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 27, 2022

Weekly Overseas Health IT Links –27th 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/data-exchange-challenges-impede-electronic-public-health-reporting

Data Exchange Challenges Impede Electronic Public Health Reporting

Over 70 percent of hospitals experienced at least one major challenge with electronic public health reporting, according to 2019 ONC data.

By Hannah Nelson

August 19, 2022 - The healthcare industry must focus on increasing electronic health information exchange (HIE) to ensure the availability of timely data for public health efforts, according to an ONC data brief.

Survey data from 2019 found that more than 70 percent of hospitals experienced at least one major challenge with electronic public health reporting.

Additionally, less than one in five primary care physicians—and about a quarter of pediatric and internal medicine primary care physicians—reported electronically sharing data with public health agencies.

“It is important to note that ONC’s analysis did not report on physicians’ overall levels of public health reporting—which often occur through manual, paper-based methods—nor does it reflect recent levels of electronic public health reporting which may have improved during the pandemic,” ONC officials Chelsea Richwine and Vaishali Patel emphasized in a HealthITBuzz blog post.

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https://healthitanalytics.com/news/crisis-management-system-to-support-the-988-suicide-lifeline

Crisis Management System to Support the 988 Suicide Lifeline

A new, data-driven crisis management system to support the three-digit suicide prevention hotline and improve care delivery has been launched.

By Shania Kennedy

August 18, 2022 - Healthcare technology solutions company Bamboo Health has developed a behavioral and mental health crisis system designed to support the 988 Suicide and Crisis Lifeline and improve care delivery. The solution is currently live in two states, and more states will be launching the system in the coming months.

Mental health in the US has become a growing population and public health concern in recent years, and the COVID-19 pandemic served to exacerbate these concerns further. During the pandemic, patient demand for mental healthcare surged, but access barriers persisted for many patients seeking care.

The federally mandated 988 hotline is one attempt to improve the American behavioral and mental health crisis care system, designed to transform the system as 911 did for emergency medical services. The three-digit number was officially launched in July as an easier-to-remember alternative to the National Suicide Prevention Lifeline.

Individuals can call, text, or chat 988 during a behavioral or mental health crisis to be routed to the nearest local crisis center to receive help, including crisis counseling, resources and referrals, or mobile crisis unit dispatch. However, concerns about crisis center capacity and hotline usage, which is expected to triple within the first year.

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https://www.digitalhealth.net/2022/08/government-launches-evidence-discrimination-medical-devices-technologies/

Government calls for evidence on discrimination in medical devices

The government has launched a call for evidence to discover if and how medical devices and technologies may be discriminatory and widen inequalities in healthcare.

Jordan Sollof – 15 August, 2022

As part of an Independent Review on Equity in Medical Devices, led by Professor Dame Margaret Whitehead, the government is aiming to tackle healthcare inequalities by collecting new evidence on how medical devices and technologies may be biased against patients of different ethnicities, genders and other socio-demographic groups.

The call for evidence will be open for eight weeks, with the hope of hearing from those who work most closely with medical devices such as oxygen measuring devices, infrared scanners and related software and hardware including databases and instructions.

This applies across a device’s entire lifecycle from evaluation to marketing and implementation to identify potential biases at each and every stage.

Professor Whitehead, chair of the independent review, said: “We aim to establish where and how potential ethnic and other unfair biases may arise in the design and use of medical devices, and what can be done to make improvements.

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https://www.fdanews.com/articles/209068-medwand-device-gets-510k-clearance

MedWand Device Gets 510(k) Clearance

August 19, 2022

MedWand Solutions has received 510(k) marketing clearance from the FDA for its MedWand telemedicine device for remote clinical exams.

The handheld device features sensors that detect multiple vital signs including core temperature, blood oxygen saturation and pulse rate, among other measurements. It also includes an electrocardiogram feature that has not yet been cleared by the agency.

The company said it will immediately launch the MedWand Evaluation Kit which includes the device and a tablet computer that is pre-configured for access to the cloud-based VirtualCare telemedicine platform.

The company also plans to launch two other products that use the newly cleared device, the MedWand Mobile Clinic and the MedWand Remote Clinic.

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https://www.digitalhealth.net/2022/08/industry-news-in-brief-67/

Industry news in brief

The latest Digital Health News industry roundup features the formation of Visiba Care’s UK Advisory Board, recognition for ORCHA and Royal Perth Hospital in Australia introducing electronic prescriptions.

Jordan Sollof – 19 August, 2022

Visiba Care announce formation of UK Advisory Board

Swedish virtual care platform provider, Visiba Care, has announced the appointment of their UK advisory board. The board has been created to provide expert insight, intelligence and knowledge and to ensure Visiba Care can respond to the needs of the UK’s current and future healthcare system.

Chaired by Mike Bell, chair of Croydon Health Services NHS Trust and Lewisham and Greenwich NHS Trust, the board brings together experts from across the healthcare sector.

Current members of the advisory board include:

  • Jake Arnold-Forster, co-founder at Carradale Futures
  • Dr Nav Chana, national PCH clinical director at the National Association of Primary Care (NAPC)
  • Dr Marc Farr, chief analytical officer at East Kent Hospitals University NHS Foundation Trust
  • Martin Godfrey, general practitioner and governing body member at Lambeth Clinical Commissioning Group

Liverpool City Region shows appetite for supporting healthtech start-ups

Lorna Green, CEO of LYVA Labs, a non-profit organisation that supports early-stage healthtech start-ups in the Liverpool City Region, has highlighted the area’s appetite for supporting budding start-ups in the healthtech space and the importance of giving them support in funding and beyond.

In January of this year, LYVA Labs secured its first allocation of funding of £7.5million from the Liverpool City Region Combined Authority – five million to ringfence into start-ups and 2.5million to fund the team and expert advisors.

The company works with entrepreneurs and businesses that are at the ‘idea stage’ of their business journey, helping them access the funding and resources needed to progress a concept to a functioning product or service.

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https://ehrintelligence.com/news/ehealth-exchange-crisp-shared-services-announce-tefca-qhin-intentions

eHealth Exchange, CRISP Shared Services Announce TEFCA QHIN Intentions

CRISP Shared Services, which provides infrastructure for five statewide HIEs, intends to be the first participant in eHealth Exchange’s anticipated QHIN.

By Hannah Nelson

August 18, 2022 - eHealth Exchange has announced its intention to apply as a Qualified Health Information Network (QHIN) in the Trusted Exchange Framework and Common Agreement (TEFCA).

CRISP Shared Services, which provides health information exchange (HIE) infrastructure for five statewide HIEs, intends to be the first participant in eHealth Exchange’s anticipated QHIN.

“eHealth Exchange has long been a cornerstone of CRISP Shared Services’ ability to share data with organizations across the region, state, and country, including with the federal government,” Brandon Neiswender, acting chief executive officer for CRISP Shared Services, said in a press release.

“Given its long history advancing interoperability and advocating for patients, we know eHealth Exchange will be the right partner to help us navigate this next step in nationwide data sharing.”

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https://www.fiercebiotech.com/medtech/visibly-now-seeing-eye-eye-fda-brings-online-vision-test-back-market?

Visibly, now seeing eye-to-eye with the FDA, brings online vision test back to market

By Andrea Park

Aug 17, 2022 12:19pm

In a somewhat paradoxical twist, a few extra minutes of screen time can now actually help, rather than hurt, your eye health.

That eye-catching claim has become a reality courtesy of the FDA, which recently gave the go-ahead to an eye test that requires only a smartphone and a computer and can be performed from the comfort of a user’s own home, according to an announcement this week from Visibly, the maker of the online test.

After helping a user set up the test—which includes adjusting the computer’s volume and brightness and any surrounding lighting, as well as finding a place to stand approximately 10 feet away from the screen—the computer and smartphone work in tandem to guide them through the exam. As the computer displays various letters and symbols, users enter their responses on the mobile app, adding and removing corrective lenses and covering each eye as directed.

The test—called the Visibly Digital Acuity Product, or VDAP—takes around six minutes from start to finish, after which time the results are automatically sent to a physician in the user’s region for review. The doctor returns a prescription within 24 hours, though Visibly notes on its website that most arrive within just two hours.

Users can access the test directly through Visibly’s website, and the company also partners with eyecare providers, telemedicine sites, insurance companies and more to embed the exam into their own offerings.

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https://www.healthcareitnews.com/news/how-point-care-ultrasound-devices-speed-diagnostics-and-support-health-equity

How point of care ultrasound devices speed diagnostics and support health equity

The handheld technology is gaining in popularity and offers many benefits to providers, including improved outcomes, a physician imaging expert says.

By Bill Siwicki

August 18, 2022 08:40 AM

Dr. John Martin, chief medical officer at Butterfly Network

Photo: Butterfly Network

Ultrasounds are among the most used imaging in healthcare. But some in the health IT industry see an alternative way of conducting ultrasounds that they say can help with issues from staffing shortages to health equity.

Dr. John Martin is chief medical officer at Butterfly Network, an ultrasound platform vendor. He sees point of care ultrasound (POCUS) devices as the future of this school of imaging.

We interviewed the doctor to discuss the future of POCUS, the role artificial intelligence can play with POCUS, and the use of POCUS to address health equity.

Q. You suggest that in a couple of years, POCUS will be widespread across healthcare organizations as an affordable, scalable way to improve and speed up diagnostics. How do they work, and what factors do you see driving the adoption of these devices?

A. In many care scenarios, the ability to reduce the time it takes to make a better clinical decision is critical. In the past, healthcare providers followed the path of "history, physical, pause," and thereafter a clinician decided whether a patient should get imaging.

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https://www.healthcareittoday.com/2022/08/18/commonwell-meditech-tefca-and-qhins/

CommonWell, MEDITECH, TEFCA, and QHINs

August 18, 2022

John Lynn

The topic of TEFCA and QHINs has been an extremely important one in the world of healthcare IT and particularly when it comes to healthcare interoperability.  In many ways, it’s setting the national infrastructure for healthcare interoperability going forward.  So, we should be paying attention.

As we continue to learn about how the industry is responding to TEFCA and which organizations are planning to apply to be a QHIN, we thought it would be valuable to sit down with CommonWell and a CommonWell member, MEDITECH, to learn more about their thoughts on TEFCA and CommonWell’s choice to apply to be a QHIN.  In the video interview below, Mike Cordeiro, Director Interoperability Market and Product Strategy at MEDITECH, and Paul Wilder, Executive Director of CommonWell Health Alliance share their insights on these important topics.

Before we dove into the topic of TEFCA and QHINs, I asked Wilder to share about CommonWell and their relationship with EHR vendors.  Cordeiro also shared MEDITECH’s perspective on working with CommonWell.  They both shared what it’s like to work alongside multiple competing vendor voices where they are working collaboratively towards the goal of interoperable health data.

Then, we dove into how CommonWell is approaching TEFCA and what Wilder described as the obvious decision for CommonWell to apply to be a QHIN.  He also shares how the EHR members of CommonWell will benefit from CommonWell being a QHIN.  Cordeiro shared how MEDITECH’s client base will be able to take advantage of the benefits CommonWell supporting TEFCA will provide implementers like MEDITECH.  This is a slightly different approach than EHR vendors like Epic and NextGen which have said they plan to apply to be a QHIN.  However, it seems like both approaches will have similar benefits to end users.

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https://ehrintelligence.com/news/va-digital-healthcare-playbook-highlights-health-it-optimization-case-studies

VA Digital Healthcare Playbook Highlights Health IT Optimization Case Studies

Phase one of the VA Digital Healthcare Playbook highlights projects that have helped improve health information exchange and health IT usability.

By Hannah Nelson

August 17, 2022 - Phase one of the Department of Veterans Affairs (VA) Digital Healthcare Playbook identifies health IT case studies that are helping transform patient care.

The guide, created in collaboration with the Digital Medicine Society, intends to drive digital transformation and encourage multidisciplinary collaboration.

VA notes in the playbook that current challenges to health IT usability include physician dissatisfaction with EHRs, overregulation, isolated data silos, and incompatible systems.

For instance, MercyOne, an accountable care organization (ACO) with over 400 service locations, had several disparate data sources lacking a common standard.

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https://mhealthintelligence.com/news/audio-only-telehealth-effective-in-treating-underserved-patients

Audio-Only Telehealth Effective in Treating Underserved Patients

A recent study found a mere 6.5 percent difference in satisfaction rate between audio-only and video-based telehealth in treating older and underserved patients.

By Mark Melchionna

August 17, 2022 - While exploring methods for virtually treating older and underserved patients, a study from the American Journal of the Medical Sciences found that audio-only telehealth produced similar benefits and was not inferior to video-based telehealth.

These findings come as industry leaders work to assess the efficacy of audio-only and video-based telehealth.

In this study, researchers gathered a diverse group of participants; 43 percent were Black, and 68 percent were women. They also considered factors such as age and insurance status when drawing conclusions.

The study occurred through a clinical trial, where all participants were randomly assigned to have their next visit occur through either phone or video-based platforms. The central unit of measurement was visit satisfaction rate, reported on a ten-point scale. Researchers noted noninferiority data based on whether patient satisfaction between the telehealth methods exceeded a -15 percent margin.

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https://www.theverge.com/2022/8/15/23306368/home-blood-pressure-apps-cuff

Apps don’t make at-home blood pressure monitoring better

They don’t give an additional boost from a non-smart device

Managing blood pressure at home is already difficult, and syncing blood pressure equipment up to an app doesn’t make the process any better, a new study found. In this case, just like many others, technology isn’t a good replacement for medical support.

Millions of adults in the United States have uncontrolled blood pressure, and high blood pressure can put people at risk for heart disease and stroke. Helping people manage their blood pressure is a major goal for health systems — but just sending someone who has high blood pressure home with a cuff isn’t particularly helpful, research shows. What does help is pairing people’s at-home blood pressure tracking with education support programs, regular counseling about medications from pharmacists, or systems that send regular updates to doctors.

Those types of add-ons, though, are expensive and time-consuming. Apps, on the other hand, are cheap and quick — and some blood pressure cuffs now come with paired apps that can interpret the results and make recommendations.

The new study, published in the journal JAMA Internal Medicine, divided over 2,000 patients with high blood pressure into two groups. The people in one group were sent an OMRON blood pressure monitor, and the people in the other group were sent the same monitor along with instructions to set up the OMRON Connect smartphone app.

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https://www.weforum.org/agenda/2022/08/how-the-responsible-use-of-ai-can-create-safer-online-spaces/

How the responsible use of AI can create safer online spaces

Aug 16, 2022
Steve Durbin

Artificial Intelligence

·         AI algorithms have massive implications for human life and the wider society.

·         Ethical dilemmas surrounding AI include digital disparities and its weaponization.

·         Autonomy should be balanced with human oversight while the responsible use of AI should be elevated, so it can be leveraged to tackle discrimination.

Artificial intelligence (AI) has become an everyday reality and business tool spurred by computer advancement, data science and the availability of huge data sets. Big tech companies – Google, Amazon and Meta – are now developing AI-based systems. The technology can mimic human speech, detect cancer, predict criminal activity, draft legal contracts, solve accessibility problems, and accomplish tasks better than humans. For businesses, AI promises to predict business outcomes, improve processes and deliver efficiencies at substantial cost savings.

But there are growing concerns with AI, still.

AI algorithms have become so powerful – with some experts labelling AI as being sentient – that any corruption, tampering, bias or discrimination can have massive implications on organizations, human life and society.

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https://www.insideprecisionmedicine.com/topics/informatics-topic/electronic-health-records-and-genomic-data-not-yet-a-perfect-match/

Electronic Health Records and Genomic Data – Not Yet a Perfect Match

By Laura Cowen

Electronic health records (EHRs) – systems that control all hospital data – have been around since the early 1970s. One of the first, the Health Evaluation thru Logical Processing (HELP) system, was developed by medical informatics pioneer Homer Warner at LDS Hospital, now Intermountain Healthcare, in Salt Lake City, Utah.

Warner’s system used medical logic to evaluate patient data and provide clinical decision support (CDS). With time it was refined to include more information, such as clinical laboratory and pharmacy data and cardiology and pulmonary function test results, and it is still in use today.

EHRs were initially developed and used by academic institutions, but in the 1990s, when hardware became more affordable and the internet led to the use of web-based systems, commercial EHR vendors gradually took over. Although these commercial systems now have huge capabilities, they currently struggle to support the increasing use of genomic data in medicine.

Identifying the problems with genomic data

The issue is widely recognized, so much so that the Association for Molecular Pathology (AMP) set up the EHR Interoperability for Clinical Genomics Data Working Group to assess the challenges and look for solutions to the current problems associated with incorporating genomic data into EHRs.

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https://ehrintelligence.com/news/hl7-da-vinci-project-recognizes-health-it-experts-as-community-champions

HL7 Da Vinci Project Recognizes Health IT Experts as ‘Community Champions’

The HL7 Da Vinci Project leadership created the Community Champions Program last year to celebrate stakeholders advancing interoperability across the industry.

By Hannah Nelson

August 16, 2022 - The Health Level Seven International (HL7) Da Vinci Project has named eight health IT experts its 2021 Da Vinci Community Champions.

The individuals represent the diverse membership of the HL7 Da Vinci Project, a collaborative multi-stakeholder effort comprised of health plans, hospital systems, accountable care organizations (ACOs), and health IT vendors.

As an HL7 Fast Healthcare Interoperability Resources (FHIR) accelerator, the Da Vinci Project is working to accelerate interoperability standards to support value-based care, reduce clinician burden, and streamline clinical workflows.

Last year, the Da Vinci Project leadership created the Community Champions Program to recognize and celebrate the problem solvers advancing interoperability across the industry.

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https://patientengagementhit.com/news/closing-digital-divide-requires-more-than-patient-access-to-health-it

Closing Digital Divide Requires More Than Patient Access to Health IT

Healthcare providers need to close the loop scheduling appointments and addressing digital health literacy in order to truly close the digital divide.

By Sara Heath

August 16, 2022 - It’ll take more than improving patient access to health IT to close the digital divide, according to a new assessment from the VA’s Office of Inspector General.

The OIG report found that a program aiming to close the digital divide successfully distributed health IT to veterans in need, but actual patient utilization was low. Despite expanding patient access to the health IT needed for things like video consults, the digital divide remains, the OIG report concluded.

The digital divide is an emerging social determinant of health that got a lot of time in the spotlight during the first period of the COVID-19 pandemic. As healthcare organizations shuttered their door to in-person medical care, patient access to telehealth increased.

But not everybody saw the same telehealth access; income-based and racial health disparities in telehealth utilization and access plagued health equity efforts and underscored a digital divide nationwide.

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https://healthitsecurity.com/news/zero-trust-adoption-reaches-record-high-in-healthcare

Zero Trust Adoption Reaches Record High in Healthcare

Okta found that 58% of surveyed healthcare organizations started implementing Zero Trust initiatives this year, compared to just 37% last year.

By Jill McKeon

August 16, 2022 - Zero trust adoption is gaining significant traction in the healthcare sector this year, Okta discovered in its latest report on the state of zero trust security.

In Okta’s 2021 report, just 37 percent of surveyed healthcare organizations had started implementing zero trust initiatives. This year’s report observed a 21 percent increase in healthcare organizations that have already begun implementing zero trust initiatives.

Additionally, 96 percent of healthcare respondents said that they already have or are planning to implement a zero trust initiative in the next 12 to 18 months, compared to 91 percent last year.

Zero trust relies on the idea that no device or user is automatically trusted before being scrutinized by a set of strict authentication processes. Rather than a single technology or strategy, zero trust is a collection of cyber defenses that examine threats within and outside of a network perimeter.  

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https://ehrintelligence.com/news/va-releases-digital-healthcare-playbook-to-improve-patient-care

VA Releases Digital Healthcare Playbook to Improve Patient Care

The guide will help healthcare leaders navigate digital healthcare solutions to better patient care, streamline operational efficiencies, and lower costs, VA official stated.

By Sarai Rodriguez

August 15, 2022 - The Veterans Affairs Department has released Phase One of its Digital Healthcare Playbook, which identifies available digital healthcare solutions that can help the US healthcare system transform patient care delivery.

Through this guide, created in collaboration with the Digital Medicine Society, the VA intends to drive digital transformation, encourage multi-sector/multidisciplinary collaboration, enable an inclusive research environment, and overall improve patient outcomes.

“This is all about trying to find the best strategy and … eliminate the blockers that exist for VA and private sector to collaborate on digital health,” Arash Harzand, the chief medical advisor for digital health at the Veterans Health Administration Innovation Ecosystem, said in a statement to Nextgov.

Harzand explained that the playbook would serve as an industry guide to what the VA wants in new healthcare technology devices and an internal department analysis of the current software landscape.

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https://healthitanalytics.com/news/ai-pain-care-tool-may-increase-access-reduce-costs-for-chronic-pain-patients

AI Pain Care Tool May Increase Access, Reduce Costs for Chronic Pain Patients

A cognitive behavioral therapy intervention for chronic pain, personalized for patients using artificial intelligence, achieved similar results as standard therapies.

By Shania Kennedy

August 15, 2022 - New research published in JAMA Internal Medicine shows that an artificial intelligence (AI)-based cognitive behavioral therapy intervention for chronic pain (AI-CBT-CP) had similar outcomes to standard CBT-CP, which could result in increased access and reduced costs.

According to the study, CBT-CP is an effective alternative to opioids for chronic pain management. However, CBT-CP requires multiple sessions with a therapist, and there are not enough therapists to provide these services due to the ongoing clinician shortages and healthcare workforce issues. Because therapists are scarce, many patients have severely limited access to CBT-CP or fail to complete their treatment.

With relatively few other options available, many chronic pain patients may turn to opioids. Opioid prescription and misuse have come under scrutiny amid the ongoing opioid epidemic. Some research suggests that opioid overdoses increased significantly over the course of the COVID-19 pandemic.

Clinicians have advocated for enhanced patient-centered care for chronic pain patients for years,  and this research contributes to those efforts. To determine if AI-CBT-CP is a viable alternative to its standard counterpart, the researchers compared the performance of both interventions in 278 patients with chronic back pain from the Department of Veterans Affairs health system.

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https://mhealthintelligence.com/news/telehealth-supported-medication-abortion-services-during-pandemic

Telehealth Supported Medication Abortion Services During Pandemic

Telehealth-enabled care models created new options for medication abortion services for those who lacked access during the height of the COVID-19 pandemic, new research shows.

By Mark Melchionna

August 15, 2022 - To ensure continued access to care amid restrictions that resulted from the COVID-19 pandemic, many clinics turned to telehealth to provide medication abortion services, which proved to be highly effective, according to a study published in the Annals of Family Medicine.

It is a well-known fact that the COVID-19 pandemic heavily impacted healthcare delivery. Like many other types of care, reproductive healthcare and abortion services became significantly more difficult to obtain during this time.

The study evaluated how US clinics used telehealth abortion services as well as the efficacy level of these services and the patient benefits.

Researchers collected data from 14 clinics, interviewing a total of 20 clinical staff members. The practice settings included independent primary care practices, specialized family planning clinics, telehealth-only web-based clinics, and primary care clinics within health systems.

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https://www.mobihealthnews.com/news/study-medicare-remote-patient-monitoring-use-surges-during-pandemic

Study: Medicare remote patient monitoring use surges during pandemic

Researchers found remote patient monitoring use among Medicare beneficiaries increased from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021.

By Emily Olsen

August 11, 2022 03:52 pm

Remote patient monitoring use soared among Medicare beneficiaries during the COVID-19 pandemic, according to an analysis published in JAMA Internal Medicine

The study reviewed traditional Medicare claims from Jan. 1, 2018, through Sept. 30, 2021, looking for remote patient monitoring (RPM) CPT codes. That included new codes introduced in 2019 for tracking general physiological data. Researchers then compared general RPM use during the pandemic to continuous glucose monitoring, a more specific case with different CPT codes.

They found general RPM use increased from 91 claims per 100,000 enrollees in February 2020 to 594 claims per 100,000 enrollees in September 2021, representing a 555% jump. During the same time, CGM use increased only 42%. 

The study also analyzed how these RPM services were being used and by which practitioners. During the pandemic, 63.1% of general RPM was provided by primary care clinicians. Meanwhile, 19.7% was provided by cardiologists and 4.1% was offered by pulmonology specialists. 

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https://www.healthcareittoday.com/2022/08/15/the-challenges-of-offering-free-devices-to-patients-lessons-learned-from-the-vas-41000-device-program/

The Challenges of Offering Free Devices to Patients – Lessons Learned from the VA’s 41,000 Device Program

August 15, 2022

John Lynn

When you think about digital health, many people take for granted that the patients are going to have the devices and connectivity to be able to do things like telehealth visits and remote patient monitoring (RPM).  While the number of people who have both is large, there’s still a significant section of patients who don’t have access to one or both of these things.  Plus, these are often some of the most vulnerable people who need healthcare the most.  Bridging that technology gap that often includes a health equity gap is a real challenge.

This was illustrated well in a VA program which would issue devices to veterans to be able to take part in virtual visits.  The goal of the program was to bridge the digital divide that existed for many veterans who didn’t have the right device or connectivity to receive virtual care.  Considering the VA is basically a self insured employer when it comes to veteran care, it makes sense that they would want to do as much healthcare as is clinically possible via virtual care and that they’d want to overcome the digital divide to offer the best care to all veterans.

According to a recent OIG report, the program was successful to a degree, but fell well short in a number of important areas.  When it comes to issuing the devices to patients, the program was quite successful as they put 41,000 devices in patients hands in the first three quarters of 2021.  That’s a large number of devices to distribute to patients.

Unfortunately, it seems like these devices were not always used to connect to the intended video telehealth visits.  Only an estimated 20,300 (49%) of patients issued a device actually did a video telehealth visit.  That’s a lot of patients with devices that never used them for patient care.  What’s even more shocking is that 10,700 of the patients who got devices never even had a video telehealth visit scheduled.  That means about 10,000 patients who had a video telehealth visit scheduled decided not to go.  I’ll admit that I don’t know the VA’s cancellation rate which may be higher since their care is essentially “free” for veterans, but I’d have to think that a 25% cancellation rate on telehealth appointments is high even for the VA.

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https://www.politico.com/news/2022/08/15/artificial-intelligence-health-care-00051828

Artificial intelligence was supposed to transform health care. It hasn’t.

Machine learning could improve medicine by analyzing data to improve diagnoses and target cures, but technological, bureaucratic, and regulatory obstacles have slowed progress.

By Ben Leonard and Ruth Reader

08/15/2022 03:55 PM EDT

Investors see health care’s future as inextricably linked with artificial intelligence. That’s obvious from the cash pouring into AI-enabled digital health startups, including more than $3 billion in the first half of 2022 alone and nearly $10 billion in 2021, according to a Rock Health investment analysis commissioned by POLITICO.

And no wonder, considering the bold predictions technologists have made. At a conference in 2016, Geoffrey Hinton, British cognitive psychologist and “godfather” of AI, said radiologists would soon go the way of typesetters and bank tellers: “People should stop training radiologists now. It’s just completely obvious that, within five years, deep learning is going to do better.”

But more than five years since Hinton’s forecast, radiologists are still training to read image scans. Instead of replacing doctors, health system administrators now see AI as a tool clinicians will use to improve everything from their diagnoses to billing practices. AI hasn’t lived up to the hype, medical experts said, because health systems’ infrastructure isn’t ready for it yet. And the government is just beginning to grapple with its regulatory role.

“Companies come in promising the world and often don’t deliver,” said Bob Wachter, head of the department of medicine at the University of California, San Francisco. “When I look for examples of … true AI and machine learning that’s really making a difference, they’re pretty few and far between. It’s pretty underwhelming.”

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Enjoy!

David.

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