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, September 24, 2022

Weekly Overseas Health IT Links –24th September, 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/2022/09/nhs-scotland-set-for-transformation-with-new-collaboration/

NHS Scotland set for transformation with new collaboration

NHS Scotland is set to transform the health of the local population with new digital technologies and patient pathways thanks to the launch of a collaboration between NHS, university and industry partners.

Cora Lydon 14 Sep, 2022

NHS Golden Jubilee’s national Centre for Sustainable Delivery, NHS Greater Glasgow & Clyde, University of Glasgow, AstraZeneca UK and Lenus Health have all signed a Memorandum of Understanding (MoU), which aims to improve the health of the Scottish population and expand opportunities for clinical research.

Professor Iain McInnes, University of Glasgow vice principal, said: “We are delighted to be signing this important MoU, which represents a strengthening of the vital triple helix partnership between research, industry and the NHS.

“Using the world-changing research carried out at the University of Glasgow, we will work together with AstraZeneca and the NHS in Scotland with the aim to deliver more high calibre trials and ultimately improve patient care.”

Transforming healthcare services

Professor Jann Gardner, chief executive of NHS Golden Jubilee, said: “The national Centre for Sustainable Delivery at NHS Golden Jubilee has been set up specifically to renew and transform healthcare services across NHS Scotland and is uniquely positioned to deliver transformation programmes at scale through the Accelerated National Innovation Adoption pathway.

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https://www.digitalhealth.net/2022/09/lancashire-and-south-cumbria-pioneer-drones-for-pathology-deliveries/

Lancashire and South Cumbria pioneer drones for pathology deliveries

Lancashire and South Cumbria NHS providers are revolutionising the way medical samples are delivered between hospital sites with the use of drone technology.

Cora  Lydon 12 Sep, 2022

University Hospitals of Morecambe Bay NHS Foundation Trust (UHMBT) and Lancashire Teaching Hospitals NHS Foundation Trust (LHTR) will be trialling electrically charged drones for pathology sample deliveries, cutting delivery times across the region by over an hour, optimising the operation of pathology labs and speeding up access to results.

Professor Anthony Rowbottom MBE, clinical director for pathology at LHTR, said: “This important project will revolutionise deliveries across a specific part of Lancashire and South Cumbria and provide valuable insight into how this can be expanded across a larger pathology partnership network.

“Not only will this expedite the transfer of patient samples but if successful could provide scope for branching into other NHS services and, in the not-too-distant future, should be seen as standard practice. In the long-term, with the right ambition and direction, why not aspire towards potentially extending drone use to home delivery for patients.”

The drones will be used to transport medical samples between the Royal Lancaster Infirmary, Westmorland General and Furness General Hospital initially. In the second phase of the trial there will be a simulation of a potential expansion to Royal Preston Hospital.

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https://www.healthcaredive.com/news/flo-anonymous-mode-period-tracker-app-abortion-roe/631926/

Period tracker Flo launches anonymous mode amid post-Roe privacy concerns

Published Sept. 15, 2022

Dive Brief:

  • Period tracking app Flo has rolled out an anonymous mode to protect users’ sensitive reproductive health data months after the U.S. Supreme Court overturned Roe v. Wade.
  • The company, which has dominant market share with 48 million monthly users and has faced regulatory scrutiny over privacy in the past, pledged to release the mode shortly after the court’s decision.
  • The new anonymous mode gives users the option to use the app without their name, email address or technical identifiers associated with their health data.

Dive Insight:

The Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization overturned decades of precedent and threw the nation’s healthcare system into chaos. The ruling gave rise to a patchwork system of reproductive health access in the U.S., and concerns among pro-abortion activists and privacy advocates that states could use data from period tracking and other reproductive health apps against patients seeking abortion services.

In the wake of the decision, a number of popular women’s health apps pledged to enhance their privacy and security protocols, including Flo. The U.K.-based women’s health app launched its anonymous mode Wednesday for all iOS users. The company said Android users will get access next month.

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https://www.statnews.com/2022/09/15/6-tactics-to-make-artificial-intelligence-work-on-the-frontlines/

6 tactics to make artificial intelligence work on the frontlines

By Katherine C. Kellogg, Mark P. Sendak and Suresh BaluSept. 15, 2022

Artificial intelligence is a transformative tool in the workplace — except when it isn’t.

For top managers, state-of-the art AI tools are a no-brainer: in theory, they increase revenues, decrease costs, and improve the quality of products and services. But in the wild, it’s often just the opposite for frontline employees who actually need to integrate these tools into their daily work. Not only can AI tools yield few benefits, but they can also introduce additional work and decrease autonomy.

Our research on the introduction of 15 AI clinical decision support tools over the past five years at Duke Health has shown that the key to successfully integrating them is recognizing that increasing the value for frontline employees is as important as making sure the tools work in the first place. The tactics we identified are useful not only in biopharma, medicine, and health care, but across a range of other industries as well.

Here are six tactics for making artificial intelligence-based tools work on industry frontlines.

Increase end-user benefits

AI project leaders need to increase benefits for the frontline employees who will be the actual end users of a new tool, though this is often not the group that initially approaches them to build it.

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https://medcitynews.com/2022/09/integrated-evidence-how-patient-data-derived-from-digital-healthcare-delivery-can-drive-innovation/

Integrated evidence: How patient data derived from digital healthcare delivery can drive innovation

For a long time, doctors’ offices, large or small, operated under a seeming contradiction; even […]

By Stephanie Reisinger

Sep 15, 2022 at 4:32 PM

For a long time, doctors’ offices, large or small, operated under a seeming contradiction; even as modern medicine pushed the frontiers of innovation, providing new treatments and sometimes cures for devastating diseases, so much of our healthcare system remained stuck in the pre-digital past. The most obvious example is one that many of us have experienced – the floor to ceiling “walls” of file cabinets full of paper patient records. Fortunately, this innovation gap is closing (and these file cabinets are disappearing!) faster than ever.

In fact, today, some of the most exciting innovations in healthcare extend beyond new therapeutic approaches and breakthrough medical devices. The digitization of all aspects of healthcare delivery is dramatically changing how healthcare is provided across the U.S. and around the world. From electronic medical records (EMRs) that document a patient’s healthcare status during a visit to their doctor, to virtual/telehealth visits and consumer healthcare apps that monitor all aspects of an individual’s health status – digital healthcare delivery is transforming healthcare.

A consequential output of healthcare digitization is the generation of electronic patient data – and enormous amounts of it — of which clinical researchers have taken notice. For decades, clinical research relied almost exclusively on capturing patient data de-novo, either on paper or electronic forms in clinical trials for often narrowly selected patient populations and highly prescriptive treatment protocols. These trials have undeniably produced high-quality evidence related to the safety and efficacy of the investigational drugs studied; however, the generalizability of clinical trial results to “real world” care settings are often not well understood. Additionally, the lack of patient diversity in trials remains a significant problem — primarily because clinical trials are typically executed within large academic medical centers that are inaccessible to uninsured, or rural populations.

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https://www.healthcareitnews.com/news/tampa-general-gains-clinical-and-operational-rewards-its-command-center

Tampa General gains clinical and operational rewards with its command center

In the first two years of the program, the health system reduced length of stay by half of a day, cut out 20,000 excess days and saved $40 million by eliminating inefficiencies.

By Bill Siwicki

September 16, 2022 11:46 AM

Tampa General Hospital faced high occupancy levels, increasing patient volumes and higher acuities – beds were filled with more patients who were also sicker.

THE PROBLEM

To meet the needs of the community, the organization needed to transform its operations to increase access to the health system, including emergency department, inpatient and procedural services.

This was an initiative that could not wait, said Ronetta Lambert, senior director of CareComm operations at Tampa General Hospital.

"While Tampa General is undertaking a master facility plan to grow physical space, that is not an immediate solution," she explained. "We needed to be able to safely treat more patients within our existing footprint.

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https://www.healthleadersmedia.com/innovation/cignas-evernorth-adds-new-apps-its-digital-health-platform

Cigna's Evernorth Adds New Apps to its Digital Health Platform

Analysis  |  By Eric Wicklund  |   September 16, 2022

The health plan is one of several healthcare organizations to develop a list of curated digital health apps and programs that can be prescribed for members or integrated into connected care treatments.

Digital health apps give healthcare organizations an opportunity to direct resources to patients in need of specialty care, but matching the right resources to the right patient is difficult when the marketplace features hundreds of thousands of apps.

To tackle that dilemma, health systems like Kaiser Permanente, UC Davis, Froedtert, and Banner Health and health plans like Cigna, Optum, and Express Scripts are developing formularies, or platforms that contain vetted apps and digital health programs. Healthcare providers are then able to prescribe apps that meet the requirements for efficacy and privacy.

Evernorth, the health services business of Cigna, recently added five new digital health platforms to its Digital Health Formulary, giving members access to care management resources to address sleeping issues, inflammatory conditions, anxiety, and substance abuse.

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https://ehrintelligence.com/news/user-focused-ehr-design-needed-to-drive-care-improvement

User-Focused EHR Design Needed to Drive Care Improvement

EHR design and training must focus on end-user needs to ensure health IT does not add to clinician burden, AMCI panelists said.

By Hannah Nelson

September 15, 2022 - According to an article published in JAMIA, future EHR systems must become more user-focused to enable providers to deliver improved care.

A panel sponsored by the American College of Medical Informatics (ACMI) at the 2021 AMIA Symposium addressed the question: “Are Electronic Health Records dumbing down clinicians?” The panel gave examples of how EHR use can worsen clinicians’ performances along with important benefits.

One clinician-panelist noted that end-users are hesitant to question clinical decision support from EHR platforms. Too many false positive alerts can limit clinicians’ abilities to respond to rare critical alerts.

Another panelist detailed the adverse effects of EHR use on nurses. A concern is that EHR use obscures the nursing narrative about each patient.

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https://healthitanalytics.com/news/artificial-intelligence-tool-helps-combat-antibiotic-resistance-misuse

Artificial Intelligence Tool Helps Combat Antibiotic Resistance, Misuse

Florida researchers have developed a clinical decision-making tool to help determine whether a case of pediatric diarrhea is caused solely by a virus, thereby improving antibiotic stewardship.

By Shania Kennedy

September 15, 2022 - A new study published in JAMA Pediatrics found that an artificial intelligence (AI)-based clinical decision-making tool can help improve antibiotic stewardship for diarrheal disease in settings with poor sanitation and hygiene.

According to the World Health Organization (WHO), diarrheal disease is the second leading cause of death in children under 5 years old. The disease caused the deaths of 370,000 children in 2019. Viruses cause many cases of diarrhea, but cases of the condition resulting from septic bacterial infections are on the rise.

Some diarrhea cases facilitate the need for antibiotics, but the varied causes of diarrheal disease require other treatment options. However, most pediatric diarrhea cases in developing countries are treated with antibiotics, regardless of the condition’s cause, according to the study authors.

“That means the vast majority of cases are treated inappropriately,” said Eric J. Nelson, MD, PhD, a University of Florida (UF) Health physician, a tenured associate professor in the UF College of Public Health and Health Professions’ environmental and global health department, and one of the study’s lead authors, in the press release.

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https://mhealthintelligence.com/news/physician-uptake-of-telehealth-rpm-higher-than-other-digital-health-tools

Physician Uptake of Telehealth, RPM Higher Than Other Digital Health Tools

Remote care tools have seen the largest increase in physician adoption since 2016, with more physicians noting their importance as digital health adoption rises, a new survey shows.  

By Anuja Vaidya

September 15, 2022 - As digital health adoption among healthcare providers increases, the most significant growth was seen in adopting digital tools that support remote care, like virtual visits and remote patient monitoring (RPM), according to a new survey.

Conducted by the American Medical Association, the survey polled 1,300 US physicians. This is the third in a series of surveys. The AMA conducted the same survey in 2016 and 2019, polling the same sample of physicians recruited by WebMD.

Survey results show a massive increase in the adoption of digital health tools, with the average number of tools used by a single physician growing from 2.2 in 2016 to 3.8 in 2022.

This spike in adoption can be seen across age groups and genders. In 2016, the average number of digital health tools in use by a physician between the ages of 28 and 40 was 2.1 and by a physician between 51 and 65 was 1.7. These figures jumped to 3.8 in both groups by 2022.

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https://www.healthdatamanagement.com/articles/ceos-digital-strategies-come-up-short?id=131050

CEOs: Digital strategies come up short

Senior healthcare leaders say IT can help transform healthcare, but they acknowledge that their organization’s strategies need more work.

Sep 06 2022   


Marla Durben Hirsch

Contributing editor

CEOs acknowledge that information technology will play a vital role in transforming healthcare. But few say that their organization has created a digital strategy that looks far enough into the future, according to a global survey of 200 leaders of midsize and large healthcare provider organizations.

Many CEOs also view the challenges in adapting to new technologies as a potential barrier to transformation, according to the recently released KPMG survey report: 2021 Healthcare CEO Future Pulse.

The survey shows that top executives see many ways that technology can help address key issues, including improving workforce retention, enhancing customer service, offering patient-centric care, shifting to delivering more care outside the hospital and dealing with new payment models.

“The CEOs are realizing the importance of technology. The ones that value technology will do better. The ones that keep it in the back office will not do as well,” says David Chou, a long-time CIO in the healthcare industry and founder of davidchou.health.  

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https://www.healthcareitnews.com/news/developing-trust-healthcare-ai-step-step

Developing trust in healthcare AI, step by step

A new analysis examines how artificial intelligence in medicine can impact clinical decisions and identifies the steps that could build more trust in machine learning models from doctors and patients.

By Andrea Fox

September 15, 2022 10:18 AM

A new Chilmark Research report by Dr. Jody Ranck, the firm's senior analyst, explores state-of-the-art processes for bias and risk mitigation in artificial intelligence that can be used to develop more trustworthy machine learning tools for healthcare.

WHY IT MATTERS
As the usage of artificial intelligence in healthcare grows, some providers are skeptical about how much they should trust machine learning models deployed in clinical settings. AI products and services have the potential to determine who gets what form of medical care and when – so the stakes are high when algorithms are deployed, as Chilmark's 2022 "AI and Trust in Healthcare Report," published Sept. 13, explains.

Growth in enterprise-level augmented and artificial intelligence has touched population health research, clinical practice, emergency room management, health system operations, revenue cycle management, supply chains and more.

Efficiencies and cost-savings that AI can help organizations realize are driving that array of use cases, along with deeper insights into clinical patterns that machine learning can surface.

But there are also many examples of algorithmic bias with respect to race, gender and other variables that have raised concerns about how AI is being deployed in healthcare settings, and what downstream effects of "black box" models could be.

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https://www.healthcareittoday.com/2022/09/15/solving-the-cybersecurity-gap-in-healthcare-it-digital-transformation/

Solving the Cybersecurity Gap in Healthcare IT Digital Transformation

September 15, 2022

The following is a guest article by Terry Young, Director, Service Provider Marketing at A10 Networks.

The COVID-19 pandemic intensified public awareness of their personal vulnerability when broadband service becomes unavailable or gets disrupted. This has also spurred massive government funding to close the broadband gap (the digital divide) and provide connectivity to unconnected or underserved communities.   

But there is another gap that needs more attention, the “cybersecurity gap”. That is, the growing chasm between capabilities of cybercriminals against the inexperience of unserved communities and the resources of regional internet service providers now charged with extending essential broadband connectivity. 

The pandemic has ignited a significant rise in cyberthreats of all types targeting the most vulnerable residents and the most critical community services. Moreover, the reality is that communities in rural areas are especially vulnerable to distributed denial of service (DDoS) attacks due to the lack of security infrastructure and the vulnerability of the scarce community resources, such as healthcare, favorite targets for cyber-attackers. DDoS attacks, in particular, can knock out Internet access through the biggest access pipe rendering the broadband investment useless. DDoS attackers are known for exploiting the weakest link – those neglected entry points, the outdated network equipment, the essential health service that a small community can’t afford to be out of service.  

Rural Communities are Especially Vulnerable

In the US, there are about 2,300 regional internet service providers (ISPs) registered with the FCC. These 2,300 organizations try to cover the 20% of the US population and 97% of the landmass that is considered “rural”, including all the small healthcare facilities that serve rural communities. These are the companies that have stepped up in the past to provide connectivity in service areas that larger companies thought were uneconomic and they have the primary responsibility for “bridging the digital divide” for the remaining 23-42M US locations that are the focus of government broadband funding.

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https://mhealthintelligence.com/news/375-healthcare-organizations-urge-senate-to-ensure-expanded-telehealth-access

375 Healthcare Organizations Urge Senate to Ensure Expanded Telehealth Access

A letter, co-led by the American Telehealth Association and signed by 375 healthcare stakeholders, requests that the US Senate approve a two-year extension to allow for expanded telehealth access.

By Mark Melchionna

September 14, 2022 - Signed by 375 stakeholders and co-led by the American Telemedicine Association (ATA) and its advocacy arm ATA Action, a letter to the US Senate asks that expanded telehealth access be solidified for the next two years while working toward a permanent extension of the flexibilities and waivers currently in place.

At the beginning of the COVID-19 pandemic, the government eliminated regulations that limited the extent to which telehealth could be used. This followed the declaration of the public health emergency (PHE), as many patients were no longer able to receive in-person care.

However, many now anticipate the telehealth flexibilities will be eliminated as COVID-19 cases have declined and telehealth use has leveled off.

The ATA and ATA Action composed a letter that urges the US Senate to extend the flexibilities and waivers put into place during the pandemic for two years. The flexibilities include removing in-person requirements for telemental health and restrictions on location of providers and patients engaging in telehealth.

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https://www.forbes.com/sites/bernardmarr/2022/09/14/how-ai-and-machine-learning-will-impact-the-future-of-healthcare/?sh=3b8317cf47e5

How AI And Machine Learning Will Impact The Future Of Healthcare

Bernard Marr

Sep 14, 2022,01:24am EDT

 Our modern healthcare system is currently facing huge challenges exacerbated by the pandemic, a rise in lifestyle-related diseases, and an exploding world population.

The good news is that using AI to create intelligent processes and workflows could make healthcare cheaper, more effective, more personalized, and more equitable.

Some experts are predicting that the healthcare industry is the sector that could be the most affected by the enormous changes of the fourth industrial revolution.

I recently spoke with Tom Lawry, National Director of AI for Health & Life Sciences at Microsoft, about the future of healthcare. Here are some of his biggest insights and predictions:

Current Challenges in Healthcare

The U.S. currently spends more money on healthcare than any other country in the world, but its individual health outcomes are lower than most other developed nations.

Additionally, clinician burnout is a huge problem, particularly since the pandemic.

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https://www.fiercehealthcare.com/providers/post-dobbs-fallout-tracker-kan-voters-resoundingly-reject-abortion-ban

Post Dobbs fallout tracker—Senators urge HHS to strengthen HIPAA protections surrounding reproductive health info sharing

By Healthcare Staff

Sep 14, 2022 10:30am

UPDATED: Wednesday, Sept. 14 at 10:30 a.m.

Senators urge HHS to strengthen HIPAA protections surrounding reproductive health info sharing

Thirty senators penned a letter to Health and Human Services Secretary Xavier Becerra calling on the department to more heavily lean on the Health Insurance Portability and Accountability Act (HIPAA) to protect patients and providers "from having their health information weaponized against them." 

The group, headed by Senate Committee on Health, Education, Labor and Pensions (HELP) Chair Patty Murray (D-Wa.), pointed to comments from Becerra and the administration promising to take every action in their power to push back on state-level abortion restrictions. 

To this end, HHS should take "immediate action ... to initiate the rulemaking process to augment privacy protections under [HIPAA] regulations," the senators wrote in the letter.

Specifically, the department "should update the HIPAA Privacy Rule to broadly restrict regulated entities from sharing individuals’ reproductive health information without explicit consent, particularly for law enforcement, civil or criminal proceedings premised on the provision of abortion care," they wrote. 

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https://www.healthcareitnews.com/news/physician-adoption-digital-health-tools-accelerating-ama-research-shows

Physician adoption of digital health tools is accelerating, AMA research shows

A three-time survey of 1,300 physicians from 2016-2022 revealed growing recognition of technology's benefit, with the biggest growth seen in remote care tools and planning for digital therapeutics.

By Andrea Fox

September 14, 2022 06:50 AM

The American Medical Association's digital health research released today shows increased rates of digital health adoption among physicians over the last six years and provides insights into their expectations.

"The AMA survey illustrates the importance physicians place on validated digital health tools that improve health while streamlining the technological and administrative burdens faced each day in medicine," said AMA President Dr. Jack Resneck Jr. in a statement.

"These technologies also must be designed and deployed in ways that advance health equity," he added.

Doctors across specialties adopting RPM tools

The purpose of the survey, which measured across all ages and specialties, according to AMA, was to investigate physicians' motivations and requirements for onboarding digital health technologies and integrating them into their medical practices.

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https://www.healthcareittoday.com/2022/09/14/a-wide-ranging-look-at-meditech-with-helen-waters/

A Wide Ranging Look at MEDITECH with Helen Waters

September 14, 2022

John Lynn

A few years ago, I did an interview with then MEDITECH CEO, Howard Messing, to look back at the 50 years MEDITECH had been providing IT software and solutions to healthcare.  That interview gave me a new appreciation for the company and the success they’ve had all these years as they focus on their customers.

Given the relatively recent transition of leadership, I thought it would be a good time to check in with MEDITECH’s Executive Vice President & COO, Helen Waters.   In our discussion, we cover a broad range of topics including how the leadership change has gone, the impact of COVID, and where they’re headed in the future.

Waters offered some great insights into the culture of MEDITECH and their efforts to continue that culture and legacy including a discussion of the majority female leadership team including their female CEO which is quite unique in the industry.  She also highlighted how COVID had a tremendous impact on their organization and some of the functionality they’d built prior to COVID but hadn’t been adopted and utilized widely by customers became important for customers to start using quickly.  Plus, I ask her how things like physician burnout have impacted MEDITECH’s approach to design and product development.

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https://ehrintelligence.com/news/calhhs-data-exchange-framework-set-to-boost-interoperability

CalHHS Data Exchange Framework Set to Boost Interoperability

By January 31, 2023, hospitals, physician practices, and certain other entities are required to sign an agreement governing participation in the CalHHS Data Exchange Framework.

By Hannah Nelson

September 13, 2022 - The recently unveiled California Health and Human Services Agency (CalHHS) Data Exchange Framework is set to promote health data interoperability across the state, according to The National Law Review.

By January 31, 2023, hospitals, physician practices, and certain other entities must sign a data sharing agreement (DSA) governing participation in the CalHHS Data Exchange Framework. Once the Framework takes full effect on January 31, 2024, parties must exchange health data with other Framework participants. 

The Framework includes two main components: (1) a single data sharing agreement to be executed by Framework participants and (2) a standard set of policies and procedures that Framework participants will follow.

CalHHS released a final version of the DSA and an initial set of policies and procedures to govern the Framework on July 5, 2022.

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https://healthitsecurity.com/news/third-party-tracking-on-abortion-clinic-websites-sparks-data-privacy-concerns

Third-Party Tracking on Abortion Clinic Websites Sparks Data Privacy Concerns

Researchers analyzed abortion clinic websites and found third-party tracking tools on 99% of them, raising data privacy concerns.

By Jill McKeon

September 13, 2022 - Researchers discovered third-party tracking tools on the majority of analyzed abortion clinic websites, raising data privacy concerns, according to a research letter published in JAMA Internal Medicine.

Although tracking tools are commonplace on the internet, the Supreme Court’s decision in Dobbs raised significant concerns over the confidentiality of abortion-related data, which some fear could be used to incriminate people who obtain abortions. Sharing data with third-party entities that may not hold themselves to the same strict privacy standards potentially puts that data at risk.

The researchers analyzed 414 abortion clinics and 244 unique web pages (since some clinics shared common web pages) based on the National Abortion Federation clinic list. After accounting for broken links, researchers narrowed in on 223 accessible web pages, 221 of which included a third-party data transfer. Additionally, 69 percent of pages included a third-party cookie.

Researchers detected data transfers to 290 unique third-party domains owned by just 66 parent entities. Google and Meta topped the list of the most prevalent tracking entities on abortion clinic web pages. The data transfers typically included a user’s IP address and the web page that was visited.

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https://www.computerworld.com/article/3673249/as-telehealth-use-plummets-the-healthcare-industry-faces-a-crossroads.html

As telehealth use plummets, the healthcare industry faces a crossroads

COVID-19 forced many medical providers to roll out telehealth technology to handle remote. But as the pandemic has waned, so has the use of virtual care, leaving the healthcare industry to decide whether to fall back on old methods or move forward.

By Lucas Mearian

After reaching historically high adoption rates during the height of the COVID-19 pandemic, the use of telehealth services has plummeted since the beginning of the year.

Experts say that places the healthcare industry at a fork in the road, where providers, payors, and tech companies must choose whether to embrace an effective and convenient healthcare medium or be left behind as telehealth marches forward.

The road toward adoption of telehealth — the use of electronic communications to provide care and other services — has been long. Before the COVID-19 pandemic took hold in 2020, the adoption rate in the US, nearly 60 years after telehealth technology was first introduced, was just 0.9% of outpatient visits.

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Oracle Q1 2022 Results

Oracle reports Q1 results: revenue up 18%, EPS $0.58 versus $0.89, meeting Wall Street expectations for revenue but falling short on earnings.

Notes from the earnings call:

  • Unfavorable foreign currency exchange rates cost the company $0.08 in adjusted EPS.
  • Cerner contributed $1.4 billion of Oracle’s quarterly revenue, 12% of its total.
  • Cloud revenue increased significantly, representing 30% of total revenue.
  • CEO Safra Catz says that Oracle’s quarterly margin of 39% will increase “as we drive Cerner and its profitability to Oracle standards and continue to benefit from economies of scale in the cloud.”
  • The company says it has migrated Cerner’s back office systems to its Oracle Fusion ERP system.
  • CTO Larry Ellison says Oracle Cerner’s first newly developed application will be released within 12 months, developed with Oracle’s new Apex low-code tool and running on Oracle Cloud Database. He says Apex has security and fault tolerance built in, with the stateless application immediately failing over to another data center when problems arise.

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https://www.healthcareitnews.com/news/fbi-spotlights-cybersecurity-risks-outdated-medical-devices

FBI spotlights cybersecurity risks of outdated medical devices

The bureau has new recommendations for healthcare organizations to address unpatched medical devices, which it says are increasingly being targeted in cyberattacks.

By Andrea Fox

September 13, 2022  10:46 AM

On Tuesday, the FBI issued a report offering recommendations to address a number of cybersecurity vulnerabilities in active medical devices stemming from outdated software, as well as the lack of security features in older hardware.

Once exploited, the vulnerabilities could impact healthcare facility operations, patient safety, data confidentiality and data integrity. If a cyberattacker takes control, they can direct devices to give inaccurate readings, administer drug overdoses or otherwise endanger patient health.

The FBI noted in its briefing that a mid-year healthcare cybersecurity analysis found that equipment vulnerable to cyberattacks includes insulin pumps, intracardiac defibrillators, mobile cardiac telemetry, pacemakers, and intrathecal pain pumps.

Routine challenges include the use of standardized configurations, specialized configurations – including a substantial number of managed devices on a network – and the inability to upgrade device security features, according to the FBI's announcement.

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https://www.healthleadersmedia.com/clinical-care/telehealth-diagnoses-match-person-clinical-visit-diagnoses-869-cases-study-finds

Telehealth Diagnoses Match In-Person Clinical Visit Diagnoses in 86.9% of Cases, Study Finds

Analysis  |  By Christopher Cheney  |   September 13, 2022

Concordance between telehealth diagnoses and in-person visit diagnoses was lowest when in-person visit diagnoses involved physical examination, neurological testing, or pathology.


KEY TAKEAWAYS

·         In non-primary care specialties, diagnostic agreement between telehealth visits and in-person visits ranged from 77.3% for otorhinolaryngology to 96.0% for psychiatry.

·         Diagnostic agreement between telehealth visits and in-person visits was significantly higher for specialty care compared to primary care (88.4% versus 81.3%).

·         There is a significant level of agreement between telemedicine diagnoses and in-person outpatient visit diagnoses, a recent research article found.

In the early phase of the coronavirus pandemic, telehealth utilization increased exponentially—one published estimate pegged the increase in utilization in April 2020 at 20-fold. A concern associated with this increase in telehealth utilization is the accuracy of telemedicine diagnoses compared to in-person visits.

The recent research article, which was published by JAMA Network Open, examines data collected from more than 2,000 Mayo Clinic patients who had telehealth diagnoses followed by an in-person visit diagnosis for the same clinical concern in the same specialty within 90 days.

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https://hbr.org/2022/09/how-to-use-digital-health-data-to-improve-outcomes

How to Use Digital Health Data to Improve Outcomes

by  John Glaser, Margaret O’Kane, Brad Ryan, and  Eric Schneider

September 12, 2022

Summary.   

The amount of health information generated by digital tools is rapidly growing. It can and should be used to improve the quality of health care. This article makes the case and explains what will be required to make it happen.

We hear a lot about “digital health” these days. As data about our health piles up — thanks to sources like electronic health records, personal fitness apps and gadgets, and home genome test kits — we should understand a lot more than we used to about what’s wrong with our health and what to do about it. But having a lot of data is not enough. We have to be aware of what we have, understand what it means, and act on that understanding. While the challenges are in some ways more acute in the United States because of its fragmented system of care, they exist in health care across the globe.

Here’s an all-too-common scenario:

June, aged 67, is in the emergency department with abdominal pain and rectal bleeding. Tests reveal inoperable colon cancer that’s probably been developing for years. After several difficult and unsuccessful courses of chemotherapy, she enters hospice care and passes away several weeks later.

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https://mhealthintelligence.com/news/telehealth-supports-access-to-medication-abortion-services

Telehealth Supports Access to Medication Abortion Services

New research shows that telehealth can help women access secure medical abortion services through text messaging tools and at-home medications.

By Mark Melchionna

September 12, 2022 - Research published last week in The Lancet found that telehealth can be used to safely provide medical abortion services, ensuring access in low-resource settings. 

Due to laws and other restrictions, women often use abortion tools that are convenient, even though they may not necessarily be safe. Data from the World Health Organization (WHO) shows that in a year, about 25 million unsafe abortions occur worldwide, accounting for 45 percent of all abortions.

However, since the beginning of the COVID-19 pandemic, the benefits associated with telehealth-enabled care options have led providers to increasingly implement the care modality.

Researchers from the Karolinska Institutet in Sweden and the University of Cape Town in South Africa aimed to examine whether telehealth could be used to provide abortion services to underserved communities.

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https://healthitsecurity.com/news/hc3-details-healthcare-cybersecurity-implications-of-ai-5g-emerging-tech

HC3 Details Healthcare Cybersecurity Implications of AI, 5G, Emerging Tech

HC3 outlined the cybersecurity implications of emerging technologies such as AI, 5G, and smart hospitals in its latest brief.

By Jill McKeon

September 12, 2022 - As emerging technologies continue to revolutionize patient care, organizations must also consider the healthcare cybersecurity implications that come along with them. The Health Sector Cybersecurity Coordination Center (HC3) issued a brief that explored various emerging technologies, their roles in healthcare, and how each intersects with security.

Specifically, HC3 focused on artificial intelligence (AI), 5G cellular, and smart hospitals, among others.

It is important to note that each of these technologies holds significant promise for revolutionizing healthcare. But like any other emerging technology, users and industries have an obligation to weigh the potential security risks before, during, and after implementation.

“Artificial intelligence is not inherently insecure,” HC3 noted. However, security and healthcare experts have long raised concerns about the potential for security mishaps if AI is handled improperly.

The sheer amount of data that AI algorithms need in order to draw clinical conclusions requires users to consider the security of protected health information (PHI) every step of the way.

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https://www.darkreading.com/attacks-breaches/attackers-exploit-zero-day-wordpress-plugin-vulnerability-backupbuddy

Attackers Exploit Zero-Day WordPress Plug-in Vulnerability in BackupBuddy

The critical flaw in BackupBuddy is one of thousands of security issues reported in recent years in products that WordPress sites use to extend functionality.

Jai Vijayan

Contributing Writer, Dark Reading

September 10, 2022

Attackers are actively exploiting a critical vulnerability in BackupBuddy, a WordPress plug-in that an estimated 140,000 websites are using to back up their installations.

The vulnerability allows attackers to read and download arbitrary files from affected websites, including those containing configuration information and sensitive data such as passwords that can be used for further compromise.

WordPress security vendor Wordfence reported observing attacks targeting the flaw beginning Aug. 26, and said it has blocked close to 5 million attacks since then. The plug-in's developer, iThemes, issued a patch for the flaw on Sept. 2, more than one week after the attacks began. That raises the possibility that at least some WordPress sites using the software were compromised before a fix became available for the vulnerability.

A Directory Traversal Bug

In a statement on its website, iThemes described the directory traversal vulnerability as impacting websites running BackupBuddy versions 8.5.8.0 through 8.7.4.1. It urged users of the plug-in to immediately update to BackupBuddy version 8.75, even if they are not currently using a vulnerable version of the plug-in.

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https://healthitsecurity.com/news/medical-device-security-vulnerabilities-discovered-in-baxter-infusion-pumps

Medical Device Security Vulnerabilities Discovered in Baxter Infusion Pumps

If exploited, these medical device security vulnerabilities could result in alteration of system configuration and improper access to sensitive data.

By Jill McKeon

September 09, 2022 - Four medical device security vulnerabilities are impacting certain Sigma and Baxter Spectrum infusion pumps, a Cybersecurity and Infrastructure Security Agency (CISA) explained in an advisory. Rapid7’s principal IoT researcher informed Baxter of the vulnerabilities.

If exploited, the vulnerabilities could result in alteration of system configuration and improper access to sensitive data, CISA stated. Most of the vulnerabilities are exploitable remotely and have a high attack complexity.

The following devices may be impacted by the four vulnerabilities:

·         Sigma Spectrum v6.x model 35700BAX

·         Sigma Spectrum v8.x model 35700BAX2

·         Baxter Spectrum IQ (v9.x) model 35700BAX3

·         Sigma Spectrum LVP v6.x Wireless Battery Modules v16, v16D38, v17, v17D19, v20D29 to v20D32, and v22D24 to v22D28

·         Sigma Spectrum LVP v8.x Wireless Battery Modules v17, v17D19, v20D29 to v20D32, and v22D24 to v22D28

·         Baxter Spectrum IQ LVP (v9.x) with Wireless Battery Modules v22D19 to v22D28

The highest-severity vulnerability, with a CVSS score of 5.5, impacts certain versions of the Baxter Spectrum Wireless Battery Modules (WBM). Researchers discovered that the device does not perform mutual authentication with the gateway server host, which could allow an attacker to perform a machine-in-the-middle attack. Through this attack, a hacker could modify parameters and make the network connection fail.

Another vulnerability affecting the Baxter Spectrum WBM (v20D29) involves the use of an externally controlled format string and received a CVSS score of 5.0.

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https://www.fiercehealthcare.com/payers/look-inside-cvs-caremarks-strategy-improving-health-equity

A look inside CVS Caremark's strategy for improving health equity

By Paige Minemyer

Sep 12, 2022  07:20am

When the CVS Caremark team geared up to take on health disparities, it quickly realized that any initiative would require a significant basis in data to succeed.

That entailed both gathering more data and building the tools necessary to track and analyze them. 

For example, Joel Helle, vice president of physician services at CVS Specialty, told Fierce Healthcare that Caremark has not historically gathered race and ethnicity data, but now asks payers and plans sponsors for that information to more accurately target where disparities are occurring.

"It's real race and ethnicity data, and we know who those patients are," he said. "That's the future, in my mind, of what everybody needs to do."

In addition, the company built a proprietary tool that combs data from 17 different indexes to identify where disparities exist, he said. That tool, he said, puts "red dots" on the map to highlight risks, and the Caremark team can then use its internal data to further drill down to challenges in specific communities.

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https://www.fiercehealthcare.com/health-tech/make-telemedicine-work-visually-impaired

How to make telemedicine work for visually impaired patients

By Frank Diamond

Sep 8, 2022  07:00am

Telemedicine came into its own during the COVID-19 pandemic.

Under the CARES Act, physicians could bill the same amount for a telemedicine visit with Medicare patients as they could for an in-person visit. And many commercial healthcare insurers followed suit, relaxing restrictions for telemedicine for most patients.

This “points to the fact that now that telehealth is mainstream, it is essential that no group be left behind if at all possible,” Jonathan Weiner, a professor of health policy and management and health informatics at the Johns Hopkins Bloomberg School of Public Health, tells Fierce Healthcare. “This would include patients with disabilities that impact their use of telehealth as well as those facing technical or financial access barriers. And while telehealth rates may have decreased since the peak of the pandemic, we aren’t going back to the pre-COVID era. This mode of care is here to stay, and we must view these barriers as an important potential cause of healthcare disparities.”

However, not all demographic groups benefited from the changes. People who are visually impaired or blind face barriers to using telemedicine, as a survey conducted by the American Foundation for the Blind (AFB) discovered.

The AFB surveyed 488 adults in the U.S. who are blind, have low vision or are deafblind and found that 70% of visually impaired patients tried to use telemedicine, but 57% reported problems accessing the platforms. Visual impairment is a growing problem, as Health Affairs reported yesterday.

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https://www.healthcareittoday.com/2022/09/12/open-standard-offers-access-control-revocation-and-other-traits-to-reproductive-health-data/

Reproductive Health Data: Open Standard Offers Access Control, Revocation, and Other Traits

September 12, 2022

Andy Oram

A team of women coders caught attention at DEF CON on June 26 with a secure reproductive health tracking app (Figure 1) that lets a menstruating person exchange data securely with health staff. Their core technology was OpenTDF, a free software library that advances a crucial goal in health care: patient control over their own data, in tandem with the ability to share data with their doctors and other people through access policies and encryption.

The need for patient control and privacy protection has become more timely than ever with the U.S. Supreme Court decision to reverse Roe v Wade. The public staggered under news that a prosecutor in Nebraska got access to private Facebook postings through a warrant in order to prosecute a teenager for abortion.

This article isn’t about the politics or morality around abortion; it’s about the current state of health care privacy and the right of the individual to control their data. The reproductive health app itself, SecureCycle, is not yet ready for use. It was created in a recent hackathon held by Virtru to promote OpenTDF, which they created and put under an open source BSD license.

Few healthcare apps truly protect privacy. The Mozilla Foundation, which has rigorously upheld online privacy for years, rates applications related to reproductive health for privacy. They reveal a wide divergence in privacy protection. A recent email from the Foundation said, “18 of the 20 reproductive health apps we reviewed earned our *Privacy Not Included warning label.” Risks can be subtle: For instance, although Apple Watch is fairly trustworthy on its own, breaches can open whenever you try to transfer your data to another service.

 

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https://www.healthleadersmedia.com/innovation/childrens-hospital-los-angeles-tests-mhealth-app-take-teen-depression

Children's Hospital Los Angeles Tests an mHealth App to Take on Teen Depression

Analysis  |  By Eric Wicklund  |   September 06, 2022

The hospital is partnering with digital health company Limbix to test its SparkRx digital therapeutic app on adolescents who have an increased risk of depression.

Children's Hospital Los Angeles has launched a year-long study to determine whether a digital therapeutic mHealth app can help treat depression in adolescents.

CHLA is partnering with digital health company Limbix on the project, which will test the company's SparkRx app on roughly 40 people between the ages of 13 and 22 with elevated depressive symptoms who are being treated in the hospital's cardiology and gastroenterology programs. The app uses cognitive behavioral therapy (CBT) concepts to guide users through an interactive program on their smartphones to identify the relationship between mood and behavior.

"We’re excited about this opportunity to offer our patients a new resource for adolescent depression via a digital therapeutic that could help minimize barriers and increase access to mental health treatment," Heather Bemis, PhD, a licensed clinical psychologist in the Division of Comfort and Palliative Care at CHLA's Department of Anesthesiology Critical Care Medicine at CHLA and principal investigator of the study, said in a press release.

The five-week program is divided into five segments, which are intended to be completed each week. Patients are guided through the program by a character called Limbot, who provides examples of how they have undertaken behavioral activation therapy as they pas through each stage. Patients complete a patient health questionnaire and participant symptom check each week, and have access to online resources and in-app crises services if needed.

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Enjoy!

David.

 

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