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 20, 2022

Weekly Overseas Health IT Links –20th 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://www.digitalhealth.net/2022/08/ai-predictive-trial-staffordshire-hn-reduce-ae-admissions/

AI predictive trial in Staffordshire reduces A&E admissions by 35%

A trial which looked at how existing patient data could be used to predict those most likely to need hospital care has led to a 35% reduction on average in A&E attendances across Staffordshire.

Jordon Sollof - 11 August 2022

The aim of the trial was to look at how existing patient data could be used to predict those most likely to attend A&E or need hospital care in the near future and intervene with targeted clinical coaching to reduce their dependence on A&E and GP services.

The project was led by Dr Paddy Hannigan, chair of the Stafford and Surround Clinical Commissioning Group (CCG) and clinical lead for Staffordshire & Stoke-on-Trent Integrated Care System (ICS) digital programme, who launched the trial with two of the six CCGs and three acute hospitals in 2016.

When the trial first began, CCGs were firmly the statutory organisations in place, however, in July 2022 they were dissolved to make way for ICSs following the Royal Assent of the Health and Care Bill.

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https://www.digitalhealth.net/2022/08/northern-care-alliance-it-disruption-serious-incident/

Northern Care Alliance IT disruption resulted in one serious incident

IT disruption at the Northern Care Alliance NHS Foundation Trust resulted in one serious incident which involved incorrect information about a patient being sent to a coroner, a report to the trust’s board has revealed.

Hanna Crouch 8 Aug 2022

Back in May 2022, the trust confirmed it has been experiencing “disruption and instability issues” with some of its IT systems and then later some systems were moved to a “stable platform”.

The affected sites were The Royal Oldham Hospital, Fairfield General Hospital in Bury, Rochdale Infirmary and North Manchester General Hospital (which is operated by Manchester University NHS Foundation Trust).

At the time of the incident, details surrounding what had happened were not released but a report presented to the Northern Care Alliance’s board in July 2022 revealed that the issues related to the trust’s virtual infrastructure and that a software defect in the VMware vSAN software was the “root cause”.

According to the report, early analysis of the incident has stated that as a result of the disruption, there was one serious incident where a referral was made to the coroner containing incorrect patient information. There was also two incidents of moderate harm – one medication error and one surgery related incident.

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https://www.healio.com/news/hematology-oncology/20220810/use-of-emr-data-alone-may-lead-to-overestimates-of-survival-time-of-patients-with-cancer

August 11, 2022

Use of EMR data alone may lead to overestimates of survival time of patients with cancer

Key takeaways:

  • The cancer registry included more than twice as many deaths as the EMR.
  • Median OS from the date of diagnosis was 58.7 months using EMR data compared with 20.8 months using EMR data combined with cancer registry data.
  • Survival estimates in studies that use the EMR as the only data source may be misleading.

Use of electronic medical record data alone led to overestimates of OS compared with survival curves generated using combined EMR and cancer registry data, according to study results published in JCO Clinical Cancer Informatics.

Rationale and methods

Use of real-world data enables researchers to observe outcomes of patients not treated as part of clinical trials, but rather in routine practice, Michael F. Gensheimer, MD, clinical associate professor in the department of radiation oncology at Stanford University School of Medicine, told Healio.

“Pharmaceutical companies and others are excited about real-world data and real-world evidence because they can potentially help us learn how treatments work in situations not well represented in clinical trials, such as for patients with rare tumor mutations or elderly patients,” Gensheimer said. “EMR data has huge advantages for research. For example, it has rich detail about patients’ comorbidities and symptoms that might not be available anywhere else.”

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https://www.healthaffairs.org/content/forefront/medicare-billing-codes-digital-therapeutics-path-forward

Medicare Billing Codes For Digital Therapeutics: A Path Forward

10.1377/forefront.20220805.305660

Nearly five years have passed since the US Food and Drug Administration (FDA) cleared the first prescription digital therapeutic (PDT), and nearly another dozen have followed. PDTs are defined as FDA-cleared or -approved software-based medical devices, prescribed by a clinician, that are intended to prevent, manage, or treat a medical condition. Cleared PDTs to date span a range of clinical indications, from substance use disorder to ADHD to insomnia. Yet, to date, there is neither a Medicare benefit category nor a physician fee schedule for these products.

Currently, the only public coverage for PDTs is via one-off contracts with state Medicaid plans. Commercial payers, such as Aetna and BCBS, have remained hesitant to cover digital therapeutics largely due to reported concerns of generalizability, few long-term studies to evaluate, and lack of cost-effectiveness data relative to standard pharmaceutical therapies for similar clinical indications.

A bill introduced in the US Senate in early 2022, the Access to Prescription Digital Therapeutics Act, proposes establishing a dedicated Medicare benefit category for prescription digital therapeutics. Although the Centers for Medicare and Medicaid Services (CMS) currently has the statutory authority to interpret and modernize its Medicare benefit categories to include digital health technologies and there have been multiple efforts to lobby CMS to include PDTs within the Durable Medical Equipment benefit category, the agency has yet to act. CMS has gradually been releasing new billing codes to streamline commercial billing of PDTs but has stopped short of proposing federal coverage. However, the process underpinning the assignment of new Healthcare Common Procedure Coding System (HCPCS) codes for these products and the framework for direct and indirect billing of PDTs remain opaque.

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https://www.healthcareitnews.com/news/whats-holding-machine-learning-back-healthcare

What's holding machine learning back in healthcare?

This form of AI has made progress in diagnosis and medical coding. An expert discusses why it has yet to plow further.

By Bill Siwicki

August 12, 2022 10:51 AM

Healthcare is jam-packed with complex data stored in multiple places and evolving every day. That makes it a great target for the form of artificial intelligence known as machine learning.

Oxford defines machine learning as "the use and development of computer systems that are able to learn and adapt without following explicit instructions, by using algorithms and statistical models to analyze and draw inferences from patterns in data."

In recent years, machine learning already has proven useful in diagnosis and can help with the efficiency of medical coding. But there are many other places where machine learning can be useful but has yet to make headway. Why is that?

Harshith Ramesh is co-CEO of Episource, a vendor of risk-adjustment services and software for medical groups and health plans, and an expert in machine learning. We interviewed him to discuss why machine learning is such a good fit for healthcare, how it has helped to date with diagnosis and coding, and, most important, what is holding it back in healthcare.

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https://www.healthcareittoday.com/2022/08/12/standards-are-just-a-language-you-still-have-to-know-how-to-talk/

Standards Are Just a Language, You Still Have to Know How to Talk

August 12, 2022

John Lynn

I was recently meeting with Gurpreet (GP) Singh from Ellkay when I was in his area.  Over dinner we had a great discussion about healthcare interoperability and standards.  While many of us know ELLKAY from their work in EHR conversion, it’s really amazing how much ELLKAY has done when it comes to healthcare interoperability and also making that interoperability data useful.  In our conversations about the healthcare interoperability landscape, GP said something that really caught my attention:

Standards Are Just a Language, You Still Have to Know How to Talk

I thought this was a beautiful way to describe standards.  Knowing a language is one thing.  Having the intelligence to know how to use that language to convey an idea and understanding the context of what’s being said is a totally other thing.  The same is true with healthcare data standards.  It’s one thing to have a standard.  It’s another thing to understand the context of the data that’s being shared.

Plus, it’s one thing to have a standard and another thing for people to actually use the standard properly.  Imagine if I were speaking another language and then just started doing my own thing.  Would people understand me?  Of course not.  And yet, that’s what we see many people doing with healthcare standards.  Sometimes that’s the fault of the standard which is poorly defined or can’t be fully defined.  However, more often is companies that don’t fully implement the standard as intended.  That’s a big problem when you’re trying to communicate effectively.

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https://ehrintelligence.com/news/directtrust-supports-260-million-direct-secure-messages-in-q2-2022

DirectTrust Supports 260 Million Direct Secure Messages in Q2 2022

DirectTrust attributes the growth in the number of organizations using direct secure messages to ongoing adoption in the post-acute market.

By Hannah Nelson

August 11, 2022 - DirectTrust saw a 14 percent increase in healthcare organizations leveraging direct secure messages In the second quarter of 2022 compared with the same period last year.

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

More than 260 million direct secure messages were sent and received within the DirectTrust network during the second quarter of 2022.

The end of Q2 metrics also revealed that the number of consumers using direct secure messaging increased one percent to more than 668,000, compared with the same quarter last year.

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https://patientengagementhit.com/news/nursing-homes-underreport-patient-safety-events-pressure-ulcers

Nursing Homes Underreport Patient Safety Events, Pressure Ulcers

Researchers said the underreporting of patient safety events may adversely impact the Nursing Home Care Compare star ratings that inform consumer care access decisions.

By Sara Heath

August 11, 2022 - Nursing homes are vastly underreporting patient safety events, like the occurrence of moderate pressure ulcers, to the Centers for Medicare and Medicaid Services, a practice that could impact the reliability of publicly reported Nursing Home Care Compare ratings intended to guide consumer care access decisions.

The data, gathered by researchers from the University of Chicago and published in the journal Medical Care, showed that nursing homes only reported 22.4 percent of the pressure ulcers that resulted in hospitalization in which pressure ulcer was the primary diagnosis.

When opening the criteria further, researchers found a starker problem. The investigators looked at hospitalizations with a secondary diagnosis of pressure ulcer and found that 45 percent of those went unreported by nursing homes.

These findings follow a previous study from the University of Chicago finding that nursing homes also underreport the number and severity of falls to CMS. This research series homes in on the reliability of the publicly reported Nursing Home Care Compare data used as part of star ratings informing consumer care access choices.

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https://www.fiercehealthcare.com/health-tech/amazon-care-teaming-ginger-add-behavioral-health-services

Amazon Care teaming up with Ginger to add behavioral health services

By Heather Landi

Aug 10, 2022 03:30pm

Amazon Care, which currently offers virtual health visits, in-person primary care visits at patients' homes or offices and prescription delivery, is adding behavioral health care to its slate of services.

Amazon's health service business plans to team up with teletherapy startup Ginger as an optional add-on to Amazon Care. Through the partnership, Amazon Care users will be connected to Ginger's on-demand mental health services including behavioral health coaches, licensed therapists and psychiatrists, according to a live website about the service.

Amazon touted the partnership as a way for employees to get mental and physical health care in one place. "With the behavioral health add-on, we'll handle coordination between Care teams and Ginger therapists and psychiatrists," the company said on its website.

The two companies will share patients' health information, according to the website.

The website says Amazon Care  primary care providers treat common behavioral health concerns and care coordinators will refer employees to "high-quality, in-network behavioral health specialists for acute-to-moderate concerns whenever possible."

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https://www.beckershospitalreview.com/digital-health/how-baptist-health-is-keeping-patients-digitally-connect-to-care.html

How Baptist Health is keeping patients digitally connected to care

Naomi Diaz – 10 August, 2022

The PineApp, Miami-based Baptist Health's newly built app, is trying to change the traditional trajectory and mindset of health and wellness from one of episodic care — care only when you need it — to a holistic, uninterrupted and ingrained part of a person's life.

Tony Ambrozie, chief digital information officer of Baptist Health, told Becker's that the way the app does so is by improving patients' access to health information.

With the PineApp, patients can access their Baptist Health appointments, medical records, track their symptoms, view their medications, set reminders, bookmark their favorite physicians, complete their intake forms at home and submit them digitally, reducing their on-site wait times. But Mr. Ambrozie says this is only the beginning of the app's capabilities.

"You will see that we're releasing something every two weeks," said Mr. Ambrozie. "We want something new to be added for patients all the time and we're working in multiple trains to develop, test and implement a number of different features to release in stages."

Feature capabilities will include access to patient's recorded vital signs, medical procedures, and healthcare documents like discharge summaries and clinician notes. 

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https://www.healthleadersmedia.com/revenue-cycle/rev-cycle-processes-pushes-us-top-list-highest-medical-billing-costs

Rev Cycle Processes Pushes US To Top of List for Highest Medical Billing Costs

Analysis  |  By Amanda Norris  |   August 10, 2022

Complex coding structures are driving up medical billing costs and making the US one of the most expensive countries to get paid.

Billing and insurance-related costs in the US are higher than the costs in other countries, and this stems from our complex coding structures, according to a study published in Health Affairs.

According to the study, researchers used a microlevel accounting of billing and insurance-related costs in different national settings at six provider locations in five nations: Australia, Canada, Germany, the Netherlands, and Singapore. This newest study supplements the prior study measuring the costs in the US.

“We found that billing and insurance–related costs for inpatient bills range from a low of $6 in Canada to a high of $215 in the US for an inpatient surgical bill (purchasing power parity adjusted),” the researchers said.

To compare, only Australia had similar billing and insurance-related costs to the US. Australia has a mix of publicly and privately funded payers, as well as universal coverage. Billing and insurance-related costs were significantly less in Canada than in the other nations. Germany, Singapore, and the Netherlands had comparable billing and insurance-related costs, the study said.

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https://ehrintelligence.com/news/ehr-vendor-cerner-pays-1.8m-to-settle-racial-discrimination-claims

EHR Vendor Cerner Pays $1.8M to Settle Racial Discrimination Claims

The settlement will resolve racial discrimination claims alleging EHR vendor Cerner engaged in discriminatory hiring practices against qualified Black and Asian applicants.

By Sarai Rodriguez

August 10, 2022 - EHR vendor Cerner has reached a settlement with the US Department of Labor to pay nearly $2 million to resolve primary findings of racial discrimination.

In a compliance review, the US Department of Labor’s Office of Federal Contract Compliance Programs (OFCCP) alleged the company participated in discriminatory hiring practices against qualified Black and Asian applicants between 2015 to 2019.

OFCCP found Cerner Corp.’s actions violated Executive Order 11246, which prohibits federal contractors from discriminating in employment based on race, color, religion, sex, sexual orientation, gender identity, or national origin.

The Black and Asian applicants involved applied for positions to work at five facilities in Missouri and Kansas, specifically Cerner Oaks Campus and Cerner Innovations Campus in Kansas City, Missouri; and Cerner Corp. and Cerner Continuous Campus North Tower in Kansas City, Kansas.    

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https://ehrintelligence.com/news/the-sequoia-project-releases-draft-information-blocking-resources

The Sequoia Project Releases Draft Information Blocking Resources

The Sequoia Project requests public feedback until August 19 on a set of resources that aim to help stakeholders comply with 21st Century Cures Rule information blocking requirements.

By Hannah Nelson

August 10, 2022 - The Sequoia Project has released a set of draft resources for public feedback that aim to help entities better comply with the 21st Century Cures Rule information blocking requirements.  

The resources include:

·         “Good practices” for information sharing and information blocking compliance

·         Operational implications of the move to an expanded definition of electronic health information (EHI)

·         Further exploration of the expanded definition of EHI and additional considerations

·         An infographic that shows the range of systems and connections implicated by the expanded definition of EHI

·         A set of ongoing and new policy considerations

·         The Sequoia Project’s Information Blocking Compliance Workgroup (IBWG) developed the documents.  

Members of the public can submit feedback via an online form or email InteropMatters@sequoiaproject.org through August 19.

“This body of work was the result of intensive collaboration among IBWG members and we are excited to move forward with the release of these resources for public review prior to their publication in September,” Mariann Yeager, chief executive officer of The Sequoia Project, said in a public statement.

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https://mhealthintelligence.com/news/telehealth-use-linked-to-more-after-hours-work-for-providers

Telehealth Use Linked to More After-Hours Work for Providers

New research shows that telehealth use may result in providers completing more EHR-based work after hours, potentially driving up symptoms of burnout.

By Mark Melchionna

August 10, 2022 - A study published in JMIR Medical Informatics shows that higher telehealth use may lead to more after-hours work for providers, particularly EHR-based work, potentially resulting in higher levels of burnout. 

As providers and patients increasingly adopt telehealth, various questions surrounding its benefits and drawbacks remain. These include whether providers who use telehealth face extra work after hours, leading to increased stress and burnout.

Research published in April revealed that clinician burnout often has a relationship with the likelihood of a provider departing from their position.

The study in JMIR sought to determine whether telehealth could play a role in mitigating this issue or whether virtual care worsened it.

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https://mhealthintelligence.com/news/telehealth-use-shot-up-10.2-nationally-in-may

Telehealth Use Shot Up 10.2% Nationally in May

Telehealth utilization increased by 10.2 percent in May, occupying 5.4 percent of all medical claim lines, according to new data.

By Mark Melchionna

August 10, 2022 - For the second month in a row, the FAIR Health Monthly Telehealth Regional Tracker reported an increase in telehealth use at the national level and in all US census regions.

The tracker is a service assessing changes in telehealth activity monthly by tracking various metrics such as claim lines, procedure codes, and diagnostic categories. The population that the tracker covers is privately insured, including Medicare Advantage members, but it does not include Medicare Fee-for-Service and Medicaid beneficiaries.

Several years into the COVID-19 pandemic, telehealth plays an increasingly significant role in healthcare.

The January release of the FAIR Health Monthly Regional Telehealth Tracker reported an increase in telehealth utilization throughout all US regions for the third month in a row. There was an increase in COVID-19 cases in early 2022, which likely contributed to the uptick in telehealth usage.

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https://www.fiercehealthcare.com/health-tech/excluding-race-and-ethnicity-data-makes-algorithm-bias-worse-study-says

Excluding race and ethnicity data makes algorithm bias worse, Health Affairs study warns. Instead, here's what to do

By Anastassia Gliadkovskaya

Aug 8, 2022 04:12pm

To combat algorithmic bias in healthcare, including race and ethnicity is critical, a new study says. 

Algorithms are used to make healthcare decisions, and can often be more accurate than a clinical assessment, but also carry the risk of bias and discrimination. The study, published in the latest issue of Health Affairs, emphasized that while a common precaution might be removing race and ethnicity data altogether, “this approach is misguided.” In fact, knowledge, not ignorance, of race and ethnicity helps combat bias, researchers said.

While self-reported data is the gold standard for race and ethnicity, estimating (imputing) this data can help identify and address bias. Existing validated methods, like Bayesian Improved Surname Geocoding (BISG), predict race and ethnicity and assess health equity. They were developed by the RAND Corporation, Carnegie Mellon, Kaiser Permanente and the Centers for Medicare and Medicaid Services to mitigate limitations of Medicare data and estimate the probability that each beneficiary would self-identify as a certain racial or ethnic group. 

Value-based strategies, while intended to improve care quality, can exacerbate disparities depending on how they are designed. Providers who perform poorly on measures that influence incentive payouts are more likely to care for disadvantaged patients, and may thus receive smaller reimbursements, making it harder to improve care delivery. 

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https://hbr.org/2022/08/what-are-your-decision-making-strengths-and-blind-spots

Decision making and problem solving

What Are Your Decision-Making Strengths and Blind Spots?

by  Cheryl Strauss Einhorn

August 09, 2022

Summary.    Many of us approach decision making from the same perspective over and over. We use the same tools and habits every time, even if the decisions are vastly different. But following the same strategy for every problem limits your abilities. To make better decisions, you...

What do you do when you face an important but complicated decision? Do you turn to experts? Dig for data? Ask trusted friends and colleagues? Go with your gut?

The truth is many of us approach decision making from the same perspective over and over. We use the same tools and habits every time, even if the decisions are vastly different. But following the same strategy for every problem limits your abilities. To make better decisions, you need to break out of these patterns and see things differently, even if it is uncomfortable.

First, you need to understand your own decision-making strengths and your blind spots: What is the psychology of your decision making? What is your typical approach? What mental mistakes or cognitive biases tend to get in your way? Looking inward to what you value can illuminate why you make decisions the way you do — and how you might be shortchanging yourself with your approach. From there, you can disrupt your traditional processes.

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https://www.mddionline.com/digital-health/smart-necklace-can-track-blood-sugar-through-sweat

Smart Necklace Can Track Blood Sugar Through Sweat

Researchers at The Ohio State University have developed a “smart necklace” that can be worn around the neck to measure a person’s glucose levels using biomarkers from sweat excreted when he or she exercises.

A sensor fashioned into jewelry can potentially be used as a non-invasive way to measure glucose and other vital signs.

Elizabeth Montalbano | Aug 08, 2022

Jewelry of the future may be used not only as a fashion accessory, but also to monitor aspects of a person’s health, thanks to new research from The Ohio State University. Researchers there have developed a device that can be worn around the neck to monitor a person’s glucose levels from sweat excreted when he or she exercises, they said. It could one day be used as a way to help people with diabetes to keep track of their blood sugar without painful pin pricks, they said. The so-called “smart necklace” includes a typical clasp and pendant, but also features a battery-free, wireless biochemical sensor that researchers used to measure test subjects’ blood sugar through their perspiration, they said.

“Sweat actually contains hundreds of biomarkers that can reveal very important information about our health status,” Jinghua Li, assistant professor of materials science and engineering at Ohio State, stated in an article in Ohio State News. “The next generation of biosensors will be so highly bio-intuitive and non-invasive that we’ll be able to detect key information contained in a person’s body fluids.”

Indeed, scientists are finding human perspiration a useful natural component for novel wearable-device design. A research team from Penn State University already has used sweat to measure glucose with the development of a non-invasive patch-like sensor made with a nickel-gold alloy.

Meanwhile, engineers at the University of California (UC) San Diego developed a wearable microgrid that harvests energy from various renewable sources—including perspiration—to power small electronic devices.

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https://www.healthit.gov/buzz-blog/health-it/project-us-advancing-health-equity-requires-better-data

Project US@ – Advancing Health Equity Requires Better Data

Carmen Smiley and Julie Pursley | August 9, 2022

One of the single greatest social determinants of health is where a patient lives.  It can determine their risk factor for a specific illness or chronic disease, such as asthma, and can also affect much broader measures of well-being and life expectancy. Thus, our ability as healthcare professionals to measure and act on such factors relies heavily on how we accurately capture and manage standardized patient addresses. The standardization of patient address data across healthcare strengthens our ability to measure the social, economic, political, and physical environments that impact health. It also improves our ability to identify and match patient records within and across health systems. Technical standards, specifications, operational guidance, and best practices must work together for handling high quality patient data to advance health equity. A health equity by design philosophy seeks to improve data integrity and better patient matching for all patients. 

The beneficial impact of address standardization on accurately matching and linking patient records was a driving force behind the 2021 launch of Project US@ (‘USA’), a unified effort to standardize patient addresses. This year, Project US@ worked with an internal resource, the HHS Equity Technical Assistance Center (ETAC), whose subject matter experts in equity reviewed Version 1.0 of the Project US@ Technical Specification and the accompanying AHIMA Companion Guide. The goal of the review was to help center equity in our work and consider specific needs of different communities, thereby ensuring that all communities benefit from the project. Central themes that emerged from the review were: 

  • Engaging and collaborating with partners as a critical way to put the value of equity into action 
  • Considering the value proposition of address matching for communities that have been marginalized by the healthcare system 
  • Ensuring that the people providing their data are treated as the rightful owners of the data and as such, are fully involved in the process of collecting, analyzing, interpreting, and using the data.  

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https://healthitanalytics.com/news/wearable-ai-sensor-supports-personalized-health-data-processing-analysis

Wearable AI Sensor Supports Personalized Health Data Processing, Analysis

Researchers at the University of Chicago have created a wearable computing chip, which can analyze a person’s health data in real time using artificial intelligence.

By Shania Kennedy

August 09, 2022 - New research from the University of Chicago’s Pritzker School of Molecular Engineering (PME) shows that a flexible, stretchable computing chip worn directly on the skin can collect and analyze health data in real time using artificial intelligence (AI).

The device, known as a neuromorphic computing chip, uses semiconductors and electrochemical transistors to collect data from biosensors touching the skin. Unlike other wearables, such as smartwatches, which leave a small gap between the user’s skin and the device, the chip is designed to be worn directly on the skin to improve sensor accuracy and data collection.

To achieve this, the researchers needed to accommodate the movement of the wearer’s skin, which provides a unique challenge for wearable device developers. For the chip to integrate seamlessly with the skin, it had to stretch and move similarly. To give the chip the necessary flexibility, the researchers utilized polymers, which can not only stretch and bend but can also be used to build transistors and semiconductors.

However, these improvements in the chip’s ability to conform to the skin and collect better data resulted in a need for additional processing power. The more data a wearable can collect, the more complex the data analysis becomes. Smartphones, which are often connected to wearable technology to send and process data, are not capable of doing so for a device like a neuromorphic computing chip.

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https://mhealthintelligence.com/news/comprehensive-telehealth-approach-improves-outcomes-among-diabetes-patients

Comprehensive Telehealth Approach Improves Outcomes Among Diabetes Patients

New research shows that a comprehensive telehealth approach, which included medication management and depression support, provided several benefits for patients with poorly controlled type 2 diabetes.

By Mark Melchionna

August 09, 2022 - A study published in JAMA Internal Medicine showed that a comprehensive telehealth approach, which included various types of support in addition to telemonitoring, significantly benefits patients with persistently poorly controlled type 2 diabetes (PPDM).

Although standard telehealth methods can provide various benefits for these patients, in this study, researchers aimed to determine how comprehensive telehealth interventions compared with usual practices.

Researchers conducted a randomized clinical trial at two Veterans Affairs healthcare systems.

Following an assessment involving 1,128 patients, researchers included 200 in the final sample. Patients were divided into two study groups, one receiving care through a simple telehealth intervention (99) and the other through a comprehensive telehealth approach (101). The former received only telemonitoring and care coordination services, while the latter received telemonitoring, self-management support, diet/activity support, medication management, and depression support.

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https://healthitsecurity.com/news/hc3-provides-tips-for-maintaining-iot-security-in-healthcare

HC3 Provides Tips For Maintaining IoT Security in Healthcare

IoT security is crucial to safeguarding protected health information (PHI) and reducing vulnerabilities in any healthcare setting, HC3 noted in an analyst note.

By Jill McKeon

August 09, 2022 - In its latest analyst note, the HHS Health Sector Cybersecurity Coordination Center (HC3) outlined internet of things (IoT) security risks and mitigation tactics.

“Today, there are about 7 billion devices connected through IoT and it has been estimated that devices using this technology will increase 20 billion more by 2025. While IoT has existed for a while, advancements in technology have made it more practical and accessible,” HC3 explained.

As healthcare becomes increasingly interconnected, IoT devices have become crucial to workflows and functionality. But with those improvements come significant security risks. A recent SonicWall report observed a 123% spike in IoT malware attack volume in healthcare.

Any internet-connected device has the potential to be vulnerable to cyberattacks, the note emphasized.

“Additionally, adding IoT to an organization can increase the attack surface on which a company can be vulnerable if the network isn’t sectioned off into secure zones,” HC3 continued.

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https://www.beckershospitalreview.com/innovation/ai-software-used-to-detect-prostate-cancer-gets-fda-clearance.html

AI software used to detect prostate cancer gets FDA clearance

Noah Schwartz

Omaha, Neb.-based medical device company Bot Image has received FDA clearance for its ProstatID technology, a prostate cancer detection tool that combines MRI technology and artificial intelligence.

ProstatID recognizes and measures the volume of the prostate gland from MRIs to detect signs of cancer. The technology can then assign a cancer probability score to each image, according to the Aug. 8 Bot Image news release.

"Prostate cancer screening and detection methods adoption has changed little over the past 30 years, despite the mountain of evidence pointing to the efficacy of superior technologies and the futility of the old methods," company founder and CEO Dr. Randall W. Jones said. "Sadly, this has resulted in the unnecessary and premature deaths of countless numbers of men in the US alone. ProstatID represents an exciting step in the fight to save lives."

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https://www.healthcareitnews.com/news/hospitals-still-dont-have-handle-their-iot-devices

Hospitals still don't have a handle on their IoT devices

More than half of respondents to a new survey say their healthcare organizations experienced one or more cyberattacks in the past 24 months involving connected medical devices.

By Andrea Fox

August 09, 2022 10:39 AM

The Insecurity of Connected Devices in HealthCare 2022 report from Cynerio and The Ponemon Institute details some alarming trends for healthcare, including widespread and repeated attacks, financial losses measured in the millions and frequent failures to take basic cybersecurity measures.

WHY IT MATTERS

The report surveyed experts in leadership positions at 517 healthcare systems throughout the United States, and found that although healthcare internet of things/internet of medical things expand hospital attack surfaces, those devices are typically not protected. 

According to a joint statement from the researchers, 71% of survey respondents rated the security risks presented by IoT/IoMT devices as high or very high, while only 21% reported a mature stage of security to protect those devices. 

Of the 46% of those surveyed who performed well-known and accepted device security procedures, only 33% of these respondents keep an inventory. 

Survey results also indicated that 47% of those hospitals and medical facilities experiencing an attack paid a ransom, with 32% of the ransoms ranging from $250,000 to $500,000. The report addresses a range of financial impacts, attack types and investments made in connected device and biometrics security.

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https://www.healthleadersmedia.com/technology/oig-vhas-digital-health-program-saw-less-50-devices-used

OIG: VHA's Digital Health Program Saw Less Than 50% of Devices Used

Analysis  |  By Eric Wicklund  |   August 09, 2022

According to a report by the Office of the Inspector General, the Veterans Health Administration's Digital Divide program issued about 41,000 telehealth tablets to veterans to conduct virtual visits, yet less than half actually had those visits, and many of those devices haven't been returned properly.

The Veterans Health Administration has found that it's one thing to give veterans digital health tools, but another thing to see them use the technology.

The VA's Office of the Inspector General (OIG) has issued a report on a VHA's Digital Divide program, developed by the Office of Connected Care and launched in late 2020, which furnished roughly 41,000 veterans with iPads so that they could connect with care providers on a virtual platform. Investigators found that more than half of the veterans hadn't used the devices by late 2021.

And that was only one of many problems with the program.

"In total, the review team determined that VHA could have made better use of approximately $14.5 million in program funds with better device monitoring and retrieval controls and oversight," the OIG report concluded.

The study highlights the challenges with developing and launching a telehealth program, along with the many boxes that need to be checked to make sure it's working properly. And this is all before any clinical data is even collected.

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https://www.forbes.com/sites/forbestechcouncil/2022/08/05/six-strategies-for-capturing-value-from-digital-health-and-medtech/?sh=643f80584b26

Six Strategies For Capturing Value From Digital Health And Medtech

Mark Dohnalek

Aug 5, 2022,08:30am EDT

President and CEO of Pivot International, a US-based global manufacturing, engineering, loT and product development firm.

Digital health is big business. How big? The global digital health market is set to realize an outstanding growth rate of 17.9 % from 2021 to 2030. The pandemic-driven acceleration of digital health is fueling unprecedented market demand for medtech, but capitalizing on this mushrooming market is harder than many companies realize. Here are the chief challenges they’ll face and six strategies for overcoming them.

Challenge No. 1: Ecosystem Integration

Solution: Extensive Stakeholder Collaboration

Much of capturing value from digital health depends on the degree to which a medtech device achieves a flawless functional fit within the broader ecosystem. But this ecosystem represents a particularly complex “fitness landscape” into which medtech must seamlessly integrate. This, however, requires extensive stakeholder buy-in and collaboration to ensure a device’s development is fully informed by the following:

Institutional and businesses processes.

Payment and reimbursement models.

Technology systems, data security and device interoperability.

Policy, compliance and regulatory statutes.

Patient consent and privacy provisos.

Clinical outcome standards.

Social, ethical and legal strictures.

Digital adoption capability.

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https://ehrintelligence.com/news/corrupted-patient-database-triggers-va-oracle-cerner-ehr-system-outage

Corrupted Patient Database Triggers VA Oracle Cerner EHR System Outage

The VA Oracle Cerner EHR system outage affected users across the Department of Veterans Affairs (VA), Department of Defense (DoD), and the Coast Guard.

By Sarai Rodriguez

August 08, 2022 - The Department of Veterans Affairs (VA) most recent Oracle Cerner EHR outage was initiated by a corrupted patient database, according to reporting from FedScoop.

On Thursday, the EHR system went down for more than four hours, impacting users across the VA, the Department of Defense (DoD), and the Coast Guard, VA spokesperson Terrence Hayes told the news outlet.

The outage starting at 12:07 p.m. resulted in downtime and delays to VA patient databases while the corrupted database was fixed and reprogramed.

“Oracle-Cerner received monitoring alerts indicating an issue with one of its databases,” Hayes explained. “The system was taken offline to execute recovery of the database, during which time the sites switched to standard downtime procedures.”

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https://mhealthintelligence.com/news/majority-of-healthcare-consumers-believe-wearables-improve-their-health-fitness

Majority of Healthcare Consumers Believe Wearables Improve Their Health, Fitness

Most healthcare consumers who own wearables use them to monitor their health and fitness, with pulse rate, calories, and heart health being the most common metrics tracked, a new survey shows.

By Anuja Vaidya

August 08, 2022 - Among Americans who use wearables, a majority (70 percent) said they had improved their fitness and health, according to a new report released by Deloitte.

The report is based on a survey conducted by Deloitte's Center for Technology, Media & Telecommunications, which polled 2,005 US consumers in the first quarter of 2022.

Survey results confirm the enduring popularity of virtual care. Nearly half (49 percent) of respondents said they attended at least one virtual visit in the past year. Of all age groups, millennials were most likely to use telehealth, with 59 percent of millennial respondents saying they had a virtual visit in the past 12 months.

According to the survey respondents, the top benefits of telehealth include increased convenience and reduced risk of contracting COVID-19. The top challenges cited by respondents included lack of human touch or face-to-face connection and connectivity issues.

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https://patientengagementhit.com/news/are-community-pharmacies-ideal-for-sdoh-screenings

Are Community Pharmacies Ideal for SDOH Screenings?

The unique relationship pharmacists have with patients makes community pharmacies an ideal location to address healthcare barriers through SDOH screenings, experts said.

By Sarai Rodriguez

August 08, 2022 - As one of the most accessible healthcare providers, community pharmacists, who patients frequently see patients, are in a unique position to implement SDOH screenings and address care barriers, according to a study published in the Journal of the American Pharmacists Association.

Ultimately, patient outcomes are influenced by more than just medical factors. Understanding social determinants of health—the conditions in which people are born, grow, live, work, and age—helps clinicians identify barriers that play a role in patient health.

As a response to value-based care trends, SDOH screenings can help distinguish where the patient might need more support.

“There is a growing movement to integrate SDOH screenings within primary care,” Christopher Daly, co-principal investigator and clinical assistant professor of pharmacy practice for the University at Buffalo, said in a press release. “Pharmacies serve as a point of contact in most communities, with patients visiting their local pharmacies twice as frequently as their primary care providers.”

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https://healthitsecurity.com/news/cisa-sheds-light-on-last-years-top-malware-strains

CISA Sheds Light On Last Year’s Top Malware Strains

CISA provided details about 2021’s top malware strains in its latest advisory, including information about TrickBot, Qakbot, Remcos, and more.

By Jill McKeon

August 08, 2022 - The Cybersecurity and Infrastructure Security Agency (CISA) provided insight on the top malware threats of 2021 in its latest advisory. Co-authored by the Australian Cyber Security Centre (ACSC), the advisory detailed 11 top malware strains, their delivery methods, and mitigation tactics.

“Malware, short for ‘malicious software,’ can compromise a system by performing an unauthorized function or process,” the advisory explained.

“Malicious cyber actors often use malware to covertly compromise and then gain access to a computer or mobile device. Some examples of malware include viruses, worms, Trojans, ransomware, spyware, and rootkits.”

The advisory shed light on the following malware strains, all used by cyber criminals to deliver ransomware or facilitate data exfiltration or theft:

  • Agent Tesla
  • AZORult
  • Formbook
  • Ursnif
  • LokiBot
  • MOUSEISLAND
  • NanoCore
  • Qakbot
  • Remcos
  • TrickBot
  • GootLoader

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https://cosmosmagazine.com/technology/ai-medicine/

Promise and problems: how do we implement artificial intelligence in clinical settings and ensure patient safety?

By Evrim Yazgin

5 August 2022

The use of AI in medicine holds enormous promise, but presents equally large challenges.

In a classic case of finding a balance between costs and benefits of science, researchers are grappling with the question of how artificial intelligence in medicine can and should be applied to clinical patient care – despite knowing that there are examples where it puts patients’ lives at risk.

The question was central to a recent university of Adelaide seminar, part of the Research Tuesdays lecture series, titled “Antidote AI.”

As artificial intelligence grows in sophistication and usefulness, we have begun to see it appearing more and more in everyday life. From AI traffic control and ecological studies, to machine learning finding the origins of a Martian meteorite and reading Arnhem Land rock art, the possibilities seem endless for AI research.

Perhaps some of the most promising and controversial uses for artificial intelligence lie in the medical field.

The genuine excitement clinicians and artificial intelligence researchers feel for the prospect of AI assisting in patient care is palpable and honourable. Medicine is, after all, about helping people and the ethical foundation is “do no harm.” AI is surely part of the equation for advancing our ability to treat patients in the future.

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https://dataconomy.com/2022/08/data-governance-framework/

The data governance framework is an indispensable compass of the digital age

Eray Eliaçık August 4, 2022

To achieve business results, all businesses must establish a data governance framework that ensures that data is treated similarly across the organization. Without effective data governance, tracking when and from where erroneous data enters your systems and who is utilizing it is impossible.

Is it hard to follow your company’s strategic, tactical, and operational duties and responsibilities? We have some good news for you; they are all covered by a well-designed data governance framework. So let’s take a closer look at it.

What is a data governance framework?

A set of rules and procedures protects an organization’s corporate data management and role delegations called a data governance framework.

Every organization is led by business drivers, which are crucial elements or procedures for the company’s ongoing success. What data needs to be carefully controlled and to what extent in your data governance strategy depends on the specific business drivers of your firm.

The tasks and responsibilities of a well-designed data governance system include strategic, tactical, and operational aspects. It guarantees that data is reliable, well-documented, and simple to find within your business. It also guarantees that the data is secure, compliant, and private.

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https://www.beckershospitalreview.com/ehrs/q-a-with-cio-donna-roach-on-what-s-stalling-healthcare-data-sharing.html

Q&A with CIO Donna Roach on what's stalling healthcare data-sharing 

Giles Bruce -

Health data interoperability has long been a goal of health IT executives and policy experts. But it's 2022 — and the healthcare system doesn't appear all that close to getting there.

Becker's spoke to experts from health systems, industry and academia on what it will take to create an open exchange of healthcare information in the U.S.

Here is the first entry in the series, a Q&A with Donna Roach, CIO of University of Utah Health in Salt Lake City:

Note: Her responses have been lightly edited for clarity and brevity.

Q: What will it take to get to EHR interoperability?

A: One area of complexity is that we don't have a unique patient identifier. This has been codified in federal law. We're not allowed to have a unique patient identifier across the United States. If I have a patient record, I can identify it in my system, but if that patient goes down to Florida for the winter, sharing of that data can be very difficult to do.

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https://www.healthcareitnews.com/news/geisingers-telemedicine-program-shoots-20-specialties-more-70

Geisinger's telemedicine program shoots from 20 specialties to more than 70

And from 200 providers to more than 2,000. The rural health system's associate VP of telehealth talks in depth about this virtual care success story.

By Bill Siwicki

August 08, 2022 11:25 AM

Pennsylvania's Geisinger health system faces several challenges common to the healthcare industry, such as improving access to care, recruiting and retaining providers, and scaling technologies for rapid deployment across multiple campuses and dozens of medical specialties.

THE PROBLEM

Serving predominantly rural communities, many of Geisinger's patients experience barriers to getting the care they need. For example, transportation to and from appointments is a challenge patients may face, especially those living in remote areas that have long drives to their appointments.

Other patients, such as seniors and those with chronic conditions, may be homebound due to health complications. Telehealth alleviates the challenges these patients face in managing their health by creating access to routine and specialty appointments from wherever is most convenient for them.

"To address recruiting and retention of providers, telehealth was intended to facilitate recruiting providers who live outside of central Pennsylvania and enable existing providers who are not able to physically travel to clinics and hospitals due to injury or illness," said David Fletcher, associate vice president of telehealth at Geisinger.

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https://www.healthcareitnews.com/news/va-taps-internal-informatics-director-take-reins-rocky-ehr-rollout

VA taps internal informatics director to take reins of rocky EHR rollout

The agency announced that Dr. David Massaro will lead the deployment of the Oracle Cerner EHR to ensure improved adoption and patient safety.

By Andrea Fox

August 08, 2022 10:03 AM

The U.S. Department of Veterans Affairs has selected Dr. David Massaro as acting senior medical advisor for its Office of the Functional Champion to lead the Electronic Health Record Modernization Integration Office. He serves as the clinical executive representing the Veterans Health Administration and will lead functional initiatives to develop and implement the new EHR and support VA's medical personnel.

WHY IT MATTERS
While the rollout of the Cerner-developed EHR was at first encumbered by COVID-19 delays, the modernization efforts have since been plagued by issues stemming from a botched initial deployment at Mann-Grandstaff VA Medical Center in Spokane, Washington from 2020-2021 that resulted in lost records and patient harm.

According to the VA, Massaro was selected for his commitment to EHR reliability. After serving as the VHA's director for Integrated Health Practice, Massaro was previously the acting chief of clinical informatics operations within the Office of Health Informatics. He was assigned the role of VHA senior advisor for health informatics and director for clinical integration during the establishment of the EHRM IO.

His resume includes roles as acting chief health informatics officer for the Office of Community Care and acting member of the Office of Integrated Veteran Care executive leadership team. 

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https://www.healthcareittoday.com/2022/08/08/closing-the-gender-health-gap-how-digital-technology-can-support-better-womens-health/

Closing the Gender Health Gap: How Digital Technology Can Support Better Women’s Health

August 8, 2022

The following is a guest article by Juliet Bauer, Chief Growth and Marketing Officer at Livi

I’m often asked where I believe digital technology can make the biggest impact in healthcare. My answer? Women’s health. Today, women spend around a quarter of their lives in poor health or disability, compared with one fifth for men. In a health system that has historically been geared towards men, a gender health gap persists where you are more likely to receive poorer medical advice and diagnosis if you are a woman.

When I look at that gap, I see a key space for digital healthcare in helping us overcome many of the obstacles that we currently face. Those obstacles, which one could summarize as being centered around needs for greater access, education and information, I believe can be overcome through digital’s very power to connect us to all three. 

That’s why I was delighted to see data and digital included prominently as key areas within the recently published Women’s Health Strategy in the UK. 

Expanding the reach of women’s health services

One of the key challenges outlined in that document is of course the postcode lottery that has been described in the UK around women’s health services. We know If you’re a woman living in area of deprivation, you will experience unequal access to key services in pre-conception, maternity care, sexual health and the menopause, to name just a few. 

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Enjoy!

David.

 

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