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, August 13, 2022

Weekly Overseas Health IT Links – 13th August 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/va-appoints-functional-champion-for-ehr-modernization-program

VA Appoints Functional Champion for EHR Modernization Program

The new functional champion appointment will assist the VA EHR Modernization program as it struggles with implementation delays and cost overruns, the VA stated.

By Sarai Rodriguez

August 05, 2022 - The Department for Veterans Affairs (VA) has named David Massaro, MD, as a functional champion for its EHR Modernization program, according to reporting from FedScoop.

The industry leader started off his VA career in 2006 as a practicing physician for the Aleda E. Lutz VA Medical Center in Saginaw, Michigan.

As time went on, Massaro accepted new challenges and took on more executive positions, VA officials stated. Previously, he was the acting chief health informatics officer in the Office of Community Care within VA’s Office of Health Informatics.

Under this new role as EHRM functional champion, Massaro will be coordinating the development and implementation of the modernization program across VA offices.

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https://healthitsecurity.com/news/assessing-the-risk-of-poorly-configured-internet-exposed-protocols

Assessing the Risk of Poorly Configured, Internet-Exposed Protocols

A new report sheds light on internet-exposed protocols and provides best practices for mitigating risk.

By Jill McKeon

August 05, 2022 - In the Cybersecurity and Infrastructure Security Agency’s (CISA) “Shields Up” notice following Russia’s invasion of Ukraine, the agency recommended that organizations go back to basics by establishling secure passwords, patching vulnerabilities, and properly securing internet-exposed protocols to avoid exposing data.

In its latest report, inspired by CISA’s notice, cybersecurity company ExtraHop narrowed in on internet-exposed protocols and explored the risks of unsecured ports and protocols, providing tips for mitigating risk along the way.

ExtraHop conducted a survey of thousands of organizations across multiple sectors, including healthcare, and analyzed specific protocols (including older, unsupported versions) that were found active on networks. Researchers used the findings to benchmark cyber risk and readiness for a variety of industries.

It is important to note that internet-exposed protocols are not inherently bad, and some are public by design. ExtraHop noted that a small number of exposed devices and protocols are typically needed in order to maintain business functionality. However, poor configuration can open organizations up to security risks.

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https://www.digitalhealth.net/2022/08/nhs-england-launches-remote-monitoring-initiative-for-heart-failure/

NHS England launches remote monitoring initiative for heart failure

NHS England has launched a new initiative to support heart failure patients with the tools and expertise they need to remotely monitor their condition at home.

Cora Lydon – 1 August, 2022

The Managing Heart Failure @ Home initiative minimises face-to-face appointments for these patients and reduces unavoidable hospital stays and readmissions.

In a blog post, Professor Nick Linker, national clinical director for heart disease at NHS England, wrote: “This approach is about enabling heart failure services to work in the most efficient way possible.”

Managing Heart Failure @ Home was launched to professionals earlier this month. NHS England is now looking for teams who are interested to become early adopters of the scheme. Those who come on board will have the opportunity to trial the home-care system, and improve the care they offer their patients.

Professor Linker added: “Managing Heart Failure @home is working with professionals to support people to manage their own health and to stay well at home, using remote monitoring, supported self-management and education. This can minimise unnecessary face-to-face appointments and reduce avoidable hospital admissions and readmissions.

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https://www.digitalhealth.net/2022/08/advanced-major-outage/

Major outage of multiple health and care systems provided by Advanced

A number of health and care systems delivered by business software and services provider Advanced are currently experiencing major outages.

Jordon Sollof 4 August 2022

According to Digital Health Intelligence, Advanced has 36 NHS clients, supplying services to thousands of healthcare professionals. Furthermore the company’s Adastra software works with 85% of NHS 111 services.

The following systems which currently have major outages are:

  • Adastra – a clinical patient management software that impacts around 40 million patients
  • Caresys – a care home management software that helps over 1,000 care organisations
  • Carenotes – an electronic patient record software used by over 40,000 clinicians
  • Crosscare – a clinical management system for hospices and private practice used by over 70 adult and children’s hospices across the UK
  • Staffplan – a care management software that helps over 1,000 care organisations

All outages are being treated as ‘critical incidents’ and with the ‘highest priority’ whilst under investigation.

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https://www.vox.com/future-perfect/2022/8/3/23288843/deepmind-alphafold-artificial-intelligence-biology-drugs-medicine-demis-hassabis

Finally, an answer to the question: AI — what is it good for?

Got a protein? This AI will tell you what it looks like.

Finding the best ways to do good.

That headline might seem a bit churlish, given the tremendous amount of energy, investment, and hype in the AI space, as well as undeniable evidence of technological progress. After all, AI today can beat any human in games ranging from chess to Starcraft (DeepMind’s AlphaZero and AlphaStar); it can write a B- college history essay in seconds with a few prompts (OpenAI’s GPT-3); it can draw on-demand illustrations of surprising creativity and quality (OpenAI’s DALL-E 2).

For AI proponents like Sam Altman, OpenAI’s CEO, these advances herald an era where “AI creative tools are going to be the biggest impact on creative work flows since the computer itself,” as he tweeted last month. That may turn out to be true. But in the here and now, I’m still left somewhat underwhelmed.

Not by what these AI tools can do, exactly. Typing a short prompt into DALL-E 2 and getting back, say, “a medieval painting where the wifi isn’t working” feels close to magic. Still, human beings can write essays and human beings can draw illustrations, and while GPT-3 and DALL-E 2 can do those tasks faster, they can’t really do them better. They’re superhuman in velocity, not quality. (The exception in the above group is DeepMind’s game-playing model, which really is superhuman — just ask poor defeated Go master Lee Se-dol — but until those AI skills can be employed in the much more complex real world, it’s mostly an interesting research project.)

So AI can be fascinating and cool and even be a little bit scary, but what it isn’t yet is truly able to play a vital role in solving important problems — something that can be seen in the fact that all of these advances have yet to boost America’s sluggish productivity numbers.

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https://www.healthcareitnews.com/news/how-consumer-app-api-rule-cures-act-will-push-interoperability-0

How the consumer app API rule of the Cures Act will push interoperability

An expert from LexisNexis Risk Solutions offers a closer look at a policy that could make a big difference in enabling more widespread and seamless data exchange.

By Bill Siwicki

August 05, 2022 12:00 PM

The 21st Century Cures Act, signed in 2016, covers various components of healthcare, including modernizing the FDA approval process. Another part of the law deals with interoperability.

While HIPAA was designed to safeguard data, the portability component of the HIPAA mandate became a huge issue. There was no standardized format or means to make moving data from one place to another possible, and data holders like EHR vendors believed they owned patient data.

With the 21st Century Cures Act, policymakers now have said no, health data belongs to individuals, and there needs to be an easy means for them to access it.

The Cures Act sought to make some fundamental rules around this for interoperability. Lawmakers thought there needed to be a very specific, well-articulated means by which data is moved from where it is held to where it needs to go.

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https://ehrintelligence.com/news/oracle-can-get-va-ehr-project-back-on-track-exec-assures-lawmakers

Oracle Can Get VA EHR Project’ Back on Track,’ Exec Assures Lawmakers

A top Oracle executive told legislators that moving the Cerner VA EHR to a cloud data center will improve system reliability.

By Hannah Nelson

August 04, 2022 - Mike Sicilia, executive vice president of Oracle, promised to get the Department of Veterans Affairs (VA) EHR modernization (EHRM) project "back on track" at a recent House Committee on Veterans' Affairs hearing.

Since VA granted EHR vendor Cerner a $16 billion contract in 2018, the IT project has entailed a series of delays, inaccurate cost estimates, and system issues.

However, the Oracle executive said that the company's recent acquisition of Cerner will fix the problem-riddled VA system, the Oracle executive said.

"The VA rollout is clearly behind schedule, below expectations, and on the same course as so many other programs that go over budget," Sicilia said. "But let me also say that with Oracle's acquisition of Cerner, we believe we can get back on track, exceed expectations, and keep our costs in line."

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https://healthitanalytics.com/news/experts-propose-quality-measures-for-veterans-at-high-risk-for-adverse-outcomes

Experts Propose Quality Measures for Veterans at High Risk for Adverse Outcomes

An expert panel assessment identified clinical activities that can be developed into quality measures to improve care for patients at risk of adverse outcomes in the Veterans Health Administration.

By Shania Kennedy

August 04, 2022 - In a consensus statement published this week in JAMA Network Open, a panel of 14 health experts and veterans identified what quality measure concepts are important to improve care for veterans at high risk of adverse outcomes in the Veterans Health Administration (VHA).

Veterans’ health is a major population health issue, and significant research is being conducted to help improve veterans’ health outcomes, including efforts to use AI and data analytics to enhance PTSD treatment and bolster access to opioid use disorder treatment through telehealth. However, patient safety is also a top concern for healthcare professionals and advocates in the veterans’ health space.

According to the consensus statement, there is no guidance on what constitutes measurable, high-quality care for veterans with complex health needs, who are most at-risk for adverse outcomes like hospitalization or death. The experts posit that such measures would need to be relevant across multiple disease states and chronic conditions, and identifying such measures can help providers and health systems better design and report on quality improvement efforts.

To identify potential quality measures, the panel extracted 519 relevant concepts for quality measure development in three categories: assessment, management, and other features of healthcare. Measures were extracted from a systematic review of scientific literature that suggested, evaluated, or used indicators of quality care for patients at high risk of adverse outcomes.

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https://mhealthintelligence.com/news/18-health-systems-collaborate-to-develop-hospital-at-home-tools

18 Health Systems Collaborate to Develop Hospital-at-Home Tools

Ariadne Labs and CaroNova brought the health systems together to develop tools to help providers set up and enhance hospital-at-home programs. 

By Mark Melchionna

August 04, 2022 - Eighteen health systems participated in the first phase of the Home Hospital Early Adopters Accelerator, a program created by Adriadne Labs in collaboration with CaroNova to help providers develop home hospital tools.

The number of hospitals providing at-home acute care has shot up in recent years. The primary reason for this is the addition of the Centers for Medicare and Medicaid Services' Acute Hospital Care at Home waiver to the Hospital Without Walls initiative in November 2020. More than 100 health systems spanning 36 states are currently approved for the program.  

The 40-week accelerator program included 91 representatives from 18 health systems in the US and South Africa. Some US-based health systems that participated were CaroMont Health, Cape Fear Valley, H. Lee Moffitt Cancer Center & Research Institute, UNC Health, Vanderbilt University Medical Center, and Novant Health. 

Together, they created a set of 20 tools to support home hospital programs, including criteria for identifying patients who are eligible for home hospital services and workflows for admissions, IV medications, and potential escalation of care. The group also developed solutions for food services and oxygen use.

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https://ehrintelligence.com/news/how-ecr-can-cut-clinician-burden-advance-public-health-surveillance

How eCR Can Cut Clinician Burden, Advance Public Health Surveillance

Electronic case reporting (eCR) has helped the Minnesota Department of Health (MDH) decrease clinician burden throughout COVID-19.  

By Hannah Nelson

August 03, 2022 - The implementation of electronic case reporting (eCR) at the Minnesota Department of Health (MDH) has helped improve data accuracy for public health surveillance while cutting clinician burden, according to a study published in JAMIA.

Electronic case reporting (eCR) is the automated generation and transmission of case reports from EHRs to public health agencies.

The researchers explained that MDH took an “incremental approach to enhancement,” which allowed the agency to begin receiving electronic initial case reports (EICRs) for COVID-19 surveillance as the agency expanded its system and staff bandwidth.

The authors noted that switching to eCR has decreased the clinician burden of paper-based reporting while also improving inefficiencies and inaccuracies from phone/fax data entry.

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https://healthitanalytics.com/news/md-health-system-launches-ai-driven-collab-to-tackle-clinician-burnout

MD Health System Launches AI-Driven Collab to Tackle Clinician Burnout

Maryland-based TidalHealth has entered into an artificial intelligence-driven partnership to reduce provider burnout and enhance patient safety.

By Shania Kennedy

August 03, 2022 - Maryland-based TidalHealth and artificial intelligence (AI) software company Regard have launched a collaboration designed to increase patient diagnosis accuracy, reduce clinician burnout, and enhance revenue through improved documentation.

TidalHealth will implement Regard’s software across its network in Maryland and Delaware to optimize practitioners’ workflows. The software, which uses AI to help physicians diagnose medical conditions, is intended to help TidalHealth clinicians automate EHR chart reviews and enhance patient safety by ensuring all diagnoses are identified.

Regard’s algorithms aggregate and mine the patient's medical history through their EHR, decreasing room for diagnostic error and optimizing billing, according to the press release. By enhancing these processes, the software has the potential to help TidalHealth improve the overall quality of care and allow for accurate hospital reimbursement.

Regard states that its software can identify approximately 50 of the most common medical conditions and has been used on over 40,000 patients.  

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https://mhealthintelligence.com/news/medicare-remote-patient-monitoring-use-shot-up-during-pandemic

Medicare Remote Patient Monitoring Use Shot Up During Pandemic

A recent study showed that during the COVID-19 pandemic, there was a 555 percent increase in the use of remote patient monitoring among Medicare beneficiaries.

By Mark Melchionna

August 03, 2022 - A study published in JAMA Internal Medicine found a substantial increase in the use of remote patient monitoring (RPM) services within the Medicare population amid the COVID-19 pandemic, which could lead to a rise in costs if usage continues to increase at the same rate.

Following the expansion of RPM coverage in Medicare in 2019, questions regarding its efficacy and use have arisen. To determine how RPM trends varied before and during the COVID-19 pandemic, researchers reviewed Medicare RPM claims data from Jan. 1, 2018, to Sept. 30, 2021.

Researchers used monthly claims volume per 100,000 enrollees to measure general RPM use. They found that the number of claims per 100,000 enrollees reached 594 in September 2021, significantly higher than the 91 claims per 100,000 enrollees in February 2020. This represents a 555 percent increase. 

Researchers also examined the use of continuous glucose monitoring (CGM). There was a 42 percent increase per 100,000 enrollees in claims related to CGM use.

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https://patientengagementhit.com/news/cms-preserves-patient-safety-data-reporting-in-ipps-final-rule

CMS Preserves Patient Safety Data Reporting in IPPS Final Rule

The move to keep patient safety data reporting as part of the IPPS final rule comes after months of lobbying from patient safety advocacy groups.

By Sara Heath

August 03, 2022 - The Centers for Medicare and Medicaid Services (CMS) has codified patient safety reporting as part of its Inpatient Prospective Payment System final rule for 2023, a move that’s being lauded by patient safety advocate groups nationwide.

In the IPPS proposed rule, the agency pitched a pause in patient safety reporting. The proposed rule stated that CMS would not calculate and therefore not publicly report data for the PSI-90 measure, which looks at certain patient safety events like pressure sores, falls, and sepsis.

“CMS’ proposal reflected concerns about the impact COVID-19 would have on the ability to interpret data and was also sensitive to the risks of financially penalizing hospitals for factors potentially out of their control,” the agency explained of its proposal.

That proposal was panned by patient safety advocates, who said public reporting of patient safety events on the Care Compare website arms patients and their caregivers with the information necessary to make a care access decision. Patient safety is essential for clinical quality outcomes and a positive patient experience, and patients have a right to access publicly available patient safety data, advocates like The Leapfrog Group warned in comments letters.

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https://www.fiercebiotech.com/medtech/resmed-continues-german-expansion-acquisition-mementors-insomnia-digital-therapeutic

ResMed continues German expansion with acquisition of Mementor's insomnia digital therapeutic

By Andrea Park

Aug 2, 2022 01:00pm

With the pedal firmly to the metal in its U.S. business—thanks in no small part to rival CPAP machine maker Philips’ ongoing recall—ResMed has begun looking beyond its home turf to extend that winning streak.

Its first target? Germany, where the San Diego-based company has said "guten tag" to a pair of local tech developers to give its growth plan a boost.

It made the first move in mid-June with the $1 billion acquisition of Medifox Dan, a software developer based in Hildesheim, Germany, with offerings that help medical facilities manage their patients and practices as well as train and educate both professional and family caregivers.

Now, ResMed is opening up its wallet once again, this time to buy out Mementor, a Leipzig-based company that’s building digital therapeutics with a focus on sleep medicine. Its flagship product is Somnio, a prescription-only app designed to help treat insomnia.

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https://www.healthdatamanagement.com/articles/a-new-continuum-of-care-right-care-right-place-right-time?id=130765

A new continuum of care: Right care, right place, right time

A thoughtful, deliberate, inclusive approach to telehealth – grounded in comprehensive virtual care – is needed.

Aug 03 2022


Matthew Fisher

General counsel, Carium

Two questions continue to be debated within healthcare: What is the best way for care to be delivered? And how can patients and care teams best engage with each other?

Answers to these questions have typically centered on care delivered in a clinician’s office, hospital or other institutional setting. However, within that delivery model, there wasn't much regard to what was happening within the regular course of an individual’s life, despite the fact that "regular life" might have a significant impact on an individual’s health.

Today, this limited view is undergoing a significant transformation with new means of interaction gaining prominence, causing a serious re-evaluation of how to best deliver care. Answers to the questions above are deepening and broadening, particularly in light of the adoption and effectiveness of virtual care delivery during the ongoing global pandemic.

Explosion of telehealth

Before the onset of COVID-19, healthcare was primarily reliant on in-person, episodic interactions for gathering information and disseminating advice. But that method of delivery quickly eroded due to protective measures necessitated by the pandemic. Telehealth adoption accelerated seemingly overnight. Physicians and clinical care teams quickly pivoted, relying on the full-scale use of technology for patient interactions to provide even the most basic forms of care.

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https://www.healthcareitnews.com/news/how-health-it-can-advance-health-equity-transgender-and-nonbinary-patients

How health IT can advance health equity for transgender and nonbinary patients

Leaders from athenahealth and epocrates discuss features in their EHR and decision-support app designed to make healthcare more welcoming.

By Bill Siwicki

August 03, 2022 09:42 AM

The Biden Administration recently issued an executive order advancing LGBTQ+ health equity.

Health IT experts contend that technology can advance health equity for the transgender patient population, as this group has traditionally been marginalized by the healthcare industry. In fact, evidence shows transgender people experience much higher rates of chronic health conditions compared with the general population – and discrimination and stigma impacts their physical and mental health.

To that end, athenahealth, a vendor of cloud-based enterprise software – including EHRs – for medical groups and health systems, and epocrates, an athenahealth company that serves essential clinical content to more than 1 million physicians, nurses, pharmacists and other healthcare professionals, are taking steps to empower clinicians and health systems to better serve transgender patients.

For example, athenahealth recently introduced a new capability to its EHR that allows providers to record and display important information in a patient's chart, including pronouns, name used (plus legal name) and gender identity (plus gender assigned at birth). Further, epocrates recently introduced a new clinical guidance that gives clinicians access to the latest transgender care guidance at the point of care.

Allyson Livingstone is executive director of diversity and inclusion at athenahealth. Dr. Acey Albert is director of clinical content at epocrates.

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https://www.healthcareittoday.com/2022/08/03/the-next-evolution-of-digital-health-welcome-to-the-med-averse/

The Next Evolution of Digital Health – Welcome to the ‘Med-averse’

August 3, 2022

The following is a guest article by Sheetal Chawla, VP and Head of Life Sciences at Capgemini Americas.

The promise of innovation and efficiency in the new era of medicine could change patient experiences forever

The metaverse is one of the biggest technological breakthroughs of the modern era – on par with the invention of the smartphone. One after another, industries have begun assessing how the promise of the metaverse can advance innovations and usher in progress within any given field. 

One industry with massive potential is healthcare. The concept of the metaverse – or ‘med-averse’ as some have coined it – is puzzling when thought of in conjunction with healthcare. Given the extensive physical nature of a doctor and patient interaction, the question remains how practices such as micro-surgery and physical exams will take place in an entirely digital forum. The short answer is that the extent of the capabilities for the healthcare industry within the metaverse is still vastly unknown. 

However, even if the future of healthcare in the metaverse does not involve digital surgery and hands-on medical procedures, there are still numerous possibilities for improving medical research and patient experiences. And while the jury is still out on the future potential of applications for healthcare in the metaverse, the industry is already making use of several real-world capabilities.

Accelerating research for new procedures and drug discovery

Medical research is constantly evolving. The development and certification of new procedures, devices and medicines is a lengthy process in which approvals and rigorous testing can go on for years. And while it may not be clear what the impact of the metaverse on physical medicine will be, it has already been proven that evidence-based medicine can be improved by this technology. 

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https://ehrintelligence.com/news/hl7-launches-genomex-community-to-enhance-genomic-data-interoperability

HL7 Launches GenomeX Community to Enhance Genomic Data Interoperability

HL7 seeks members to help develop scalable FHIR-based use cases for genomic data interoperability to support personalized care delivery.

By Hannah Nelson

August 02, 2022 - Health Level Seven International (HL7) and the HL7 FHIR Accelerator CodeX have announced GenomeX, a new foundational domain dedicated to advancing genomic data interoperability.

Leveraging a patient’s genomic information can help physicians proactively and more precisely treat health conditions.

“We are excited that CodeX is broadening its efforts beyond oncology to include genomics, a fast-growing area of healthcare that will increasingly improve patient care,” said Steve Bratt, CodeX program manager.

Building on the progress of the HL7 Clinical Genomics Work Group, including its FHIR Genomics Implementation Guide, CodeX’s GenomeX community will design scalable pilots that use FHIR Genomics for multiple use cases.

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https://ehrintelligence.com/news/carequality-interoperability-framework-oks-federal-participation

Carequality Interoperability Framework OKs Federal Participation

Allowing federal agencies to participate in the Carequality Interoperability Framework is expected to expand data exchange between the private sector and government agencies.

By Sarai Rodriguez

August 02, 2022 - The Carequality Interoperability Framework has expanded its policy agreements to enable the participation of federal government agencies.

The nonprofit organization said that by extending participation to federal agencies, the framework can further patient data exchange across the private and public sectors.

“The Carequality Interoperability Framework is a living, evolving framework for health information exchange across networks, technologies, geographies, and now private sector-government boundaries,” Alan Swenson, executive director of Carequality, said in a press release.

“The more we can accommodate each and every type of organization and care setting that need access to electronic health information, the closer we get to the vision of true nationwide health data sharing. Federal agencies are a critical part of ensuring this vision.”

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https://healthitanalytics.com/news/researchers-propose-framework-to-ensure-equitable-healthcare-algorithms

Researchers Propose Framework to Ensure Equitable Healthcare Algorithms

Rand Corp. researchers argue that including race and ethnicity information, rather than removing it, is key to eliminating algorithmic bias.

By Shania Kennedy

August 02, 2022 - In new commentary published in Health Affairs, researchers from the Rand Corporation posit that having knowledge of race and ethnicity, and including that data in healthcare algorithms, is necessary to combat algorithmic bias effectively, rather than taking a “race-blind” approach.

The authors further argue that when race and ethnicity are taken into account, various methodological approaches can be used ensure equitable algorithmic performance. When these data are unavailable, imputing them can enhance opportunities to identify, assess, and combat algorithmic bias in clinical and nonclinical settings, they said.

To illustrate their points, the authors describe two applications in which the imputation of race and ethnicity data has the potential to reduce algorithmic bias: equitable disease screening algorithms using machine learning and equitable pay-for-performance incentives.

Currently, there is significant research emphasis on leveraging “big data” from EHRs to develop machine-learning (ML) algorithms that support clinical decision-making. Many of these algorithms are designed to detect or predict medical conditions and outcomes, such as sepsis-related mortality, pancreatic cancer, and postpartum hemorrhage.

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https://healthitsecurity.com/news/addressing-mobile-device-security-risks-in-healthcare

Addressing Mobile Device Security Risks in Healthcare

Nearly half of surveyed healthcare organizations that suffered a mobile-related security breach said that device-based threats were a contributing factor, Verizon found.

By Jill McKeon

August 02, 2022 - Mobile device security risks have become a more prominent threat along with the rise of remote work. In fact, nearly half of more than 600 security professionals surveyed by Verizon in its new Mobile Security Index (MSI) report said that their organizations had suffered a compromise involving a mobile device in the past 12 months.  

Almost 80 percent of respondents across all industries agreed that recent changes in working practices had negatively impacted their organization’s cybersecurity. In addition, 58 percent of respondents said that their organizations had more users using mobile devices than 12 months ago.

“With the volume of devices a modern enterprise relies on, keeping them all up to date can seem like a Sisyphean task,” the report noted.

“With more and more devices, the danger of lost or missing devices grows. But it’s not just the quantity of devices that’s growing, the variety is growing too. Today there are smartphones, laptops, tablets, hybrids (like Microsoft Surface), Chromebooks, wearables and a seemingly endless range of connected devices.”

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https://www.medpagetoday.com/opinion/patientcenteredmedicalhome/100002

Location Shouldn't Matter When It Comes to Healthcare

— Let's keep letting doctors virtually treat patients no matter where either of them is located

by Fred N. Pelzman, MD August 1, 2022

Sometimes when I'm doing a video visit, in my head I hear that line near the end of the movie "The Shawshank Redemption," when the brilliant actor Morgan Freeman's character Red says that for the second time in his life, he is going to commit a crime: in this case, breaking parole by crossing state lines.

Why, as we're trying to take care of our patients, should where we are at the moment, and where they are, really matter? Back in the good old days, before video visits and telehealth, when my patients went on vacation and they got sick, they would be able to call our practice, receive some medical advice, and then we would be able to send a prescription to the pharmacy located wherever they happened to be. Did they develop a urinary tract infection while on a ski trip in Utah? We can call in some antibiotics. While hiking near their house in Connecticut, they found an engorged tick embedded in the back of their leg? We can e-prescribe a prophylactic dose to nip this in the bud.

There have even been more complicated cases, where we've had patients go to local facilities for x-rays and labs, and we've participated in co-managing an acute or subacute problem along with specialists on the ground where they were. And much of this is still fair game. But longitudinal care, chronic care, preventive medicine, annual visits? No way.

As the pandemic started to heat up, we pivoted much of our care in the outpatient world -- for the most part all care that wasn't COVID-19 -- to telehealth and video visits. Due to the public health emergency, many of the rules surrounding billing for these episodes, including the concept of crossing state lines for healthcare, were put on hold. So, when our patients decamped from New York City and sheltered in place at their home in rural Pennsylvania, we were able to continue to provide them care for both their acute and chronic medical conditions.

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https://www.healthcareittoday.com/2022/08/02/telehealth-key-to-improving-patient-care-and-reducing-physician-burnout/

Telehealth: Key To Improving Patient Care and Reducing Physician Burnout

August 2, 2022

Colin Hung

As we march towards more in-home and remote care, the need for digital innovation was at an all time high. Without giving it too much credit, COVID-19 accelerated the pace of innovation in this area. It was vital to find alternate solutions to provide the care people needed. I sat down with Dr. Jan Kimpen, Chief Medical Officer at Philips to discuss the work they have been doing in this field.

At this point we are all very familiar with telehealth. However, telehealth is only useful if it is accessible. It doesn’t matter how well the hospital and your staff are prepared to deliver remote care if the patients do not have the means to access it, whether that’s due to poor service or lacking the technology necessary. And it is exactly here that Philips began their work. By partnering with West Moreton Hospitals in Australia, they were able to provide everyone in the program with iPads, wearables, and connectivity, fully cementing the remote patient to doctor pathway.

In doing so, Dr. Jan Kimpen found that by providing patients with the necessary tools to remotely communicate with their doctors, the hospital could reduce the number of emergency room visits by 50% and the number of hospitalizations by 23%. Furthermore, by using telehealth the hospital could save AU$1,000 per month for every patient that was included in the program.

Moving forward, Philips is deeply invested in digitalization. Not only in terms of remote care, but in order to optimize and expedite the workflow for the doctors. Dr. Jan is hopeful that through embracing digitalization, the burden on doctors will lessen leading to less burnout. “We want to improve the experience of patients when they have to engage with the healthcare system. We want to improve the experience of doctors in order to curtail, a little bit, this burnout trend. And in the end, that should lead to lower costs.” Dr. Jan stated. Thus giving us the perfect blend of happy patients, happy doctors, and happy payers.

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https://ehrintelligence.com/news/clinical-communication-gaps-persist-despite-ehr-adoption

Clinical Communication Gaps Persist Despite EHR Adoption

Comparing survey data from 2008 with 2019 results revealed that widespread EHR adoption has not improved clinical communication gaps between PCPs and specialists.

By Hannah Nelson

August 01, 2022 - Despite widespread EHR adoption, clinical communication gaps between primary care physicians (PCPs) and specialists persist, according to a study published in the Annals of Family Medicine.

Poor communication has been associated with delayed diagnoses, unnecessary testing, and patient and physician dissatisfaction. 

Comprehensive Primary Care Plus (CPC+) model survey data from 2008 revealed sizable gaps in communication among physicians caring for mutual patients.

Researchers compared these results to 2019 CPC+ survey measures and found that PCPs still do not consistently communicate with specialists

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https://mhealthintelligence.com/news/hhs-doj-issue-guidance-to-eliminate-telehealth-discrimination

HHS, DOJ Issue Guidance to Eliminate Telehealth Discrimination

The federal agencies' guidance provides examples of discrimination during telehealth visits and actions to ensure virtual care remains accessible to all.

By Mark Melchionna

August 01, 2022 - In honor of the Americans with Disabilities Act (ADA) anniversary, the US Department of Health and Human Services (HHS) worked with the US Department of Justice (DOJ) to publish new guidance that seeks to eliminate discrimination in the telehealth arena.

The COVID-19 pandemic has been accompanied by rapid expansions in healthcare access, particularly through the use of telehealth. Although telehealth is a valuable resource, discrimination does exist, leading to barriers to care. For example, research has shown that racial minorities, older age groups, and those living in rural areas use telehealth less frequently than their counterparts, and the digital divide further exacerbates disparities in virtual care access.

As 2022 marks 32 years since the introduction of the ADA, HHS and DOJ released guidance focused on federal nondiscrimination laws, including the ADA Section 504 of the Rehabilitation Act of 1973, Title VI of the Civil Rights Act of 1964, and Section 1557 of the Patient Protection and Affordable Care Act, and actions healthcare providers can take to ensure they are in compliance with these laws.

The guidance aims to ensure equitable care for those with disabilities, including people who are blind, deaf, or do not speak English proficiently. Blind people who seek out telehealth solutions may find that the modality does not contain screen reader software, and deaf people may have trouble engaging with an interpreter over telehealth. Those who are not fluent in English may struggle to seek and schedule an appointment. 

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https://healthitsecurity.com/news/meta-faces-another-lawsuit-over-health-data-privacy-practices

Meta Faces Another Lawsuit Over Health Data Privacy Practices

Meta is facing scrutiny over its health data privacy practices after allegedly scraping health data from hundreds of hospital websites using its Meta Pixel tracker.

By Jill McKeon

August 01, 2022 - Meta is facing another lawsuit over its health data privacy practices. As previously reported, a report co-published by The Markup and STAT alleged that Meta (the parent company of Facebook) used its Meta Pixel tracker to scrape hospital websites for health data.

The report found evidence that the Meta Pixel, a portion of JavaScript code that allows websites to track visitor activity, was being used on hundreds of hospital websites. When the tracker was present within password-protected patient portals, it allegedly sent packets of data to Facebook whenever someone clicked a button to schedule a doctor’s appointment.

Facebook allegedly received highly sensitive protected health information (PHI), including medical conditions and doctors’ names, which could all be linked to the user’s unique IP address.

According to Meta, the Meta Pixel can collect anything present in HTTP headers, button click data, form field names, and more. The Markup tested the websites of Newsweek’s top 100 hospitals in America and found the Meta Pixel on about a third of them. In fact, the Meta Pixel is present on more than 30 percent of the most popular websites, the report found.

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https://www.fiercehealthcare.com/health-tech/oracle-vows-get-vas-16b-ehr-overall-back-track-lawmakers-warn-troubled-project-could-be

Oracle vows to get VA's $16B EHR overhaul 'back on track' as lawmakers warn project could be scrapped

By Heather Landi

Aug 1, 2022 11:29am

An Oracle executive vowed to get the Veterans Affairs' troubled health IT project "back on track" as House lawmakers warned they would consider scuttling the multi-billion-dollar project unless officials show progress in the coming months.

The VA's beleaguered $16 billion technology project has been plagued by delays, leadership turnover, and infrastructure problems since it kicked off in 2018. The VA signed a $10 billion deal with health IT company Cerner in May 2018 to move from the VA’s customized VistA platform to an off-the-shelf EHR to align the country’s largest health system with the Department of Defense (DOD), which has already started integrating Cerner’s MHS Genesis system.

The cost of the project has since ballooned by several billions of dollars and the cost may still rise.

Testifying before a House Committee on Veterans’ Affairs Subcommittee on Technology Modernization last week, Mike Sicilia, executive vice president of Oracle Industries, took the first steps to assuage lawmakers' mounting concerns about the project and assure them that the database giant has the tech muscle necessary to right the ship.

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https://www.fiercehealthcare.com/health-tech/gvs-newest-general-partner-psychiatrist-and-investor-wants-place-big-bets-healthcare

GV’s newest general partner, a psychiatrist and investor, wants to place ‘big bets’ in healthcare

By Heather Landi

Jul 28, 2022 11:00am

Spun out of Google in 2009, GV has placed big wagers on the future of healthcare and life sciences innovation. Health tech and life sciences startups now make up a third of GV’s portfolio and the venture capital firm has backed some of the more recognizable names in the space—One Medical, Flatiron Health, Grail and 23andMe.

Backed by Alphabet, GV, formerly Google Ventures, has deployed $1.3 billion into healthcare and life science companies since 2020.

As a psychiatrist and investor, Ben Robbins sees opportunities to use GV’s deep pockets and Google’s tech capabilities to tackle some of the most entrenched problems in healthcare. The VC firms focused on the intersection of technology and services.

“This is a group of people that are super interested in using the hammer of VC as a tool to improve the way care is delivered for patients and providers at a scale that I think is harder to achieve within a single institution,” Robbins said in an exclusive interview.

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https://ehrintelligence.com/news/is-physician-ehr-use-a-detriment-to-the-patient-experience

Is Physician EHR Use a Detriment to the Patient Experience?

Two-thirds of physicians reported that EHR use negatively impacted patient experience, but patients felt differently, with 91 percent of patients saying physician EHR use had a positive impact.

By Sarai Rodriguez

July 27, 2022 - EHRs are supposed to improve the care experience for providers and patients. However, both groups have contrasting attitudes towards physician EHR use and its impact on the patient experience, a recent study published in Annals of Family Medicine found.

The EHR is intended to promote safe, efficient, and high-quality medical care, the researchers wrote. Yet, it has been previously described as a “third person” in the examination room. During clinical encounters, EHR use can change a healthcare practitioner’s eye gaze, posture, and attention given to patients.

“Entering health information, placing electronic orders, and retrieving results can be distracting to patients and practitioners,” Ellen C Meltzer, lead study author and internal medicine specialist at Mayo Clinic-Phoenix, and colleagues wrote. “When practitioners focus on their computer, dialog is easily disrupted and can lead to gaps in communication and patients feeling unheard.”

The survey of nearly 60 clinicians and 1,000 patients evaluated the impact EHR use has during face-to-face visits in the primary care setting. 

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https://www.mobihealthnews.com/news/qa-why-mental-health-chatbots-need-strict-safety-guardrails

Q&A: Why mental health chatbots need strict safety guardrails

By Emily Olsen

July 29, 2022 10:25 am

Mental health continues to be a leading clinical focus for digital health investors. There's plenty of competition in the space, but it's still a big challenge for the healthcare system: Many Americans live in areas with a shortage of mental health professionals, limiting access to care.

Wysa, maker of an AI-backed chatbot that aims to help users work though concerns like anxiety, stress and low mood, recently announced a $20 million Series B funding raise, not long after the startup received FDA Breakthrough Device Designation to use its tool to help adults with chronic musculoskeletal pain.

Ramakant Vempati, the company's cofounder and president, sat down with MobiHealthNews to discuss how the chatbot works, the guardrails Wysa uses to monitor safety and quality, and what's next after its latest funding round.

MobiHealthNews: Why do you think a chatbot is a useful tool for anxiety and stress? 

Ramakant Vempati: Accessibility has a lot to do with it. Early on in Wysa's journey, we received feedback from one housewife who said, "Look, I love this solution because I was sitting with my family in front of the television, and I did an entire session of CBT [cognitive behavioral therapy], and no one had to know." 

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https://www.tennessean.com/story/opinion/2022/08/01/state-americas-health-care-relies-entrepreneurship-via-telehealth/10199330002/

Telehealth entrepreneurship can address many concerns about the future of health care | Opinion

Entrepreneurs are partnering with industry leaders to tackle issues and contribute to improved access and health equity for all - regardless of location - utilizing technology and advanced analytics to provide personalized care through telehealth.

Eric Thrailkill

Guest Columnist

·         Eric Thrailkill is a healthcare industry expert and Chairman of the Nashville Entrepreneur Center Project Healthcare program.

In 2020, at the start of the pandemic, health systems, and solution providers, almost overnight, deployed telehealth solutions in response to the public health emergency, contributing to satisfying the supply and demand for care.

A Health & Human Services report detailed a 63-fold increase in the use of telehealth by Medicare beneficiaries, from 840,000 annual encounters in 2019 to approximately 52.7 million encounters in 2020. Two years later we continue to see telehealth solutions contribute significantly to the healthcare industry. 

The initiatives during the pandemic contributed immensely to patients' healthcare needs. But many challenges remain as the healthcare industry looks beyond the public health emergency to adopt patient-centric models of care. Those challenges include technology costs and implementation, security risks, regulatory concerns, and much more. 

It's clear that telehealth is not a 'COVID-19 novelty'  

At the Nashville Entrepreneur Center (EC), through its Project Healthcare, entrepreneurs are making significant contributions to an industry reeling from pandemic exhaustion, workforce challenges, inflation concerns, and recession forecasts. 

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https://www.pymnts.com/healthcare/2022/telehealth-tech-at-crossroads-as-in-office-visits-resume/

Telehealth Tech at Crossroads as In-Office Visits Resume

PYMNTS

Telehealth continues seeking its new level in the post-pandemic treatment mix as the technology transitions to a more permanent and settled role in healthcare.

With the use of telehealth visits having stabilized in late 2021 at roughly 38 times pre-pandemic levels according to widely published reports, nonprofit health data FAIR Health’s latest Monthly Telehealth Regional Tracker found that telehealth utilization “fell nationally for the second straight month” in March, following a downward trend that began in early 2022.

FAIR said the drop-off in telehealth this year is “likely due to continuing reduction in the reported number and severity of COVID-19 infections, which may have led more patients to return to in-person healthcare services.”

With more patients eager for in-person doctor appointments after two years of heavy reliance on telehealth visits, the technology is at a crossroads, having proved its utility and now being assessed for its applications in chronic care as opposed to acute treatments like COVID.

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Enjoy!

David.

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