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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AI Clinical Decision Support Tool Can Help Predict COVID-19 Prognosis
Researchers from The Feinstein Institutes for Medical Research at Northwell Health have developed an artificial intelligence tool to predict COVID-19 prognosis and disease severity.
November 18, 2022 - Researchers from The Feinstein Institutes for Medical Research, the research arm of Northwell Health, have developed an artificial intelligence (AI)-based clinical decision support tool that can predict COVID-19 patient prognosis and severity of the disease using blood work and EHR data.
According to the study describing the tool, clinical prognostic models can assist in patient care decisions, but their performance can dip or drift because of shifts in time and location. The researchers state that these models necessitate regular monitoring and updating to address this.
Further, the authors note that prognostic models for COVID-19 do not account for these changes in performance, despite rapid, significant changes across variants and disease waves. The research team set out to develop a model that accounts for quick changes in patient conditions and outcomes.
“COVID-19 was one of the most dynamic diseases we’ve witnessed in modern history and information about how to care for patients was constantly evolving,” said Theo Zanos, PhD, senior author of the paper and associate professor at the Feinstein Institutes’ Institute of Health System Science and Institute of Bioelectronic Medicine, in the press release. “By harnessing data and developing a real-time auto-updating clinical tool, we set out to create a tool that accounts for these developments and helps clinicians make the decisions they need to deliver better care.”
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Beyond the hospital walls: how digital will revolutionise cancer care
Dr Majid Kazmi, director of innovation for cancer and surgery and deputy medical director, Guy’s and St Thomas’ NHS Foundation Trust, outlines how digital promises to revolutionise cancer care.
DHI News Team 16 Nov 2022
The number of people living longer with cancer is on the rise. In the UK, fifty percent of people can now expect to live with cancer for ten years or more after a diagnosis1.
This is clearly a good thing but it does present a challenge for the NHS when combined with a shrinking oncology workforce2 and escalating costs.
With these resource challenges, managing patients through their cancer journey is becoming more difficult.
And as people live longer with cancer, keeping patients connected, better informed and giving them the ability to make decisions about their care becomes increasingly important.
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https://www.bnnbloomberg.ca/ransomware-gangs-shift-tactics-making-crimes-harder-to-track-1.1845249
Ransomware Gangs Shift Tactics, Making Crimes Harder to Track
, Bloomberg News 18 Nov, 2022
(Bloomberg) -- Ransomware gangs increasingly use their own or stolen computer code, moving away from a leasing model that made their activities easier to monitor, new research shows.
Numerous prominent hacking groups in recent years have functioned by leasing their malicious software and computing infrastructure to other bad actors, in what’s known as ransomware-as-a-service. That model, which experts say turbocharged the number of ransomware attacks, was offered by infamous groups such as Conti, which shuttered Irish health systems, and REvil, deemed responsible for a 2021 intrusion at the IT management firm Kaseya Ltd.
But now the number of smaller hacking groups has rapidly increased, with many of them deploying their own code or stealing it from others, according to Allan Liska, a threat intelligence analyst at Recorded Future Inc. The shift has coincided with a reduction in activity by some higher-profile groups, according to research Liska presented Friday after the CYBERWARCON security conference.
The evolution is complicating efforts to track various new groups, such as Onyx, which researchers believe reuses Conti’s code and has claimed to target several victims.
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https://techcrunch.com/2022/11/18/fbi-cisa-hive-ransomware-warning/
Hive ransomware actors have extorted over $100M from victims, says FBI
The U.S. government has warned of ongoing malicious activity by the notorious Hive ransomware gang, which has extorted more than $100 million from its growing list of victims.
A joint advisory released by the FBI, the U.S. Cybersecurity and Infrastructure Security Agency, and the Department of Health and Human Services on Thursday revealed that the Hive ransomware gang has received upwards of $100 million in ransom payments from more than 1,300 victims since the gang was first observed in June 2021.
This list of victims includes organizations from a wide range of industries and critical infrastructure sectors such as government facilities, communications and information technology, with a focus on healthcare and public health entities.
Hive, which operates a ransomware-as-a-service (RaaS) model, claimed the Illinois-based Memorial Health System as its first healthcare victim in August 2021. This cyberattack forced the health system to divert care for emergency patients and cancel urgent care surgeries and radiology exams. The ransomware gang also released sensitive health information of about 216,000 patients.
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https://www.medscape.com/viewarticle/984280
Telepsychiatry Tips: Etiquette and Ethics
Nancy A. Melville
November 17, 2022
From providing virtual therapy sessions to patients in the front seats of their cars, to sessions with patients who turn out to be in another state, the new paradigm of telepsychiatry is presenting clinicians with a host of situations with unwritten or constantly changing rules.
But key practice tips are emerging for the optimization of virtual sessions, said Sanjay Gupta, MD, chief medical officer of the BryLin Behavioral Health System in Buffalo, N.Y., during a presentation on the subject at the 21st Annual Psychopharmacology Update presented by Current Psychiatry and the American Academy of Clinical Psychiatrists in Cincinnati, Ohio.
Gupta noted that while "many pitfalls [may] occur," an overriding rule that should be emphasized with telepsychiatry is that "[virtual visits] are held to the same standard of care as an in-person visit." This "rule" needs to be followed diligently, he said, as the key difference in virtual visits is a reduced sense of the formality of a psychotherapy session.
With virtual sessions, the therapeutic experience "can feel kind of trivialized," said Gupta, who is also a clinical professor in the department of psychiatry, State University of New York at Buffalo. He noted that it is crucial that "the sacredness of a private setting should not be diluted."
Challenges in finding that privacy for some, however, lead to the issue of the "patients in cars" scenario, Gupta said. Still, he added, while psychiatric sessions should never be conducted when a patient is driving, the front seat of a parked car may, for some, be the most private setting available.
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The Path to Patient Empowerment: Hospitals are granting patients access to their health information, but is that enough?
November 18, 2022
The 21st Century Cures Act codifies immediate access to health information for patients. The Act paves the way for patients to become more pro-active partners in their care. Access alone, however, is not sufficient. There is little value for patients to access health information they cannot understand. This is especially the case with radiology. A typical radiology report contains a lot of medical jargon and data that can be misinterpreted easily by those without medical training. One radiologist-led health technology company, SCANSLATED is addressing this challenge by offering AI-powered report translation software to help patients more easily understand their imaging results.
Patients Proactive Participants in Their Care
Studies have shown that patients who are more active in their care, experience better health outcomes at lower costs compared to less active patients. An “activated” patient is one that has the skills, ability, and willingness to manage their own health and health care experience.
Until recently, the healthcare system did not make it easy for patients to be active in their own care. It was difficult for patients to get copies of their medical records and when they did, the information was often out-of-date or incomplete. Only the most determined patients are able to successfully navigate the maze of healthcare policies and organizations to gather their records in one place.
Today, the widespread adoption of electronic health records (EHRs) and patient portals has made it easier for patients to access their own health information. That access is an important first step in turning passive patients into activated ones. However, to truly activate and engage patients in their care will require helping them understand the information contained in their medical records.
Radiology reports, for example, are particularly difficult for patients to understand.
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https://www.healthleadersmedia.com/innovation/hlth-takes-shot-redefining-healthcare
HLTH Takes a Shot at Redefining Healthcare
Analysis | By Eric Wicklund | November 17, 2022
The healthcare conference celebrated its 5th year in Las Vegas, where almost 10,000 attendees discussed the biggest challenges in healthcare alongside gambling, gin and tonics, and glowsticks.
KEY TAKEAWAYS
· Roughly 10,000 people attended HLTH's fifth annual conference this past week in Las Vegas.
· Attendees discussed a number of critical healthcare issues, including provider burnout, workforce shortages, interoperability, digital health, patient engagement, and AI.
· The combination of healthcare and typical Vegas-style entertainment may have ruffled some feathers, but the event gave attendees an opportunity to break down barriers and discuss a redefined landscape that focuses on both health and care.
At times it felt like a rock concert or a rally. There was food, drinks, a meditation tent, beauty salon, games, mimosas in the registration line, popcorn and ice cream. And the glitz and glamor of Las Vegas was just beyond the walls of the Venetian's conference center.
Was this really a healthcare conference?
Yes, it was. And while HLTH 2022 put on quite a show, it was still all about healthcare. But a new definition of "healthcare," which has been battered by the pandemic and bruised by the politics. Now, it's about both health and care, and all the connections that can—and should—be made to support that strategy.
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https://www.lexology.com/library/detail.aspx?g=2a9508a2-d7fa-42bf-a283-9a711abddf8d
Thaler Shut Down: High Court of Australia confirms AI incapable of being an “inventor”
DLA Piper - Nicholas Tyacke, Robynne Sanders, Greg Bodulovic, Alexandra De Zwart, Sarah McKenzie and Jordan Davis
Australia November 16 2022
Artificial intelligence (AI) is playing an increasingly relevant and important role in our lives. Be it through your personal devices, streaming platforms or the production of vaccines, our symbiotic relationship with AI is unquestionable. This rapid rise in the use of AI raises challenging questions for patent law: are AI-created technologies patentable and should AI be recognised as the inventor? We take a look at the decisions leading up to the decision of the High Court to refuse Dr Thaler’s application for special leave, where these questions were answered. With innovation heavily embracing AI across all industry sectors, this decision is key for all businesses to understand.
Litigation History
The patent application in question lists the inventor as the AI system “DABUS”, an acronym for “device for the autonomous bootstrapping of unified sentience”. The Deputy Commissioner of Patents determined that the Patents Act and Regulations were inconsistent with AI being recognised as an inventor (see Stephen L. Thaler [2021] APO 5).
Dr Thaler appealed to the Federal Court, where Justice Beach concluded that, on the contrary, an AI system can be recognised as an inventor under the Patents Act. This, Justice Beach said, would be to accord the word “inventor” with its ordinary meaning, a meaning that must not only recognise the “evolving nature of patentable inventions and their creators” in light of the newly inserted objects clause under the Patents Act, but a meaning that must reflect reality (i.e. if the AI system is not the inventor, who is: would it be the programmer, the owner, the operator, the trainer, or perhaps the person who provided input data?). Our detailed report on the first instance decision can be found here.
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Privacy and Security
A review of 12 healthcare websites that focus on substance abuse finds that 11 use tracking cookies, four use session recordings, six use Meta Pixel, and all 12 sent data to advertising companies.
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New healthcare privacy challenges as online data tracking, sharing methods evolve
With security concerns, including a potential breach and a class-action suit, around Meta Pixel and other web tracking tools, health systems should be considering "all the ways PHI may be used, disclosed and accessed," says a former OCR investigator.
By Mike Miliard
November 16, 2022 12:39 PM
This past June, a John Doe plaintiff who was a patient at Baltimore-based Medstar Health System filed a class-action complaint against Meta Platforms in the U.S. District Court for the Northern District of California.
The plaintiff alleged that Meta, the parent company of Facebook, was using its Pixel tracking technology to access patient information from websites and portals of hospitals and health systems for targeted marketing.
Since then, at least two other class-action suits have been filed against Meta alleging illegal information harvesting. And several major U.S. health systems have either been named as co-defendants (Dignity Health, UCSF) or faced lawsuits themselves (Northwestern Memorial Hospital) for alleged misuse or misconfiguration of the Pixel tool.
Meanwhile, in August, Novant Health disclosed a data breach related to the Java tracking script that may have affected 1.3 million individuals. And in October, Advocate Aurora Health said as many as 3 million users of its MyChart patient portal and LiveWell website and app may have had their data transmitted via Pixel technology.
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https://www.healthcareittoday.com/2022/11/17/directtrust-and-ehnac-announce-merger-agreement/
DirectTrust and EHNAC Announce Merger Agreement
November 17, 2022
EHNAC to merge with and into DirectTrust; EHNAC Commission will remain intact
DirectTrust and the Electronic Healthcare Network Accreditation Commission (EHNAC) today announced an agreement to merge EHNAC with and into DirectTrust, effective January 4, 2023. DirectTrust is a non-profit healthcare industry alliance created to support secure, identity-verified electronic exchanges of protected health information. EHNAC is a non-profit standards development organization and accrediting body for organizations that electronically exchange healthcare data.
With EHNAC’s incorporation into DirectTrust, DirectTrust anticipates bringing to fruition new accreditation programs, with a program focused on Credential Service Providers related to consumer access and use of health data as an early target.
EHNAC’s senior leaders, Executive Director and CEO Lee Barrett and COO Debra Hopkinson are long-standing pillars of the health IT trust and accreditation communities and will continue to work for and consult with DirectTrust. EHNAC staff members and assessors will also join DirectTrust.
The EHNAC Commission will remain intact and be designated as Commissioners overseeing accreditation-specific matters. The DirectTrust Board of Directors will continue as is.
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https://mhealthintelligence.com/news/ama-releases-blueprint-to-optimize-digitally-enabled-care
AMA Releases Blueprint to Optimize Digitally Enabled Care
A recent blueprint from the American Medical Association described how digitally enabled care can impact future healthcare and how organizations can collaborate to enhance these services.
November 16, 2022 - With the goal of filling in gaps related to virtual healthcare, the American Medical Association (AMA) and Manatt Health released a Blueprint for Optimizing Digitally Enabled Care, which describes six pillars that can help optimize digital health practices.
According to the AMA, there is untapped potential associated with digitally enabled care. The organization noted that investments, technology adoption, and patient needs play a significant role in how digitally enabled care evolves and how it can be used to improve access and care quality.
“When equitably designed and thoughtfully integrated, digital health tools can effectively augment and enhance care,” said AMA President Jack Resneck Jr., MD, in a press release. “Yet often, digital health products exist in silos and risk additional fragmentation, higher costs, and diminished care experiences. Optimizing the full potential of digitally enabled care requires a collaborative effort and the blueprint offered by the AMA outlines opportunities for physicians and other stakeholders to move in partnership toward improving the health of the nation.”
The AMA's blueprint highlights six areas stakeholders should focus on when optimizing digitally enabled care.
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The Leapfrog Group Celebrates 10 Years of Patient Safety Improvement
The US has seen a decade of patient safety improvement, including 25 percent improvement in some never events.
By Sara Heath
November 16, 2022 - Patient safety has gotten better in the past 10 years, with general hospitals across the country getting better scores in a number of performance measures, including some never events, according to The Leapfrog Group’s fall 2022 Hospital Safety Grades, which were obtained via email.
This iteration of the Hospital Safety Grades marks the 10th year the organization has issued its rankings, with an additional analysis showing positive change over time.
“Never in history have we seen across-the-board improvement in patient safety until this last decade, coinciding with the history of the Hospital Safety Grade,” Leah Binder, president and CEO of The Leapfrog Group, said in a statement emailed to journalists. “We salute hospitals for this milestone and encourage them to accelerate their hard work saving patient lives.”
The Leapfrog Group clarified that it has not always tracked the same patient safety performance measures; however, for the performance measures that have remained consistent since the measures’ inception, the organization said there’s been vast improvement over the decade.
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FDA, MITRE Publish Updated Medical Device Security Incident Response Playbook
The updated playbook highlights additional key medical device security considerations and contains a new resource appendix to help healthcare organizations navigate incident preparedness and response.
By Jill McKeon
November 16, 2022 - The US Food and Drug Administration (FDA) and MITRE released an updated version of their “Medical Device Cybersecurity Regional Incident Preparedness and Response Playbook.” The playbook provides healthcare organizations with actionable strategies and resources for responding to cyber incidents while ensuring medical device security.
Since the first iteration of the playbook was released in 2018, cyberattacks have continued to impact the healthcare sector at alarming rates. Medical device security remains a top concern for healthcare organizations, and keeping those devices in operation throughout a cyber incident is crucial.
“Because these cyber incidents have often affected multiple medical devices and IT systems, they have led to widespread disruptions from which it can take weeks or months to fully recover,” the playbook stated.
“FDA believed that it would be valuable to update the playbook to reflect these evolving trends, and once again contracted MITRE to reach out to stakeholders to identify gaps, challenges, and additional resources since the original publication of the playbook.”
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https://www.scientificamerican.com/article/mental-health-apps-are-not-keeping-your-data-safe/
Mental Health Apps Are Not Keeping Your Data Safe
With little regulation and sometimes outright deception, the possibility of discrimination and other “data harms” is high
By Piers Gooding, Timothy Kariotis on November 15, 2022
Imagine calling a suicide prevention hotline in a crisis. Do you ask for their data collection policy? Do you assume that your data are protected and kept secure? Recent events may make you consider your answers more carefully.
Mental health technologies such as bots and chat lines serve people who are experiencing a crisis. They are some of the most vulnerable users of any technology, and they should expect their data to be kept safe, protected and confidential. Unfortunately, recent dramatic examples show that extremely sensitive data has been misused. Our own research has found that, in gathering data, the developers of mental health–based AI algorithms simply test if they work. They generally don’t address the ethical, privacy and political concerns about how they might be used. At a minimum, the same standards of health care ethics should be applied to technologies used in providing mental health care.
Politicorecently reported that Crisis Text Line, a not-for-profit organization claiming to be a secure and confidential resource to those in crisis, was sharing data it collected from users with its for-profit spin-off company Loris AI, which develops customer service software. An official from Crisis Text Line initially defended the data-exchange as ethical and “fully compliant with the law.” But within a few days the organization announced it had ended its data-sharing relationship with Loris AI, even as it maintained that the data had been “handled securely, anonymized and scrubbed of personally identifiable information.”
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November 15, 2022
EHR-based decision support system helps prevent VTE in hospitalized patients
CHICAGO — In hospitalized medically ill patients, an electronic health record-based decision support system reduced major thromboembolic events compared with usual care, researchers reported.
Use of the system was also associated with higher rates of appropriate thromboprophylaxis compared with usual care.
Alex C. Spyropoulos, MD, professor at the Zucker School of Medicine at Hofstra/Northwell and the Institute of Health System Science at the Feinstein Institutes for Medical Research in Manhasset, New York, and colleagues designed the cluster-randomized IMPROVE-DD trial to determine whether an EHR-based clinical decision support system, which informed clinicians of each patient’s IMPROVE-DD venous thromboembolism risk score, would increase the use of appropriate thromboprophylaxis and reduce major thromboembolic events compared with usual care in hospitalized medically ill patients. The results were presented at the American Heart Association Scientific Sessions.
Increasing thromboprophylaxis
“A big proportion of venous thromboembolism in the community is due to hospitalization for recent medical illness,” Spyropoulos told Healio. “By far, more severe and fatal VTE events occur in nonsurgical medically ill patients. There are approximately 8 million hospitalized medically ill patients in the United States every year. Thromboprophylaxis for this heterogeneous, difficult population is misused or underused, especially in the post-discharge period. Data show only 4% of hospitalized medically ill patients receive any kind of post-discharge prophylaxis. We know that about one in four hospitalized medically ill patients are at high risk of thrombosis, not just in the hospital but after discharge.”
Existing systems to improve VTE prophylaxis in this population are either inefficient or very expensive, he said.
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Can technology help stem the tide of nurse turnover?
Panelists at HLTH say the pandemic and rising documentation loads have disillusioned nurses, and IT must support them and extend their capabilities.
Nov 15 2022
Editor in Chief, HDM
Statistics on nurse turnover is sobering, and information technology must answer the call to stem the tide of the shrinking provider workforce, and augment and extend care teams in place.
Current data suggest that the U.S. healthcare industry may have 200,000 to 450,000 nursing vacancies by 2025, but those estimates may be understated because of disillusionment with the profession, noted panelists at HLTH in Las Vegas on Sunday, November 13.
Trauma related to the COVID-19 pandemic resulted in 100,000 nurses leaving the workforce in 2021, and this year, annual turnover stands at 27 percent, said Bonnie Clipper, moderator of the panel and managing director of Innovation Advantage, a consultancy specializing in nursing issues. Younger nurses are becoming disillusioned with caregiving workloads, and 57 percent of new nurses leave the profession after two years.
Nurses leaving in droves
“There’s an exodus out of healthcare that no one talks about,” said Rebecca Love, chief clinical officer of IntelyCare, which provides technology that matches nurses wanting to work with providers seeking nurse services. “One in three bedside nurses plan to exit (the profession soon). The irony is that there have never been more nurses in the U.S. than there are today. What we have is a shortage of nurses willing to work in the healthcare system today.”
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https://www.healthcareittoday.com/2022/11/16/top-3-digital-innovations-that-transformed-healthcare/
Top 3 Digital Innovations that Transformed Healthcare
November 16, 2022
The following is a guest article by Chad Anguilm, Vice President of Growth at Medical Advantage
Patient engagement is the next frontier in healthcare and single-platform patient portals created the digital foundation for this ongoing transformation. In today’s technology-driven world, patients now expect a seamless healthcare experience, which translates to a digital “one-stop shop” for managing their personal health information.
Many patients already use patient portals for tasks such as scheduling appointments and requesting prescription refills. However, today patients are increasingly utilizing existing technology to participate in their own health journey more actively.
The Progress of Digital Transformation
Digital transformation occurs when positive changes in health information technology improve interactions between providers and patients. Legacy EHRs, while transformational for early adopters, were designed primarily for the safe exchange of patient data between providers.
Today’s EHRs have transformed the healthcare landscape by providing patients unprecedented – and long overdue – access to their personal health information. Legislation regulating patient data also favors transparency, since providers, developers, and health information networks now are prohibited from engaging in practices that would prevent patients from receiving personal health data or inhibit an exchange of data at the patient’s request.
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https://patientengagementhit.com/news/the-future-of-medtech-defined-by-healthcare-consumerism
The Future of MedTech Defined by Healthcare Consumerism
MedTech executives said healthcare consumerism and the “patient as consumer” trend will redefine their company’s long-term strategy.
By Sara Heath
November 15, 2022 - Healthcare consumerism is becoming more than just a buzzword, with medical technology (MedTech) executives signaling that the trend is starting to influence their company’s strategic planning, according to a new report from Accenture and AdvaMed.
The concept of healthcare consumerism, defined as the personal choice and responsibility in paying for and managing one’s own health, isn’t exactly new.
With the rise in high-deductible health plan (HDHP) enrollment, patients are increasingly on the hook for their medical expenses. That, coupled with the expansion of health technology options and focus on chronic disease prevention and management, has transformed the patient into a consumer who has choice and agency.
Patients are now approaching their healthcare the way they might book a trip or shop on Amazon, and healthcare needs to answer that call.
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Online Appointment Scheduling Falls Short, Dissuades Care Access for 61%
Seventy percent of patients said that despite using an online appointment scheduling tool, they had to complete appointment booking over telephone, dissuading care access for 61% of folks.
By Sara Heath
November 15, 2022 - More than half of patients are going without care access because the online appointment scheduling systems they rely on are not fulfilling their needs and expectations, according to surveying from OnePoll on behalf of Notable.
Particularly, patients reported that they are being rerouted to other methods of appointment scheduling, like telephone call, when they try to utilize an organization’s online self-scheduling tools.
Self-scheduling has been central in medicine’s transformation toward healthcare consumerism. Patients have been on the record saying they want access to online self-scheduling options for years, with surveys showing that patients like the convenience that online tools offer them.
But although most healthcare organizations have followed that call and installed online appointment scheduling tools on their websites and in their patient portals, these systems aren’t always workable, the survey of 1,005 patients showed.
Particularly, 61 percent of respondents said they did not access healthcare in the past year because using an online self-scheduling system was too complicated.
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https://healthitsecurity.com/news/many-cloud-attacks-end-in-financial-loss-for-healthcare-sector
Many Cloud Attacks End in Financial Loss for Healthcare Sector
The healthcare sector is a lucrative target for threat actors, with 86 percent of cloud attacks ending in financial loss, a new report stated.
November 15, 2022 - Numerous cloud attacks are successfully exploiting the healthcare sector for financial gain, according to a newly released 2022 Cloud Security Report by cybersecurity vendor Netwrix.
Cloud infrastructure has become an integral part of daily workloads for millions of organizations worldwide, the press release stated.
In recent years, healthcare cloud adoption has steadily increased with the current drive toward digital transformation. Following this increase, 73 percent of healthcare organizations who use cloud infrastructure store sensitive data there, which puts the infrastructure at risk for attacks.
"Healthcare organizations plan to increase the share of their workload in the cloud from 38 percent to 54 percent by the end of 2023,” Dirk Schrader, vice president of security research at Netwrix, said in a public statement.
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https://www.medscape.com/viewarticle/983930?icd=ssl_login_success_221115
Could Diet Be Another Vital Sign in the Electronic Health Record?
Dr Kristi Artz
For almost 20 years, Kristi Artz, MD, witnessed the staggering toll of diet-related disease on the patients in her emergency room (ER).
Every day, Artz's ER became ground zero for patients with the most severe chronic disease complications. Some presented with strokes, others required limb amputations from uncontrolled diabetes, all were people she hoped to save. Ultimately, Artz tells Medscape Medical News, she just "felt like I was putting a band-aid on the problem."
Artz decided to change course and pursue further training in therapeutic lifestyle interventions and culinary medicine to focus on health promotion and chronic disease reduction and remission.
When she had the opportunity to help start a lifestyle and culinary medicine program in Michigan, Artz jumped at it. She recognized the critical need to help patients assess and improve diet quality as a fundamental step to better health.
Artz is now medical director of such a program within a large integrated health system in Michigan. She and her team were early adopters of a digital platform, Diet ID, which enabled them to standardize and track diet like other vital signs, directly into the electronic health record (EHR).
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Pandemic drives technology uptake in senior living communities
November 14, 2022
The pandemic not only sped up the adoption of technology in the senior living and care field; it also opened the door to a variety of new technologies that one expert said are here to stay.
Technologic innovations have helped long-term care organizations tackle everything from resident safety and mobility to filling gaps left by staff shortages.
Infection control, as well as staff and resident screenings, introduced during the COVID-19 pandemic remain important technology components across settings, according to the 2022 edition of the LeadingAge Ziegler 200.
Infection control technology is here to stay
The publication, which includes trends in the adoption of various aging-related technologies across 1,570 market-rate communities, showed that 49% of communities — compared with 51% last year — continue to use infection control technologies.
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Team-based Clinical Documentation Cuts Physician Time Spent on EHR Notes
Researchers found that decreased time spent on EHR notes is primarily a function of manual text reduction and team-based clinical documentation practices.
November 14, 2022 - Team-based clinical documentation led to decreased physician time on EHR notes, according to an article published in JAMIA.
Researchers used 2021 EHR metadata for 130,079 ambulatory physician Epic users to identify groups of physicians who decreased note length or documentation time.
The study found that decreasing note length and decreasing physician time in notes are distinct goals supported by different strategies of note composition. Of the 37,857 physicians that the researchers identified as having reduced note length or note time, only 6,793 (17.9 percent) achieved decreases in both measures.
“Our exploration of mechanisms further supports this interpretation, as we show that decreases in these two measures are functions of distinct mechanisms of note composition and team-based contribution,” the authors wrote. “These distinct underlying forces suggest that most physicians may be pursuing one of these goals at the expense of the other.”
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https://www.aboutamazon.com/news/retail/what-is-amazon-clinic
Introducing Amazon Clinic, a virtual health service that delivers convenient, affordable care for common conditions
Written by Dr. Nworah Ayogu, Chief Medical Officer and General Manager, Amazon Clinic
November 15, 2022
At Amazon, we want to make it dramatically easier for people to get and stay healthy. We’ve begun that journey with Amazon Pharmacy—where customers can get their medication delivered to their door conveniently—in just two days for Prime Members. We’ve also entered into an agreement to acquire One Medical, a human-centered and technology-powered provider of primary care. One Medical members benefit from a dedicated relationship with their provider, a friendly and convenient in-office experience, and ongoing engagement via a dedicated app.
Amazon Pharmacy and One Medical (once the deal closes) are two key ways we’re working to make care more convenient and accessible. But we also know that sometimes you just need a quick interaction with a clinician for a common health concern that can be easily addressed virtually. We’ve thought hard about how to improve this part of the experience as well. That’s why today we’re also introducing Amazon Clinic, a message-based virtual care service that connects customers with affordable virtual care options when and how they need it—at home, after dinner, at the grocery store, or on the go—for more than 20 common health conditions, such as allergies, acne, and hair loss.
We believe that improving both the occasional and ongoing engagement experience is necessary to making care dramatically better. We also believe that customers should have the agency to choose what works best for them. Amazon Clinic is just one of the ways we’re working to empower people to take control of their health by providing access to convenient, affordable care in partnership with trusted providers. Our new health care store lets customers choose from a network of leading telehealth providers based on their preferences. Every telehealth provider on Amazon Clinic has gone through rigorous clinical quality and customer experience evaluations by Amazon’s clinical leadership team.
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https://www.healthcareitnews.com/news/provider-burnout-rates-have-leveled-says-klas-report
Provider burnout rates have leveled off, says KLAS report
The rates are holding steady at 34% since 2021, but the percentage of clinicians citing a chaotic work environment has stayed at 28% over the last five years.
November 15, 2022 02:58 PM
Combining research on provider burnout, electronic health record experiences and other data, KLAS researchers address what organizations can do to address staff shortages and patient care.
WHY IT MATTERS
Most of the measured contributors to burnout have become less prevalent than they were at the start of the COVID-19 pandemic, according to a new Provider Burnout and the EHR Experience report from the KLAS Arch Collaborative.
Beyond the news that overall provider burnout rates did not increase with this year's survey, KLAS researchers found the following factors have improved:
- High levels of trust in organizational leadership around the EHR correlated with a lower percentage of providers reporting burnout.
- Reducing the after-hours workload can decrease burnout significantly.
- Organizations that implement burnout-prevention programs are seeing results.
However, staffing shortages – a newly-measured factor studied by KLAS researchers – are more frequently reported by all types of clinicians, with 40% of those surveyed citing this contributing factor as a stressor.
The stressor with the most significant drop was too much time spent on bureaucratic tasks – from 48% to 42%.
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Providing Useful Anonymized Data for Health Research: Subsalt Finds a Blended Solution
November 15, 2022
Ever since data went online, health care organizations and others have been struggling to provide useful data for advanced analytics while guarding Protected Health Information (PHI). Data masking, data aggregation, synthetic data, and differential privacy are among the solutions, but each presents difficulties and limitations.
Each solution, for instance, requires expert intervention to determine how much data transformation is required to achieve de-identification. If you’re trying to protect data for a large population, such as people with high blood pressure, you can be fairly loose about anonymization, whereas if you’re tracking a rare condition, you have to suppress much more data to prevent individuals from being re-identified. Experts apply statistical tests to determine the right amount of protection.
Each solution also limits the questions researchers can ask. You might prepare a data set for researchers to track high blood pressure, or even to correlate high blood pressure with congestive heart failure—but if they think up some other correlation you haven’t anticipated, they may need a separate dataset with new privacy transformations to precisely study it.
I recently talked to David Singletary, co-founder of Subsalt, about their innovative approach to providing anonymized synthetic data on demand in response to a data consumer’s specific needs. Subsalt uses advanced generative AI models in an automated manner to offer multiple views into the same data, depending on the task at hand.
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Team-based Clinical Documentation Cuts Physician Time Spent on EHR Notes
Researchers found that decreased time spent on EHR notes is primarily a function of manual text reduction and team-based clinical documentation practices.
November 14, 2022 - Team-based clinical documentation led to decreased physician time on EHR notes, according to an article published in JAMIA.
Researchers used 2021 EHR metadata for 130,079 ambulatory physician Epic users to identify groups of physicians who decreased note length or documentation time.
The study found that decreasing note length and decreasing physician time in notes are distinct goals supported by different strategies of note composition. Of the 37,857 physicians that the researchers identified as having reduced note length or note time, only 6,793 (17.9 percent) achieved decreases in both measures.
“Our exploration of mechanisms further supports this interpretation, as we show that decreases in these two measures are functions of distinct mechanisms of note composition and team-based contribution,” the authors wrote. “These distinct underlying forces suggest that most physicians may be pursuing one of these goals at the expense of the other.”
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ONC Outlines Health IT Certification Tips for 2015 Edition Cures Update
While ONC Health IT Certification Program participation is voluntary, not complying with the 2015 Edition Cures Update can negatively affect end users’ ability to meet other HHS requirements.
November 14, 2022 - The 2015 Edition Cures Update made several changes to the ONC Health IT Certification Program, including new functionalities and requirements establishing the Conditions and Maintenance of Certification.
Most certified health IT developers must update their certified Health IT Modules by December 31, 2022.
Certified health IT developers with API technology certified to the § 170.315(g)(8) Application Access- data category request criterion must update their product(s) to the § 170.315(g)(10) Standardized API for patient and population services criterion.
“If certified health IT developers face challenges with successfully testing to § 170.315(g)(10), they should communicate with their ONC Authorized Certification Body (ONC-ACB) as soon as possible and work with them to successfully test with an ONC Authorized Testing Lab (ONC-ATL) by the deadline,” Laura M. Urioste of ONC wrote in the blog post.
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https://mhealthintelligence.com/news/who-releases-guide-to-enhance-delivery-of-telehealth-services
WHO Releases Guide to Enhance Delivery of Telehealth Services
The agency issued a consolidated guide containing recommendations and processes to assist policymakers and providers in delivering telehealth services.
November 14, 2022 - A recent guide issued by the World Health Organization (WHO) provided a set of recommendations and strategies for future telehealth implementation, ultimately aiming to advance telehealth use.
Amid the elimination of in-person care restrictions added during the COVID-19 pandemic, healthcare stakeholders believe telehealth will remain an integral part of the new normal.
Although these services have generally been efficient and accessible, the WHO noted that there is room for improvement and that future optimization is necessary to maintain telehealth use. This led the organization to create a consolidated guide designed to support the process of telehealth implementation among WHO Member States.
"For telemedicine to have the most impact when and where it is needed, the enabling environment is critical. Investments in national policies, governance, and standards are important to have in place," said Professor Alain Labrique, director of the Department of Digital Health and Innovation at WHO, in a press release. "This Guide is not a stand-alone solution, but rather a complementary tool that works in tandem with user-centered solutions that are accessible by all, towards delivering high-quality remote care that is accountable and suitable to the context in which patients live."
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https://healthitsecurity.com/news/cisa-3-steps-to-improve-cybersecurity-vulnerability-management
CISA: 3 Steps to Improve Cybersecurity Vulnerability Management
Automation and increased prioritization are crucial to improving efficiency within cybersecurity vulnerability management, CISA’s executive assistant director for cybersecurity wrote.
By Jill McKeon
November 14, 2022 - New cybersecurity vulnerabilities are a constant challenge for organizations of all sizes, Eric Goldstein, executive assistant director for cybersecurity at the Cybersecurity and Infrastructure Security Agency (CISA) wrote in a recent blog post.
The information may be useful for the healthcare sector, an industry that is known to face challenges with device security and managing ever-changing cyber threats. In addition, the sector is an appealing target to threat actors, who often go after unpatched vulnerabilities to exploit victims.
“Organizations with mature vulnerability management programs seek more efficient ways to triage and prioritize efforts. Smaller organizations struggle with understanding where to start and how to allocate limited resources,” Goldstein wrote.
“Fortunately, there is a path toward more efficient, automated, prioritized vulnerability management.”
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https://www.protocol.com/braintrust/data-quality-improvement-tactics
What one action has the most outsized impact on improving data quality?
Data profiling, dependency tracking, and third-party auditing can make a huge difference, members of Protocol's Braintrust say.
November 10, 2022
Good afternoon! In today's edition, we asked a group of experts to tell us about the actions that executives can take to improve data quality in short order. Questions or comments? Send us a note at braintrust@protocol.com
Ram Venkatesh
CTO at Cloudera
The key to improving data quality is implementing robust dependency tracking for data sets with quality as a first-class metadata annotation. The lack of quality in a data set can have severe and extensive consequences across any enterprise, from broken reports to incorrect predictions and everything in between. It can also be a significant source of waste and even missed service-level agreements. There are two essential pieces that together enable a quick and efficient resolution of any data quality issues: lineage and annotations.
Increasingly, data sets are no longer hidden behind poorly designed or unnecessarily complicated reports but are a part of a “network” of use cases within companies. For example, a pricing model might depend on a customer data set, an order history data set, and a catalog data set. The catalog data set might depend on a vendor feed underneath. If a data quality problem is identified in the catalog data set, users need the ability to trace both provenance — the origin of the data — and the impact on the downstream consumers who are affected. Additionally, by annotating data sets with quality measures using metadata — the data about the data — quality itself can be conveyed along a data dependency graph as a metric. Jobs, models, and reports can do pre-checks for data quality, triggering automated actions when issues are detected.
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CMS seeks to close gaps in health equity data collection as new measures roll out
By Robert King
Nov 11, 2022 04:10pm
The Biden administration is pushing to resolve big gaps in the quality and accuracy of data on health equity as it installs new requirements for payers and providers.
The Centers for Medicare & Medicaid Services (CMS) released a blog post late Thursday outlining steps to address data issues such as aligning standards for collection and gradually implementing equity scores.
“Data can tell a story, but if the data is incomplete or unaligned, the story is also incomplete,” wrote LaShawn McIver, M.D., director of CMS’ Office of Minority Health. “To work to advance health equity, we must improve our data, especially our health equity data.”
The Department of Health and Human Services (HHS) has made closing equity gaps a key pillar of the Biden administration, including pursuing new equity requirements in health plans and value-based care payment models.
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https://venturebeat.com/business/how-to-create-better-health-apps/
How to create better health apps
November 13, 2022 10:10 AM
Check out the on-demand sessions from the Low-Code/No-Code Summit to learn how to successfully innovate and achieve efficiency by upskilling and scaling citizen developers. Watch now.
In today’s connected world, digital products have to entice, excite and entertain to keep our attention. There’s an app for everything: Ordering a ride-share, purchasing groceries and even for monitoring your home. We can’t deny that this technology inspires us to continue to innovate. It removes friction from our day-to-day lives and makes connecting more efficient and convenient. However, the dark side is that some of these apps are created to keep us addicted.
Over the past few years, we’ve seen a saturation of apps focused on wellness and mental health because there’s a need for the accessibility they bring. However, many of these tools are created with haste and without considering the potential consequences on users’ lives. The underlying goal is to get the consumer to stay on the app as much as possible by conditioning users to rely on the app to make them feel better — obsessing over likes, follower counts, and refreshing news feeds.
What if the tech industry shifted the paradigm by keeping authenticity at the forefront through more intentional creation, versus providing users a “quick fix?” The good news is there are steps both the technology industry and consumers can take to safeguard against falling victim to creating and using these addictive apps.
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https://www.healthcareitnews.com/news/new-ama-blueprint-seeks-tap-full-potential-digital-health
New AMA blueprint seeks to tap the full potential of digital health
Six core concepts, developed with input from industry experts and stakeholders, offer chances for healthcare organizations to evolve in digitally enabled care.
By Andrea Fox
November 14, 2022 03:33 PM
The American Medical Association's had offered a blueprint as a call to action to address the divide between the unprecedented levels of digital health funding, partnerships, mergers and acquisitions – and their underwhelming impact, thus far, on healthcare quality improvement
WHY IT MATTERS
The report, Closing the digital health disconnect: Blueprint for optimizing digitally enabled care is composed of six foundational actions recommended by the AMA:
- Build for patients and clinicians.
- Design with an equity lens.
- Re-center care around the patient-physician relationship.
- Improve and adopt payment models that incentivize high-value care.
- Create technologies and policies that reduce fragmentation.
- Scale evidence-based models quickly.
More than $100 billion of venture funding has been invested in digital health companies since 2010, but that investment has not addressed healthcare's greatest needs, according to the AMA report.
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Q&A: Why Direct-to-Consumer Telehealth Isn't the Right Fit for Everyone
Analysis | By Eric Wicklund | November 13, 2022
Direct-to-consumer telehealth aims to give consumers a quick and easy path to healthcare services, but critics say it bypasses a critical element in healthcare delivery: The health system.
KEY TAKEAWAYS
· Direct-to-consumer telehealth is designed to enable consumers to connect virtually with a care provider for quick and easy treatment, particularly for health issues that might not require a trip to the doctor's office or hospital.
· Supporters say the platform meets the demands of the consumer and reduces unecessary traffic in waiting rooms.
· Critics, meanwhile, say the platform can be used to cut corners and bypass the health system, endangering healthcare quality.
As the HLTH conference convenes this week amid the glitz and glamor of Las Vegas, the healthcare industry is facing a conundrum. Direct-to-consumer (DTC) care is blurring the line between provider and vendor and forcing everyone to rethink the concept of healthcare delivery.
And while DTC telehealth might help boost access to care for consumers who can't easily make a doctor's appointment or go to a clinic or hospital, it does have its drawbacks. Some see the platform as way of bypassing the traditional healthcare provider and selling a product—namely, healthcare—directly to the consumer. This, in turn, leads to questions around where the traditional provider fits into the new ecosystem.
As the technology improves and payers begin to support virtual care, hospitals and health systems are debating whether to outsource some services to DTC telehealth providers or launch their own platforms in-house.
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Global Program Seeks Digital Health Technology for Developing Countries
Analysis | By Eric Wicklund | November 11, 2022
The Global Medical Doctor Validation Association (GMDVA) is looking for technology donations to support care providers working in some of the world's most underserved locations.
KEY TAKEAWAYS
· Digital health technology can help to improve healthcare delivery in developing countries, where care providers often struggle with a lack of resources and training.
· The Global Medical Doctor Validation Assocation (GMDVA) is a Belgium-based international organization athat offers resources, education, technology, and connections for providers in developing nations.
· The GMDVA has launched a new program aimed at supplying providers in developing countries with digital health technology and training to help them improve care delivery.
While digital health technology and programs have the potential to improve healthcare in the US, their value to healthcare providers in developing countries is even greater.
That's where the Global Medical Doctor Validation Association (GMDVA) comes in. Based in Belgium, the organization provides technology, education, resources, a network, and connections for placement opportunities for providers around the world.
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Telehealth is a valuable option in cardiovascular care, though challenges remain
New American Heart Association statement finds telehealth is effective for CVD care, however, issues like access to technology hinder widespread adoption
Statement Highlights:
- Telehealth is an effective option for educating, diagnosing, monitoring and following people with health issues including cardiovascular disease.
- Telehealth may reduce health care costs, improve access to care in rural and under-resourced communities, and increase quality of care and patient satisfaction.
- Advances in technology have enabled telehealth’s growth and improved accessibility to routine care.
- While the COVID-19 pandemic improved telehealth’s infrastructure and increased its use, the pandemic also exposed limitations to its use for some people, such as limited resources to afford the technology, lack of internet bandwidth and language differences that may prevent people from using digital platforms to their fullest extent.
- Research into telehealth implementation barriers and addressing those will help ensure equitable, high-quality care for people with cardiovascular disease.
DALLAS, Nov. 14, 2022 — Telehealth is a proven and valuable option for people with cardiovascular disease, however, there are limitations to its use in rural and under-resourced communities, according to a new scientific statement from the American Heart Association, published today in the Association’s flagship peer-reviewed journal Circulation. An American Heart Association scientific statement is an expert analysis of current research and may inform future treatment guidelines.
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Controversial £360m NHS England data platform ‘lined up’ for Trump backer’s firm
Patients will have no say over records going to Palantir, the software giant run by billionaire Republican backer
Sun 13 Nov 2022 18.00 AEDT
An NHS project to incorporate tens of millions of personal digital medical records into one of the biggest health data platforms in the world is to be launched without seeking new patient consent.
Health officials confirmed this weekend the proposed £360m new data platform for England will incorporate the NHS shared care records that track patients across the health and care system.
The American software firm Palantir, which is chaired by the billionaire Donald Trump supporter Peter Thiel, is considered the favourite to win the contract. The firm has hired two senior officials from the NHS and has been advised by Global Counsel, the consultancy firm set up by the former Labour cabinet minister Lord Mandelson.
Ministers have disclosed in parliamentary answers that the patient information project does not require a public consultation before the five-year contract is tendered or additional patient consent. They say the project, called a federated data platform, will help improve care and provide new insights into the nation’s health.
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Enjoy!
David.
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