Redbridge University Hospitals NHS Trust) reflect on a session from Digital Health Rewired 2022 which looked at the untapped potential of allied health professionals (AHPS) and pharmacists. 

DHI News Team 10 May, 2022

Did you know AHPs, make up the third largest clinical workforce group in health and care – we are 14 professions that are an untapped resource to drive digital transformation and innovation.

Did you know pharmacists with a passion for digital usually commence their careers within informatics implementing electronic prescribing and medicines administration (EPMA) systems.

So what’s unique about AHPs and pharmacy staff?  We think about health and wellness differently. The common traits that bind us as a group are often seen in our holistic thinking, collaborative problem solving, health promotion expertise and naturally are adopters of futuristic ways of working.

AHP and pharmacy colleagues are thriving in digital health design, innovation and the cold face of implementation and we feel like it is time to showcase this.

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https://ehrintelligence.com/news/hia-outlines-solutions-to-boost-healthcare-interoperability-data-exchange

HIA Outlines Solutions to Boost Healthcare Interoperability, Data Exchange

HIA gave six recommendations to help improve healthcare interoperability and data exchange to enhance patient care delivery.

By Hannah Nelson

May 12, 2022 - While advances in technology have helped improve data exchange, the healthcare industry continues to lag on the interoperability front, according to a Health Innovation Alliance (HIA) report that outlines solutions to meet the ONC's goal of improving healthcare interoperability by 2030.

"How we share data is going to continue to evolve as technology advances," Brett Meeks, senior policy advisor of HIA, said in a press release. "The solutions identified by the HIA address the key areas that have hampered the flow of healthcare information."

"Implementing them will revolutionize how patients interact with the healthcare system, and how care is provided," Meeks continued. "If we want to have a better system, we need to act now. The longer we wait, the more catching up we will have to do in the future."

The report notes six critical solutions that would improve healthcare interoperability.

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https://healthitanalytics.com/news/mayo-cdc-leaders-policy-coalitions-key-barriers-to-data-modernization

Mayo, CDC Leaders: Policy, Coalitions Key Barriers to Data Modernization

Leaders from Mayo Clinic, the CDC, and others came together at the 2022 TechXpo conference to discuss data modernization solutions and progress.

By Shania Kennedy

May 12, 2022 - To prepare for the next pandemic, healthcare leaders believe that data modernization is key, but several challenges stand in the way, including conflicting policies, lack of interoperability, and the workforce shortage.

At the Association of State and Territorial Health Officials (ASTHO) Public Health TechXpo conference earlier this week, various public and private health organizations shared their strategies for achieving data modernization in the coming years beyond the COVID-19 pandemic.

John D. Halamka, MD, president of Mayo Clinic Platform, gave a keynote address on the second day of the conference, during which he discussed the data problems that the COVID-19 pandemic revealed and how modernization can solve those problems at the local, state, and federal levels.

Halamka noted that healthcare organizations need data to effectively deliver the highest quality supplies and care across systems, but there are multiple challenges that prevent data gathering, standardization, and sharing, including conflicting state and federal policies.

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https://www.healthcareitnews.com/news/spotting-bias-ai-requires-holistic-approach-says-study

Spotting bias in AI requires a holistic approach, says study

Researchers from Massachusetts General Hospital note that models can be biased against some groups while performing better for others.

By Kat Jercich

May 13, 2022 02:35 PM

Researchers at Massachusetts General Hospital say that spotting bias in artificial intelligence and machine learning requires a holistic evaluation – and that models can be biased against certain groups while simultaneously performing better for others.  

"Despite the eminent work in other fields, bias often remains unmeasured or partially measured in healthcare domains," observed the researchers in the study, which was published this week in the Journal of the American Medical Informatics Association.  

"Most published research articles only provide information about very few performance metrics," they added. "The few studies that officially aim at addressing bias usually utilize single measures … that do not portray a full picture of the story on bias."  

WHY IT MATTERS  

For this particular study, the researchers examined four validated prediction models of COVID-19 outcomes in an effort to investigate whether they were biased when developed or whether the bias changed over time.  

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https://www.healthleadersmedia.com/technology/texting-between-clinicians-has-upsides-and-downsides

Texting Between Clinicians Has Upsides and Downsides

Analysis  |  By Scott Mace  |   May 13, 2022

A new study out of the Regenstrief Institute finds doctors critical of the high volume of texts, while nurses are OK with it.

As hospitals replace pagers with smartphone-based texting platforms connecting doctors, nurses, and other clinicians, some are giving mixed reviews to the technology.

So says a new study from the Regenstrief Institute, published in the journal Applied Clinical Informatics, which found a lack of shared understanding among clinicians on how to use clinical texting.

"Clinical texting is a double-edged sword – it’s easy to contact fellow clinicians, which can be viewed as good or bad," says Joy L. Lee, PhD, M.S., a Regenstrief Institute scientist, assistant professor of medicine at the Indiana University School of Medicine and corresponding author of the study. "Each hospital or hospital system needs to figure out how to use clinical texting to optimize communication, workflow and patient care and develop use guidelines."

In the study, nurses and hospitalists supported clinical texting, noting ease of access and the ability to transmit photos and create a record of communications. But they were also frustrated with implementation challenges and a lack of understanding about the appropriateness of texts.

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https://ehrintelligence.com/news/hia-outlines-solutions-to-boost-healthcare-interoperability-data-exchange

HIA Outlines Solutions to Boost Healthcare Interoperability, Data Exchange

HIA gave six recommendations to help improve healthcare interoperability and data exchange to enhance patient care delivery.

By Hannah Nelson

May 12, 2022 - While advances in technology have helped improve data exchange, the healthcare industry continues to lag on the interoperability front, according to a Health Innovation Alliance (HIA) report that outlines solutions to meet the ONC's goal of improving healthcare interoperability by 2030.

"How we share data is going to continue to evolve as technology advances," Brett Meeks, senior policy advisor of HIA, said in a press release. "The solutions identified by the HIA address the key areas that have hampered the flow of healthcare information."

"Implementing them will revolutionize how patients interact with the healthcare system, and how care is provided," Meeks continued. "If we want to have a better system, we need to act now. The longer we wait, the more catching up we will have to do in the future."

The report notes six critical solutions that would improve healthcare interoperability.

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https://www.beckershospitalreview.com/digital-health/9-out-of-10-patients-worry-about-misdiagnoses-with-ai.html

9 out of 10 patients worry about misdiagnoses with AI

Georgina Gonzalez (Twitter) -

While patients are excited about the potential of healthcare artificial intelligence in theory, when it comes down to the real thing most have major concerns, according to a May 4 study published in JAMA Network Open

More than 900 patients from the New Haven, Conn.-based Yale Cancer Center took part in the study in December 2019, sharing their worries, hopes and opinions on healthcare AI.

The majority of patients had faith in health AI in medicine, with 55.4 percent saying it would make healthcare much or somewhat better and only 6.2 percent said it would make healthcare much or somewhat worse. 

However, in practice, the black box problem of AI made patients uneasy, with over 70 percent of patients saying receiving a diagnosis from an AI without a clear rationale made them uncomfortable in some way. Concerns were brought up about a range of other factors too, with 91.5 percent saying they were concerned about misdiagnosis with AI machines, 70.8 percent were worried about privacy breaches and 69.6 percent thought they'd get less time with physicians. 

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https://www.computerworld.com/article/3657596/how-covid-19-has-changed-healthcare-it.html

5 ways COVID-19 has changed healthcare IT

During the pandemic, IT has supported overburdened medical professionals with multi-hospital dashboards, better health-record integration, automated patient monitoring, and more.

By Ryan Faas

Contributing Writer, Computerworld | 11 May 2022 20:00 AEST

Two years of COVID-19 has changed how many organizations and their IT departments function. The shift in priorities, particularly when it comes to issues like supporting remote and hybrid work models, has cut across industries. But one sector — healthcare — has had a much different experience and different needs.

As someone who used to manage IT for a healthcare provider and has worked on a number of healthcare IT projects since then, I was curious to see what changes IT departments for hospitals and other medical facilities have had to invest in, and whether these changes will persist in a post-pandemic world.

All in this together

The biggest change I heard from both hospital IT staff and the doctors, nurses, and administrators they support is that the two groups are collaborating more than before COVID. This wasn’t something I expected at all. While many IT departments have bumpy relationships with their end users, the strain on the relationship in healthcare organizations is particularly acute and volatile.

A big factor in that relationship comes down to the rollout of electronic health record systems (EHRs). Most healthcare organizations were spurred to adopt EHRs in the late 2000s and early 2010s as the federal government began urging their use through the HITECH Act of 2009 and as provisions of the Affordable Care Act in 2010. Most clinical staff initially saw EHRs as problematic because using the systems inserted extra work into their daily routines and required adjusting their workflows.

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https://www.medscape.com/viewarticle/973768

Telemedicine Increases Black Patients' Primary Care Access: Study

Ken Terry

The increased availability of telemedicine was associated with improved access to primary care for Black patients in 2020, according to a new study from the University of Pennsylvania.

The study, which used administrative data from 60 primary care clinics in the Penn Medicine system, compared appointment completion rates for Black patients and non-Black patients in 2020 relative to 2019. During 2020, the study found, the significant gap between the two groups' appointment completion rates consistently narrowed.

The study was published online May 2 in Telemedicine and e-Health.

Prior to the pandemic-related shutdown of many physician practices in March 2020, the study said, Black patients completed 60%-63% of primary care appointments and non-Black patients completed 72%-73% of their appointments. At the end of 2020, the appointment completion rate for Blacks was approximately 68% and that for non-Blacks was still about 72%, lead study author Krisda H. Chaiyachati, MD, MPH, told Medscape Medical News.

As the study noted, Black patients traditionally have had less access to primary care than White patients. "[Black patients] are more likely to reside in areas with a low supply of primary care providers, encounter insurance barriers, spend more time traveling to medical appointments, and have work or family obligations that limit their ability to complete scheduled appointments," the study authors write.

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https://www.healthdatamanagement.com/articles/data-modernization-initiative-aims-to-meet-lofty-goals-for-public-health?id=130156

Data Modernization Initiative aims to meet lofty goals for public health

Federal agencies aim to improve health data sharing among state and federal agencies, but GAO questions progress and others contend the effort is underfunded.

May 10 2022


Fred Bazzoli

Editor-in-Chief, HDM

The COVID-19 pandemic highlighted the importance of data sharing – as well as the frustrating consequences of unpreparedness when public health information is siloed and cannot be easily exchanged.

Information sharing woes were recognized early on in the pandemic as an impediment to successful management. For example, just months into the crisis, hospitals and public health agencies often had to rely on spreadsheets to exchange critical public health data. While some public-private initiatives sought to fill the gap, improvements in data sharing took months to achieve.

Given all the data sharing difficulties, the government’s ongoing Data Modernization Initiative, is critical. The Centers for Disease Control and Prevention launched DMI in 2020 to modernize the sharing of core data and surveillance information across federal and state public health agencies.

According information provided by the CDC, the DMI is aiming to “move from siloed and brittle public health data systems to connected, resilient, adaptable and sustainable ‘response-ready’ systems” that can get in front of future health crises. It intends to “deliver real-time, high-quality information on both infectious and non-infectious threats.”

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https://www.healthcareitnews.com/news/25x5-initiative-amia-sets-sights-tackling-clinical-documentation-burden

With 25x5 initiative, AMIA sets sights on tackling clinical documentation burden

In collaboration with Columbia and Vanderbilt, the medical informatics group seeks to optimize EHR charting and reduce burden on U.S. clinicians by 75% by 2025.

By Mike Miliard

May 12, 2022 10:55 AM

The American Medical Informatics Association this week announced next steps for AMIA 25x5, its multi-stakeholder effort to alleviate documentation burden for U.S. clinicians.

WHY IT MATTERS
Funded by the National Library of Medicine, the 25x5 Symposium to Reduce Documentation Burden on U.S. Clinicians by 75% by 2025 was launched this past year by AMIA in partnership with Vanderbilt University and Columbia University.

In March, AMIA established a 25x5 Task Force, chaired by Columbia's Sarah Rossetti, RN, with the university's Kenrick Cato, RN, acting as the AMIA Board of Directors Liaison.

The 25x5 Task Force convenes more than 20 AMIA members, divided into three separate workstreams focused on providers, IT vendors and policy.

The goal is to reduce documentation burden for U.S. clinicians to 25% of its current state in the next five years – and optimize EHR and other health IT by implementing recommendations from the 25x5 Symposium and other public-private sector organizations.

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https://www.healthcareitnews.com/news/klas-clinician-burnout-worldwide-problem

KLAS: Clinician burnout is a worldwide problem

New research found that nurses and allied health professionals from around the globe were the most likely to report burnout symptoms.

By Kat Jercich

May 12, 2022 11:19 AM

The KLAS Arch Collaborative published findings this week on electronic health record satisfaction outside of the United States. Researchers found that clinicians in the Middle East report the highest EHR satisfaction, while European clinicians are the least satisfied.

"Collaborative data has shown that a supportive IT structure is the factor most associated with strong EHR satisfaction," noted the report.   

"Specifically at global health systems, clinicians who strongly agree that their organization supports the EHR well are 132 times more likely to be satisfied with the EHR than those who strongly disagree," it continued.  

WHY IT MATTERS  

EHR satisfaction has been linked to clinician burnout – and, as the researchers observed, burnout is not limited to the United States.  Slightly more than a quarter of the clinicians reported at least one symptom of burnout, with nurses and allied health professionals the most likely to say so.

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https://www.healthcareittoday.com/2022/05/12/the-future-of-clinical-technology-has-arrived/

The Future of Clinical Technology Has Arrived

May 12, 2022

Guest Author

The following is a guest article by Alejandro Spiotta, M.D., Department of Neurosurgery, Medical University of South Carolina.

Physicians are only human – we don’t have limitless computing capacity, we undergo emotional strain and feel the symptoms of burnout. As a physician, one of the ways I (and many others) unplug and recharge is through interests outside of the hospital that bring levity and stimulate my mind in other ways. For some it may be through reading, painting and other creative pursuits. I enjoy the Marvel Cinematic Universe (MCU) with my children.

As the universe housing all of Marvel’s many superheroes, the MCU is filled with superhumans, intergalactic and multiversal beings, and futuristic technology – to name a few. However, the foreign beings and pure fantasy aside, I often think about how my cinematic escape from my clinical universe is increasingly less fantasy and more a roadmap for the future of health technology. I can’t help but connect its applications back to healthcare, and specifically emergency medicine, where every day is a race against the clock in acute care.

I believe the coming wave of technological improvements will profoundly and forever alter the way we as physicians interpret images, communicate across large healthcare systems and interact with patients, and ultimately treat diseases. In fact, some of these advancements are already here in some capacity. Here are some of the parallels between the MCU and the clinical realm, and some lessons I think we can draw from them.

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https://www.carehomeprofessional.com/guest-column-unlocking-the-power-of-data-to-enhance-care-quality/

GUEST COLUMN: Unlocking the power of data to enhance care quality

Care Planning Systems Solutions by Lee Peart on May 12, 2022

Marking International Nurses Day today, Global Head of Product, Andrew Coles, explains how Person Centred Software can help nurses deliver better quality care.

Care home environments deal with many social, medical, clinical, and mental health needs. It’s paramount for any person living in a care home setting to receive the appropriate level and type of support that promotes good health and wellbeing whilst keeping them safe. These needs are not independent but are interrelated and impact one another – and the best support, care and treatment plans must consider all these factors.

The COVID-19 pandemic hit the social care sector particularly hard and demonstrated the need for data sharing while showcasing the importance of data to support critical decisions. This led to much of the government’s focus on growing data standards and helping care providers go digital by adopting digital care systems.

However, data and digital is an easy ‘catch all’ statement. To maximise its usefulness, data needs to be of the highest quality, shouldn’t be a burden, and must support its users to make informed clinical decisions.

At Person Centred Software, we use the ‘4 V’s’ to measure the quality of data:

Velocity – How quickly data flows and becomes information

Veracity – How accurate and consistent data is

Variety – The breadth and scope of data

Volume – The amount of data

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https://patientengagementhit.com/news/which-barriers-block-mental-healthcare-access-for-young-adults

Which Barriers Block Mental Healthcare Access for Young Adults?

Most patients said affordability was the leading barrier to mental healthcare access, although they also expressed reservations about social acceptance.

By Sara Heath

May 11, 2022 - More and more young adults are citing cost and stigma as key mental healthcare access barriers, according to the latest in JAMA Network Open.

The study, published as a research note, found that the proportion of young adults ages 18 to 25 saying cost and fear of being committed or having to take medicine for mental health diagnoses grew between 2011 and 2019. These findings, particularly the ones about healthcare cost barriers, indicate a need for better health coverage policy decisions, the researchers wrote.

Mental health issues are common among all adults in the US but are most prominent in the young adult category (ages 18 to 25). Nevertheless, access to mental healthcare leaves much to be desired, the researchers from the City University of New York said.

“Untreated depression increases young adults’ risk for substance abuse, risky sexual behaviors, unemployment, and suicide,” the research team explained.

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https://healthitsecurity.com/news/state-by-state-legal-inconsistencies-challenge-adolescent-patient-privacy

State-by-State Legal Inconsistencies Challenge Adolescent Patient Privacy

Legal inconstancies and information blocking rules make it difficult for providers to maintain adolescent patient privacy while adhering to ethical and professional guidelines.

By Jill McKeon

May 11, 2022 - State and federal legal inconsistencies, the proliferation of EHRs, and information blocking rules under the 21st Century Cures Act present challenges to preserving adolescent patient privacy, an article published recently in Pediatrics suggested.

The 21st Century Cures Act and advancements in EHR technology and interoperability have enabled the rapid sharing of medical information, allowing patients to take ownership of their health records. But for adolescents, these provisions may also allow providers to share clinical information with parents.

“A rich evidence base demonstrates that adolescents are more likely to seek health care for potentially sensitive issues such as sexuality, mental health, and drug use if they can provide their own consent and be confident that their health information is private,” the article acknowledged.

“However, parents and guardians also have responsibilities pertaining to care for minor patients. Long-established state laws are often inconsistent in how they address these conflicting objectives, resulting in varying regulations from state to state.

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https://www.fiercehealthcare.com/health-tech/microsoft-pwc-open-source-imaging-consortium-partner-rare-lung-disease-data-repository

A global collaborative teamed up to help diagnose rare lung disease with AI. Here's how they did it

By Anastassia Gliadkovskaya

May 12, 2022 01:22am

It’s been less than a year since Microsoft, PwC and nonprofit Open Source Imaging Consortium teamed up to do something about the speed and accuracy of diagnoses for idiopathic pulmonary fibrosis (IPF), a rare lung disease.

Already, the trio has learned a lot and run into challenges. Time to diagnosis can be more than three years, with one study estimating at least half of IPF patients are misdiagnosed once or more. No formal staging system exists to predict the progression of the disease in patients. 

Together, along with input from 122 experts from fields including respiratory, radiology, neurology and machine learning, they are building out the Open Source Imaging Consortium Data Repository, a database of medical imaging and clinical data they claim is the first of its kind and the world’s largest.

With existing silos and challenges in identifying clinical patterns, the hope is that clinicians and researchers who access the new centralized repository can leverage predictive modeling and their own insights to better target patient treatment, executives told Fierce Healthcare. 

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https://www.healthleadersmedia.com/innovation/ata-urges-clinicians-take-charge-own-virtual-care-innovation

ATA Urges Clinicians to Take Charge, Own Virtual Care Innovation

Analysis  |  By Eric Wicklund  |   May 10, 2022

At the recent American Telemedicine Association conference, some heavy hitters in the telehealth world said the future will be guided by care providers who make virtual care their own.


KEY TAKEAWAYS

·         The telehealth landscape is still unsettled in the wake of the pandemic, due in large part to an uncertain path forward on policy and regulations.

·         Many speakers at ATA2022 said the industry is past the point of proving the value of a virtual care visit and can now focus on being innovative with tools and platforms to advance healthcare.

·         Interest is high on direct-to-consumer care, but the best platforms will still tie their services into a care provider to guide the patient's journey.

Health system leaders looking for sustainability in telehealth should be focusing not on the latest technology, but on how providers are adapting virtual care to their own needs.

Roy Schoenberg, president and CEO of AmWell, says the industry is well past proving the value of the audio-visual telehealth encounter. And as the nation looks to move further away from the pandemic, virtual care will be defined by how it's now being used to improve clinical outcomes and clinician workloads.

"If we can always be next to the consumer … we can completely rewrite how we care for them," he said during a main stage appearance at ATA2022 earlier this month in Boston.

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https://www.healthleadersmedia.com/technology/dictation-software-improves-doctor-patient-relationship

Dictation Software Improves the Doctor-Patient Relationship

Analysis  |  By Scott Mace  |   May 11, 2022

A Maryland physician is using speech dictation software to translate notes from a medical encounter into the patient record, reducing his time on a computer and enriching the visit for both him and his patient.


KEY TAKEAWAYS

·         Healthcare providers are now using speech dictation software to translate their notes right after the patient visit, enabling them to more quickly update the medical record.

·         Some are also “training” the technology platform to recognize text macros that expedite EHR note building.

·         A study by the American Association of Family Physicians found a 72% reduction in median documentation time per note using this technology.

A family physician in Maryland is improving his documentation (and spending less time doing it) with technology that combats physician burnout.

Anuj Bhatnagar, MD, a physician with Frederick Primary Care Associates in Frederick, Maryland, uses Suki medical dictation and AI software to populate athenahealth EHR notes. The platform is endorsed by the American Association of Family Physicians (AAFP).

"The most important thing is you can dictate anywhere you want," such as via a mobile phone, he says.

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https://healthitanalytics.com/news/ai-may-be-more-prone-to-errors-in-image-based-diagnoses-than-clinicians

AI May Be More Prone to Errors in Image-Based Diagnoses Than Clinicians

New research indicates that AI may be more prone to making mistakes than humans in image-based medical diagnoses because of the features they use for analysis.

By Shania Kennedy

May 10, 2022 - Researchers have found that deep neural networks (DNNs) make mistakes in image-based medical diagnoses that humans are less likely to make, and they hypothesize that these mistakes may indicate that clinicians and artificial intelligence (AI) use different features for analysis when looking at medical images.

According to a study published in Scientific Reports, DNNs can fail when performing image-based medical diagnosis tasks because their predictions can be unrelated to the underlying pathology of the condition they are designed to diagnose. For example, an AI skin classifier learns to associate surgical skin markings with malignant melanoma, increasing the classifier’s false positive rate by 40 percent, according to the researchers.

Since clinicians use their medical knowledge to make predictions and diagnose patients, while DNNs do not, the researchers designed their study to determine whether DNNs use different features than humans in image-based medical diagnoses. To compare the two, the researchers used Gaussian low-pass filters in nine varying severities to blur or otherwise distort images used by DNNs and radiologists evaluating breast cancer images.

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https://ehrintelligence.com/news/directtrust-facilitates-over-191m-direct-secure-messages-in-q1-2022

DirectTrust Facilitates Over 191M Direct Secure Messages in Q1 2022

Since DirectTrust began tracking transactions in 2014, the health data exchange has streamlined over 3 billion direct secure messages.

By Sarai Rodriguez

May 10, 2022 - DirectTrust supported more than 191 million direct secure messages during the first quarter of 2022, representing an 11 percent increase over the same quarter in 2021.

The nonprofit healthcare industry alliance supports secure, identity-verified electronic exchanges of protected health information (PHI) between healthcare organizations, providers, and patients to support care coordination.

Direct secure messaging enables better communication, which can result in fewer organizational inefficiencies, DirectTrust mentioned.

In this first quarter, DirectTrust exceeded 3 billion direct secure messages since the organization began tracking the statistics in 2014, an average of more than 63 million transactions per month.

DirectTrust also saw an increase in healthcare organization members served by health information service providers (HISPs). As of 2022, the number of consumers using DirectTrust direct secure messaging grew by 17 percent to more than 302,000 compared to last year.

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https://healthitsecurity.com/news/new-framework-helps-healthcare-assess-privacy-security-of-digital-health-apps

New Framework Helps Healthcare Assess Privacy, Security of Digital Health Apps

Industry groups created a framework aimed at helping healthcare providers and consumers assess the security and privacy of digital health apps that fall outside HIPAA’s purview.

By Jill McKeon

May 10, 2022 - The American College of Physicians (ACP), the American Telemedicine Association (ATA), and other industry leaders released a new framework to help providers and patients assess the security, privacy, safety, and usability of digital health apps.

“With more than 86 million Americans already using a health or fitness app, digital health brings new possibilities for the healthcare industry,” the framework’s website states.

“Yet, in a field of 365,000 products, where the vast majority fall outside of existing regulations, such as the medical device regulations, federal laws and government guidance, there has been no clear way to determine if a product is safe to use. This is stopping the national adoption of digital health, particularly in the fields of condition management, clinical risk assessment and decision support.”

Recently, regulators and industry groups have brought third-party health apps to the forefront of discussions surrounding health data privacy and security. The Federal Trade Commission (FTC) and state Attorneys General have tried to fill the gaps and enforce against health apps that fail to adequately inform users how their health data will be used.

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https://www.healthdatamanagement.com/articles/researchers-offer-vision-for-next-generation-of-clinical-decision-support?id=130191

Researchers offer vision for next generation of clinical decision support

More robust decision support within electronic health records systems to “maximally support teams may be one of biomedical informatics best opportunities to decrease healthcare costs, improve quality and increase clinical capacity.”

May 10  2022


Howard Anderson

Contributing Editor, HDM

The next generation of electronic health records systems should include far more robust clinical decision support designed for use by diverse primary care teams.

That’s the conclusion of two informaticians at the Regenstrief Institute in Indianapolis, a think-tank where one of the first electronic health records systems was developed 50 years ago.

“A clinical decision support system that maximally supports teams may be one of biomedical informatics’ best opportunities to decrease healthcare costs, improve quality and increase clinical capacity,” the researchers say in their recently published paper.


“To make computer support happen, we need to invest in understanding how teams work.”


“A team-based approach to care allows physicians to spend most of their time overseeing care rather than personally delivering the majority of care,” says Paul Dexter, MD, a research scientist at Regenstrief and an associate professor of clinical medicine at Indiana University School of Medicine. This approach could help improve the quality of care while enabling physicians to treat more patients and avoid “burn out,” he says in an interview with Health Data Management.

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https://www.medscape.com/viewarticle/972841

Smart Toilets: Next Tool Against Diseases (Including COVID)

Natalie Sabin

May 09, 2022

Every day, vital information about your health is flushed down the toilet – literally. Bowel movements contain a veritable treasure trove of biomarkers that can uncover a wide array of conditions, from things you lack in your diet to deadly diseases, including COVID-19.

"Assessing fecal matter can help doctors detect certain types of cancers, give insight into the microbiome, and provide a deeper look into nutrition and lifestyle habits," says Jessie Ge, MD, of the Department of Urology at Stanford University School of Medicine.

It can help doctors customize treatments for irritable bowel syndrome or inflammatory bowel disease, she says. And lots more.

"I don't even know how many conditions can be examined," Ge says, "because there are a lot."

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https://consumer.healthday.com/text-message-intervention-doesn-t-improve-meds-adherence-after-acs-2657282216.html

Text Message Intervention Does Not Up Meds Adherence After Heart Attack

Intervention associated with small improvements in BMI <25 kg/m2, eating at least five vegetables and two fruits/day

MONDAY, May 9, 2022 (HealthDay News) -- An intervention including receipt of multiple motivational and supportive weekly text messages does not improve medication adherence after an acute coronary syndrome, according to a study published in the May 10 issue of Circulation.

Clara K. Chow, M.B.B.S., Ph.D., from the University of Sydney, and colleagues conducted a single-blind randomized controlled trial of patients after acute coronary syndrome. A total of 1,424 patients were randomly assigned to receive usual care (control group) or receipt of multiple motivational and supportive weekly text messages on medications and healthy lifestyle with the opportunity for two-way communication (text or telephone).

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https://www.healio.com/news/pulmonology/20220509/critical-care-community-highlights-strategies-to-improve-communication-in-era-of-misinformation

May 09, 2022

Critical care community highlights strategies to improve communication in era of misinformation

A session at the Society of Critical Care Medicine Congress spotlighted the impact of medical misinformation during the COVID-19 pandemic in the ICU, ED, rural areas and on social media.

The impact of medical information is widespread. In the ICU, medical misinformation can result in “false hope for families, loss of trust in the care team, loss of attention to physicians’ words, tension toward the care team and contrasting medical decision-making,” Ashish K. Khanna, MD, FCCP, FASA, FCCM, anesthesiologist, intensivist and associate professor of anesthesiology at Wake Forest Baptist Medical Center in North Carolina, said during a presentation.

As health care providers, “the [COVID-19] pandemic pushed us into a corner. And, actually, because of us being pushed into that corner, we were partly responsible for the misinformation because we had to make early decisions based on whatever was available to us,” Khanna said.

Khanna said it was important to “step in” during the pandemic to combat misinformation circling about COVID-19.

“Over the last 2 years or so, I’ve been talking to our local news media outlet here ... and every month trying to spread as much information that is true and appropriate. ... I really felt gratified that I was able to act as a conduit and liaison and not spread panic but appropriately alert the public and spread and promote appropriate information. That is a responsibility that each and every one of us as critical care doctors have.”

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https://www.fastcompany.com/90748662/the-metaverse-is-already-reshaping-healthcare

·         05-10-22 10:00 am

3 ways the metaverse is already reshaping healthcare

Cloud gaming technology can enable physicians from disparate locations to practice procedures together, collaboratively, on a virtual patient over Zoom.

By Sam Glassenberg 4 minute Read

Let me confirm what might be nagging you about the “metaverse”: There’s more to it than what you’ve been reading.

The metaverse hype-men would have you believe that the ultimate purpose of this technology is a fancy ‘second life’ where consumers put on a clunky headset, create a digital twin of themselves, and buy that twin some virtual Nike shoes and artificial real estate. It’s all sneakers and NFTs; shopping, sports and concerts. It’s all consumerism and little impact.

At best, this is an ill-informed vision of where this technology (that the video game industry built and developed over decades) can take us. At worst, it distracts from the actual value.

The promise of the metaverse is real and, even better, the underlying technology is quietly delivering on that promise in the industry you’d least expect: healthcare.

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https://mhealthintelligence.com/news/massachusetts-to-offer-free-virtual-access-to-covid-19-treatment

Massachusetts to Offer Free Virtual Access to COVID-19 Treatment

The Baker-Polito Administration in Massachusetts is working with Color Health to implement public virtual care resources for COVID-19 treatment.

By Mark Melchionna

May 09, 2022 - Massachusetts residents are gaining access to a free COVID-19 telehealth treatment program that will focus on reviewing patient symptoms and determining if they are eligible to take Paxlovid.

The Baker-Polito Administration has partnered with Color Health to create the program. Color Health is an organization that works with the government and other employers to implement reliable public health programs for various populations.

According to NY Times coronavirus statistics, new cases have doubled in the past month, as of May 6. These cases are primarily Omicron subvariants, which resulted in 18,000 Americans in hospitals, a 20 percent increase from two weeks prior.

To reduce symptoms in patients with COVID-19, the two organizations intend to prescribe Paxlovid when necessary.

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https://ehrintelligence.com/news/amia-and-hl7-announce-healthcare-interoperability-partnership

AMIA and HL7 Announce Healthcare Interoperability Partnership

Longtime partners AMIA and HL7 have announced a two-year collaboration to advance healthcare interoperability through data standards.

By Hannah Nelson

May 09, 2022 - The American Medical Informatics Association (AMIA) and Health Level Seven International (HL7) announced a two-year partnership that aims to enhance interoperability across the healthcare continuum.

With over 5,000 members, AMIA is the leading professional organization for informatics professionals. The organization’s mission is to advance informatics and assure that stakeholders use health IT effectively to promote health and health care.

The goal of HL7 is to provide freely available data standards for interoperability that improve care delivery, optimize clinical workflows, and enhance data sharing across the care continuum.

“AMIA and HL7 have a long history of collaborating together,” Gretchen Purcell Jackson, MD, PhD, FACS, FACMI, FAMIA, AMIA board chair and president, noted in a press release.

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https://ehrintelligence.com/news/healthcare-orgs-call-congress-to-remove-national-patient-identifier-ban

Healthcare Orgs Call Congress to Remove National Patient Identifier Ban

Over 100 healthcare organizations signed a letter urging Congress to remove language in a bill that prohibits the use of federal dollars to adopt a national patient identifier standard.

By Hannah Nelson

May 09, 2022 - The College of Healthcare Information Management Executives (CHIME) and over 100 other healthcare organizations sent a letter to leaders of the House and Senate Appropriations committees calling to remove a funding ban for a national patient health identifier standard.

The letter notes that outdated rider language in Section 510 of the Fiscal Year 2023 Labor, Health and Human Services, Education, and Related Agencies (Labor-HHS) Appropriations bill prohibits HHS from spending federal dollars to adopt a national unique patient identifier standard.

“For more than two decades, innovation and industry progress has been stifled due to a narrow interpretation of this language, included in Labor-HHS bills since FY1999,” the healthcare organizations wrote. “Without the ability of clinicians to correctly connect a patient with their medical record, lives have been lost and medical errors have needlessly occurred.”

Inconsistency in patient identification also leads to financial burdens for patients, clinicians, and healthcare organizations. The letter cited a 2021 Blackbook report that revealed errors from inaccurate patient identification cost the average hospital $2.5 million and the healthcare system over $6.7 billion annually.

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https://healthitsecurity.com/news/hc3-ransomware-groups-leveraged-remote-access-encryption-tools-in-q1

HC3: Ransomware Groups Leveraged Remote Access, Encryption Tools in Q1

HC3 observed ransomware groups increasingly leveraging legitimate tools such as file transfer and remote access to target organizations in Q1.

By Jill McKeon

May 09, 2022 - The Health Sector Cybersecurity Coordination Center (HC3) observed ransomware groups increasingly turning to legitimate tools such as Cobalt Strike and Mimikatz during ransomware intrusions in the first quarter of 2022.

HC3 saw threat actors favoring file transfer, remote access, and encryption tools to infiltrate target organizations. In addition, experts noted Initial Access Brokers (IABs) consistently selling healthcare entity network access on various cybercriminal forums throughout Q1 at similar rates to 2021.

“IABs enable RaaS groups to focus time and energy on developing payloads and coordinating operations with affiliates,” HC3 stated.

More than half of the forum advertisements were for general VPN and RDP access to healthcare organizations. HC3 noted that the pandemic drove healthcare organizations to increase adoption of cloud and remote access applications without implementing complementary security features, making them easier targets.

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https://www.spokesman.com/stories/2022/may/08/vital-computer-system-has-gone-down-more-than-50-t/

Vital computer system has gone down more than 50 times since launching in Spokane, VA confirms

Sun., May 8, 2022

By Orion Donovan-Smith

orionds@spokesman.com (202) 853-2524

WASHINGTON – An electronic health record system being piloted at Spokane’s VA hospital and other sites in the Inland Northwest has been partly or completely unusable at least 50 times since its launch in 2020, the Department of Veterans Affairs confirmed.

The computer system, which health care workers rely on to track patient information and coordinate care, saw a total of 42 “unplanned degradations” and eight “unplanned outages” between its launch in 2020 and April 20, 2022, VA spokesman Randal Noller said in an emailed response to questions from The Spokesman-Review. Two more outages occurred April 25 and 26, VA officials told a congressional panel at the time, for a total of 52 incidents.

The system, which launched at Spokane’s Mann-Grandstaff VA Medical Center in October 2020, is being developed under a $10 billion contract awarded to Cerner Corporation in 2018, without the competitive bidding process that applies to most federal contracts of that size. The VA Office of Inspector General has estimated the planned 10-year effort, which is behind schedule, will cost as much as $21 billion and another $2 billion for each additional year it takes to finish.

In the email, Noller emphasized that most of the incidents were not “large-scale outages,” such as one in early April that affected VA as well as the Department of Defense and the Coast Guard, which also use the Cerner system. Many of the “degradations of service,” he said, affected only some of the users at Mann-Grandstaff and its affiliated clinics in Spokane, Coeur d’Alene, Sandpoint, Wenatchee and Libby, Montana.

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https://www.healthcareitnews.com/blog/integration-imperative-achieving-future-vision-healthcare

The integration imperative: achieving a future vision for healthcare

Too often, people think narrowly about integration, viewing it only in terms of making sure one system can talk to another. It must be far more than that.

By Kevin Vigilante

May 09, 2022 10:48 AM

Dr. Kevin Vigilante is chief medical officer at Booz Allen Hamilton. This article was co-written with Angela Jones, program manager in digital health transformation at Booz Allen Hamilton.

In our last article, we noted that many health systems and federal health agencies have been understandably preoccupied with addressing the immediate priorities of the COVID-19 pandemic by accelerating their adoption of telehealth capabilities to circumvent physical, in-person care limitations. 

We encouraged healthcare organizations to broaden their view of how today's technological advances – not only in telehealth, but also data analytics, digital sensor technologies, 5G networks, artificial intelligence and machine learning, genomic medicine, and elsewhere – can transform healthcare as we know it.

With the right mindset and planning, these fast-evolving capabilities can transform the facility-based, episodic care models of today into new care-delivery paradigms that are patient-centered, data-driven, predictive, proactive, personalized and lower cost.

This vision of future healthcare will look differently from one health system or agency to the next due to their varying missions and constituencies. But an indispensable key to success is that healthcare organizations employ integration as a defining strategic pillar of their modernization approach.

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https://www.healthcareitnews.com/news/social-determinants-health-may-help-predict-sepsis-readmission

Social determinants of health may help predict sepsis readmission

Researchers from the University of California, San Diego found that factors such as lack of insurance, economic instability and poor transportation to obtain care were associated with a 30-day readmission.

By Kat Jercich

May 09, 2022 10:47 AM

Including social determinants of health in sepsis readmission models could improve their predictive ability, a new study shows.  

For the study, published this past week in the Journal of American Medical Informatics Association, University of California, San Diego researchers used data from the National Institutes of Health's All of Us research program cohort.  

They found that including various social determinants of health improved the model's ability to predict which sepsis patients are at risk of an unplanned 30-day readmission.  

"Our results highlight the importance of [social determinants of health] in identifying which patients may benefit from additional resources around the time of discharge, or post-discharge, to prevent 30-day readmissions," wrote the researchers.  

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https://www.healthleadersmedia.com/innovation/new-digital-health-research-focuses-gas-emissions

New Digital Health Research Focuses on Gas Emissions

Analysis  |  By Eric Wicklund  |   May 09, 2022

Researchers at The Ohio State University are developing digital health technology that can track one's health through a small device worn on the ear or finger by measuring small amounts of gas emitted through the skin.

The next generation of digital health wearable might focus on body gases.

Fart and BO jokes aside, researchers at The Ohio State University are working on skin sensors that detect gaseous acetone leaving the skin. Those emissions could contain biomarkers for a wide range of health issues, including diabetes and heart disease.

“Discerning health issues through the skin is really the ultimate frontier,” Pelagia-Iren Gouma, a member of the research team and professor of materials science and engineering at OSU, said in a press release issued by the university. “The project still has a couple of years to go. But in six months, we should have proof of concept and in a year, we’d like to have it tested in people.”

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Enjoy!

David.

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