This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
The Tasmanian government
has set aside $150 million in its 2022-23 budget to modernise the state’s
public health IT infrastructure, including through a single electronic medical
record.
The funding, to be provided
over the next four years, will allow the Department of Health to commence a
10-year digital health transformation program set out in a new digital health
strategy.
As much as $475 million is
expected to be allocated to the project over its lifetime to “drive further
adoption of digital health technology to improve patient, clinician and support
staff experiences”.
“Digital health will allow
for increased care to be provided at home and across Tasmania’s geographically
dispersed population,” budget documents state.
“It will deliver a fully
integrated patient-centric healthcare system that will seamlessly share
critical health information across critical and organisational boundaries.”
Health minister Jeremy Rockliff said the initial $150 million
funding – $40 million of which is existing funding – would be used to procure
and trial a new centralised electronic medical record system.
The first ‘horizon’ [pdf] will also see a new integrated electronic patient care
record at Ambulance Tasmania and a statewide “patient record
viewer that connects all public and private health and care
providers”.
Upgrades to existing virtual care technologies, including telehealth,
to “enable more patients to receive care in their home or in their community”
and advanced data analytics capabilities are also on the cards.
“This digital transformation will deliver a range of
benefits for patients, including access to convenient healthcare in local
communities, improved communications about appointments, reduced
waiting time for services, and less duplication of care and forms,”
Rockliff said.
“It will also prevent unnecessary hospital
visits, helping to keep people out of hospital when they don’t need to be
there.
“Importantly, upgrading our digital technologies
will benefit our health professionals by providing
them with the right data, in the right place, at the right time to enable
them to make the best decisions on patient care.”
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.
TREs in the NHS – how health data sharing is saving lives
NHS
Digital’s director of research and clinical trials, Michael Chapman, looks at
the organisation’s development of a trusted research environment (TRE) in the
NHS. He is joined by Health Data Research UK’s Susheel Varma who explains the
benefits of using TREs for data sharing and Professor Angela Wood and Dr Will
Whiteley of consortium CVD-COVID-UK to discuss how the new environment is
working for them on the front line of clinical research.
DHI News Team
– 13 May 2022
There has
been much debate in the past twelve months about the future of health data
sharing. The announcement last spring of a proposed change to the way primary care data will be
collected in England has energised public debates with conversations across the
country about the need for sharing health data in a transparent, ethical and
secure way and how to best achieve that.
In a data
release system, we produce a minimised cut of data that has been requested and
send it to the requestor who then analyses it in their own system. This
approach has been in place for many years, with contractual safeguards around
the data, oversight of releases by independent bodies to ensure appropriate
decision-making, and a robust audit process to make sure that data is handled
by recipients ethically and securely.
In a data
access system, we flip this on its head by keeping the data within the full
control of the data custodian (such as ourselves) and only providing secure
access to data to approved researchers within the security perimeters of a
Trusted Research Environment (TRE).
accuRx launches first national patient-centred record viewing system
accuRx is
rolling out the first nationally-available patient record sharing system that
places patient permission at its heart and supports the sharing of medical
records to improve patient care, Digital Health News can exclusively reveal.
Cora Lyndon –
19 May 2022
Record View
is the only record viewing system that has patient permission built into its
core, enabling patients to be in control of their information and choose who it
is shared with.
It allows any
NHS healthcare professional to request access to, and view a read-only summary
of a patient’s GP medical records. Patient permission is provided via a
multi-factor authentication which lasts for 24-hours, before permission must be
sought again.
Jacob Haddad,
CEO and co-founder of accuRx said: “Record View saves huge amounts of clinical
time by removing the laborious process of staff across different healthcare
providers having to wait on hold to a GP practice, or wait for an email
response, to get vital patient information.
Most
people have at least a vague sense that someone somewhere is doing mischief
with the data footprints created by their online activities: Maybe their use of
an app is allowing that company to build a profile of their habits, or maybe
they keep getting followed by creepy ads.It’s
more than a feeling.
Many companies in the health tech sector — which provides
services that range from mental health counseling to shipping
attention-deficit/hyperactivity disorder pills through the mail — have
shockingly leaky privacy practices.
A
guide
released this month by the Mozilla
Foundation found that 26 of 32 mental health apps had lax safeguards.
Analysts from the foundation documented numerous weaknesses in their privacy
practices.
Jen
Caltrider, the leader of Mozilla’s project, said the privacy policies of apps
she used to practice drumming were scarcely different from the policies of the
mental health apps the foundation reviewed — despite the far greater
sensitivity of what the latter records.
“I
don’t care if someone knows I practice drums twice a week, but I do care if
someone knows I visit the therapist twice a week,” she said. “This personal
data is just another pot of gold to them, to their investors.”
Use of Virtual Care Tools in Some Underserved Populations is Rising
Though
various underserved populations, like those living in rural areas, are still
lagging in digital health adoption, some groups are using these tools at higher
rates.
May 19, 2022
- While evaluating consumer adoption of digital health in 2021,
researchers from Rock
Health found that certain populations, such as Medicaid members and LGBQA+
individuals, are using tools like live video telemedicine and wearables at
higher rates than their counterpart.
Rock Health
has conducted a survey every year since 2015 that aims to uncover trends in
digital health adoption and use. The 2021 Digital Health Consumer Adoption Survey
was completed last August and polled 7,980 adult consumers. Researchers
acknowledged that the report does not consider factors such as disabilities,
nor is it representative of all communities.
The first
main takeaway was that rural communities are still facing barriers to virtual
care. Specifically, the survey found that those who reside in rural areas do
not partake in video telehealth visits as often as their urban and suburban
counterparts, own fewer wearables, and do not track health metrics digitally as
often.
Further, 88
percent of rural residents trust health information from a doctor, higher than
the 52 percent who trust online resources.
Interoperability
in healthcare, it would seem, is at an important inflection point.
Rules
around data exchange have been around for years and regulate what patient
information gets shared between payers, providers and the patients themselves.
There are also standards around how that information is shared and the
forms it can take. But the transition to value-based care has caused a shift in
terms of the standards that apply to the data exchange, and new rules and technology
mean there's less chance for redundancy, administrative waste and
roadblocks to patient access.
Joerg
Schwarz, head of healthcare interoperability strategy at cloud software company
Infor, said the 21st Century Cures Act, first passed in 2016, was instrumental
in bringing interoperability into the modern era. The 21st Century Cures Act is
a huge piece of legislation with varying pieces enacted on different timelines,
including key components enacted this year.
Before
that law passed, data exchange was regulated largely by HIPAA, which stipulated
that payers and providers were allowed to share information with one another.
That data sharing was not a requirement, however. So, oftentimes, payers
and providers would decide it was not in their best interest to do so.
Digital
health company Get Well has partnered with Health Journeys, a publisher of
guided imagery and meditation audios, to offer its programs to Get Well's
clients, with a special focus on veterans.
Health
Journeys targets specific behavioral health challenges that military service
members face, including anxiety, sleep deprivation, burnout, chronic pain,
depression, anger, PTSD, grief, addiction, traumatic brain injury and injury
rehabilitation.
Health
Journeys' guided imagery will be made available to veteran patients, a
population that disproportionately experiences behavioral health conditions.
Get Well said this partnership builds on its work with the VA and advances the
company's commitment to serving veterans and service members in need of
behavioral health services.
The
percentage of adults with recent symptoms of anxiety or a depressive disorder has recently increased to 41.5%, and the percentage of
those reporting an unmet behavioral healthcare need increased to 11.7%. Get
Well said empowering people with self-management tools, like guided meditation,
is key to improving mental health.
The great digital health reset – and how IT leaders should plan for what’s
next
As a
high-flying startup ecosystem comes back down to earth, health systems with the
financial resources will be able to double down on their digital transformation
efforts.
Back
in 2020, in the immediate wake of the pandemic, we were celebrating the coming
of age of digital health – the 25X to 50X increase in telehealth visits, the
explosion in VC funding for digital health startups delivering point solutions
for digital engagement and access to care, the sense of the dawn of a new and
exciting era in healthcare.
Indeed,
that sense of optimism would pervade the startup ecosystem for the next year
and a half. Digital health startup investments reached a new high in 2021,
closing the year with more than $30 billion in venture capital funding. VCs couldn’t get
enough, plowing vast sums into unproven companies like Noom, which provided
weight-loss advice and received $540 million in a mega-funding round in 2021.
Unicorns to 'uni-gones'?
Over
the past couple of months, the sobering news of high-flying startups coming back to earth has been
a steady drumbeat in the background. While companies have continued to raise
money into the current year, the prevailing sentiment is that we won’t surpass
2021 funding levels; in fact, the contrary as VCs start to pull back on
funding. No one anticipated the sudden turn in fortunes for once high-flying
startups, especially those anointed with “unicorn” status. Many will be gone
soon.
The
institute is expanding its partnership with COTA to analyze how demographics
like zip code, ethnicity, and other socio-economic factors affect cancer care
outcomes.
The Miami
Cancer Institute is expanding its use of data analytics technology to identify
gaps in care caused by social determinants of health.
The institute,
part of Baptist Health South Florida, is extending its partnership with COTA, a
developer of oncology-based data and analytics tools, to analyze how
demographics like zip code, ethnicity, and other socio-economic factors affect
care outcomes.
“Delayed cancer
diagnosis for a patient frequently leads to poorer outcomes,” Leonard Kalman,
MD, the institute’s executive deputy director and chief medical officer, said in a press release. “Our hope is that this
collaborative research will identify the patients who are most at-risk for
delayed diagnosis so we can increase education and expand access to routine
cancer screenings for these populations.”
The issue is
in the spotlight now as the nation moves away from the pandemic, which saw a
shift from in-person care to virtual care and prompted many people to skip
check-ups, wellness visits and other healthcare services they considered
unimportant. Healthcare officials say that has led to an alarming decrease in cancer screenings,
which could lead to a sharp increase in cancer diagnoses when people finally
get around to those check-ups they should have had a year or two ago.
Make
more room for pictures on the refrigerator: GE Healthcare and the handheld
ultrasound developer Pulsenmore aim to give expectant parents the opportunity
to chart their pregnancies at home and perform the scans themselves.
Pulsenmore’s
device docks with a smartphone, allowing women to conduct their own exams and
potentially skip an in-person doctor’s visit. The user can be guided online
through a telehealth service or offline by following the steps in an app.
The
Israeli startup aims to offer fast clinical feedback for periodic fetal
ultrasound scans, and GE Healthcare is now supporting the company through an
equity investment worth up to $50 million—to help the medtech enter what it
describes as a rapidly expanding market of homecare and telemedicine services.
“Healthcare
providers are predicting a significant shift of care services from traditional
facilities to the home, which will require an increase in the level of quality
or access,” GE Healthcare Ultrasound President and CEO Roland Rott said in a statement.
“We also recognize the desire of patients—in this case, pregnant women—to be
more empowered and involved in their healthcare.”
Medicine, AI, and Bias: Will Bad Data Undermine Good Tech?
Natalie
Sabin
May 18, 2022
Imagine
walking into the Library of Congress, with its millions of books, and having
the goal of reading them all. Impossible, right? Even if you could read every
word of every work, you wouldn't be able to retain or comprehend everything —
even if you spent a lifetime trying.
Now
let's say you somehow had a super-powered brain capable of reading and
understanding all that information. You would still have a problem: You
wouldn't know what wasn't covered in those books — what
questions they'd failed to answer, whose experiences they'd left out.
Similarly,
today's clinicians have a staggering amount of data to sift through. Pubmed alone contains more than
34 million citations. And that's just the peer-reviewed stuff. Millions
more data sets explore how factors like bloodwork, medical and family history,
genetics, and socioeconomic traits impact patient outcomes.
Artificial
intelligence (AI) lets us use more of this material than ever. Emerging models
can quickly and accurately synthesize enormous amounts of data, predicting
potential patient outcomes and helping doctors make calls about treatments or
preventive care.
Cyberattacks
targeting healthcare facilities are on the rise with no end in sight, threatening
patient care, personal data, clinical outcomes and hospital resources.
Ransomware
attacks as well as data breaches are prevalent. Adversaries are fine-tuning
their techniques and weapons to target valuable information.
Healthcare
information technology, which provides critical life-saving functions, can be
vulnerable because it consists of connected, networked components – from legacy
to modern-day systems – with varying levels of security. Vulnerabilities in
software, such as the Apache
Log4j2 flaw, and hardware platforms continue to expand attack
surfaces.
To minimize
risks, the No. 1 goal is to reduce an organization’s attack surface.
Moving healthcare from the theoretical to the personal
While
technology is a tool that can aid the care delivery process, it’s easy to run
the risk of losing the important focus of the patient-clinician connection.
As a science,
healthcare can be pretty theoretical, until the moment it becomes
personal.
There’s no
great time to catch COVID, but I have been glad that it’s now and not two years
ago, when there was so much that wasn’t known about the virus, how it was
transmitted, how to protect against it and how to treat it.
This is a
truism that we tend to forget. It’s easy to get caught up in statistics and
analytics, population segmentation, evidence-based medicine and trendlines for
revenue, and believe that data, and data alone, constitutes
medicine. Those are crucial tools for clinicians that have the potential
to make medical care better. But they are only tools. They don’t span that last
mile, that connection that links the caregiver to the patient.
I gravitate
toward the theoretical in healthcare as a writer who has covered the industry
for more than three decades. It’s easy to think in terms of trends and stories
and forget the personal component. Especially over the past two years with the
pandemic, there’s a certain detachment that occurs in writing about the
healthcare response, the healthcare impact.
That was
refocused for me Sunday morning, when I got a text message containing a link to
my positive COVID result. Then a double-slap the next morning, when my wife got
her positive result.
I’ll quickly
mention that we’re both doing well. We’ve been both vaxed and boosted, have
generally been very careful about wearing masks and keeping distances from
people in public settings. It appears that our first return to church in two
years (a distances ironically maintained because of COVID concerns) was the
point of exposure. But a large number of protected, previously uninfected
people seem to be catching this latest variant quite frequently.
Using technology to improve workflows; reduce clinical burnout
AI-powered
sensing tech can assist care teams and prevent patient falls while improving
nurse workloads and mitigate risks of patient injury.
May 19 2022
Karen
Nelson, RN VP of Clinical Services, Larksfield Place Retirement Communities
Tom Hale,
MD Chief Medical Officer, VirtuSense Technologies
Faced with a national shortage of
nurses, healthcare organizations are hoping new technologies can help reduce
nurses’ workloads, minimize staff burnout and lower costs.
monitoring
patients for fall prevention represents a significant day-to-day nursing
workflow burden and staffing expense.
For example, using artificial
intelligence-powered sensing technology has the potential to prevent patient
falls, and that can relieve nurses’ observation burdens while reducing the risk
of patients getting injured.
In 2020, there were more 170,000
patient falls in U.S. hospitals, with more than 42,000 of those incidents
resulting in mild or moderate harm, and more than 800 resulting in severe harm
or death, according
to the Agency for Healthcare Research and Quality. The Centers for
Disease Control and Prevention has calculated
that annual U.S. spending on non-fatal fall injuries totals $50 billion, while
$754 million is spent on fatal falls.
Clearly, monitoring patients for
fall prevention represents a significant day-to-day nursing workflow burden and
staffing expense.
Case study: Putting technology to use
A post-acute care organization in
Wichita, Kan., is using the latest AI-powered sensing technology to help
prevent resident falls, reduce expenses and mitigate adverse effects of nurse
burnout.
Professor
Ben Goldacre admitted that he opted-out of the controversial GP data sharing
scheme.
The
author of The Goldacre Review, into the use of health data for
research and analysis, addressed the House of Commons Science and
Technology Committee on 11 May.
When
asked if he had withdrawn consent for his GP records to be shared, he replied: “I did, because I know
so much about how this data is used and how people can be de-anonymised, and
also in part because in the past, to a greater extent, I have been in the
public eye from doing public engagement work and I have friends who have had
their data illegally accessed through national datasets, not health datasets.”
Goldacre
said that a ministerial letter to GPs in July 2021 stated the data sharing
programme would continue “only after they had built a national trusted research
environment (TRE) that could hold the data securely and make it accessible to
all legitimate users, while mitigating the risks.”
He
added: “I am confident that by doing that, you can not only mitigate risks, but
begin to earn public trust.”
Cerner
this week announced that it is collaborating with Elligo Health Research and
Freenome for a clinical trial project that seeks to advance early cancer
detection via insights derived from Cerner's Learning Health Network.
WHY IT
MATTERS
The three companies will be harness real-world data from the network's
participating health system and use Freenome's "multiomics"
technology for the Sanderson Study, an forthcoming clinical trial designed to
detect multiple types of cancer.
Freenome’s
platform uses machine learning models to analyze tumor and non-tumor signals,
with the goal of detecting cancer in its earliest, most treatable stages with a
single blood draw. The aim is to innovate a more patient-centric approach to
multi-cancer detection, reducing diagnostic complexity and optimizing processes
for clinical efficiency.
Elligo
Health Research, will work with Learning Health Network members to speed site
activation and enroll a large volume of patients much faster than traditional
recruitment models, officials say, enabling diverse nationwide patient
participation, spanning many demographics and communities.
The cost
of investing in tech solutions isn't cheap, but the returns can be significant.
KEY
TAKEAWAYS
·Most new technological investments in healthcare
have been focused on maintaining and accessing the electronic health record.
·Hospitals need to assess whether they have the
internal staff required to adopt new technologies and train healthcare workers
on them.
·One way to reduce labor costs is to invest in
automation software that can perform many of the routine tasks now done by
people.
Many
organizations in nearly all industries are now involved with digital
transformation efforts, or with some level of upgrading technologies and
applications. All this investment comes with a price in terms of hardware,
software, and human capital.
As hospitals
and healthcare systems adopt new or more advanced digital technologies, many
will have to upskill employees, reskill employees, or hire outside help. These
organizations must consider the cost implications of these strategies and
understand how to get the most bang for their buck.
But some
organizations may find the answers lie not in the implementation of more
advanced technologies, but by automating as many processes as possible and
eliminating the need to add to their labor force.
Growth of
telehealth driving many tech investments
A 2022 study
revealed that one-third of adults 50 years or older are interested in using
telehealth themselves or for a loved one, which is similar to interest levels
among older adults in 2020.
May 18, 2022
- An
AARP study found that interest in telehealth use among older adults in 2022
was similar to 2020 rates, with women, Black people, and those between 50 and
64 more likely to use virtual care services.
At the
beginning of the COVID-19 pandemic, AARP found that 21 percent of adults 50 and
older used telehealth in March 2020. The new survey, which collected data
between Feb. 24 and March 4, found that 51 percent of adults claimed that they
or someone in their family used telehealth within two years prior.
For the 2022
survey, AARP polled 1,149 US adults aged 50 and over.
The survey showed
that 32 percent of adults indicated they were highly interested in using
telehealth for themselves or a loved one, relatively similar to 2020, when 30
percent of older adults expressed interest in virtual care.
Post-acute
sequelae of SARS-CoV-2 infection, known as long COVID, have severely affected
recovery from the COVID-19 pandemic for patients and society alike. Long COVID
is characterised by evolving, heterogeneous symptoms, making it challenging to
derive an unambiguous definition. Studies of electronic health records are a
crucial element of the US National Institutes of Health's RECOVER Initiative,
which is addressing the urgent need to understand long COVID, identify
treatments, and accurately identify who has it—the latter is the aim of this
study.
Methods
Using the
National COVID Cohort Collaborative's (N3C) electronic health record
repository, we developed XGBoost machine learning models to identify potential
patients with long COVID. We defined our base population (n=1 793 604) as any
non-deceased adult patient (age ≥18 years) with either an International
Classification of Diseases-10-Clinical Modification COVID-19 diagnosis code
(U07.1) from an inpatient or emergency visit, or a positive SARS-CoV-2 PCR or
antigen test, and for whom at least 90 days have passed since COVID-19 index
date. We examined demographics, health-care utilisation, diagnoses, and
medications for 97 995 adults with COVID-19. We used data on these features and
597 patients from a long COVID clinic to train three machine learning models to
identify potential long COVID among all patients with COVID-19, patients
hospitalised with COVID-19, and patients who had COVID-19 but were not
hospitalised. Feature importance was determined via Shapley values. We further
validated the models on data from a fourth site.
Findings
Our models
identified, with high accuracy, patients who potentially have long COVID,
achieving areas under the receiver operator characteristic curve of 0·92 (all
patients), 0·90 (hospitalised), and 0·85 (non-hospitalised). Important features,
as defined by Shapley values, include rate of health-care utilisation, patient
age, dyspnoea, and other diagnosis and medication information available within
the electronic health record.
-----
Politico Future Pulse
Tweet of the Week
Michael Albert @MichaelAlbertMD: “I’m going to be honest,
digital health companies publish a lot of fluff and praise each other for
publications, despite the results being trivial and the quality of the data
low. Digital health needs to recruit actual research scientists to improve
the quality of research done.”
On
Monday, President
Biden announced a deal with 20 Internet service providers, such as AT&T
T-1.7% and Comcast CMCSA-1.7%, to provide
high-speed broadband to low-income households for no more than $30-a-month.
That’s less than half the average
2021 cost of $61 and far less in many areas. That initiative, and an even
bigger companion program to build out broadband in communities that do not have
it, will be hugely important for older adults and younger people with
disabilities.
While
much of the attention on expanded broadband is focused on how it will help
young families with children, it also will improve access to medical care and
monitoring as well as social supports and services—critical benefits for older
adults who have difficulty leaving their homes.
Just
a few examples:
Telehealth:
For people with a limited ability to access in-person health care and
supportive services, telehealth
has the potential to be a major advance in medical care. It allows doctors
and other medical professionals to diagnose and monitor medical conditions
remotely and order treatment without patients having to leave their homes.
For
some chronic conditions, telehealth can deliver care faster and at less cost
than in-person visits. Patient
satisfaction appears to be as high for telehealth as in-person care. It may
be able to prevent avoidable emergency department visits and even hospital
admissions. However, we
still are learning about quality of care delivered remotely.
Removing Medical Abbreviations Can Boost Patient Portal Understanding
A new
study shows that removing medical abbreviations within patient health records
can improve patient portal understanding and digital health literacy.
May 18, 2022
- Medical abbreviations and acronyms have adverse effects on patient
understanding of information during patient portal use, a study funded by the
National Institutes of Health found.
This is
happening as more patients access their health records than ever before.
In 2020,
nearly 100 million people in the US accessed their health records through a
patient portal. That number likely increased upon the implementation of the 21st
Century Cures Act. The mandate called on medical providers to allow
patients to access the notes written by their clinicians via a digital tool.
Patient
portals are meant to benefit patients, giving them a window into which they can
view their health data and be more involved in their own care.
Study
shows a marked improvement when medical abbreviations and acronyms are spelled
out instead
A
study of patient comprehension showed that when medical abbreviations and
acronyms were avoided, patients were significantly more likely to understand
the information being provided to them by physicians.
When
10 common medical abbreviations were expanded, researchers found a significant
increase in overall comprehension from 62% to 95%. The findings suggest that
expanding medical abbreviations and acronyms can improve patient understanding
of their health information and may benefit ongoing national efforts to provide
patients with electronic access to their own documentation.
Even
though study participants had substantial prior exposure to the health care
system, comprehension of common abbreviations such as MI or HTN remained below
40%, which is lower than clinicians estimated.
Addressing A Lack of Funding In Pediatric Digital Health
May 18, 2022
The
following is a guest article by Brad Sitler from the Bear Institute for Health
Innovation. Be sure to check out their Bear Institute PACK, a
pediatric accelerator challenge for kids.
The
digital health innovation space has grown exponentially over the past 10 years,
with $2 billion invested in 2011 and $44 billion invested in 2021 by the global
financial and corporate markets. This represents a 20x increase, however, the
increase has not been equal across all segments of healthcare. One segment of
healthcare that did not see an increase in investment is children’s digital
health, which received less than 1% ($167 million) of global digital health
funding ($22 billion) in 2020, according to StartUp Health’s annual report on
digital health funding.
Start-ups
focused on pediatric digital health face unique challenges because the market
is stratified by children’s age and weight, leading to small market segments
and lower investments by VC and angels. Scaling to market is also challenging
with no sizable pediatric provider organizations, no HCA and over 250
standalone pediatric hospitals to individually pursue. Understanding and
complying with the special ethical and regulatory protections for children
constitutes another challenge. All these factors lead to the immense gap in
children’s digital health funding.
Cybersecurity Authorities Issue Advisory on Common Initial Access Tactics
Cybersecurity
authorities from the US, the UK, Canada, the Netherlands, and New Zealand
outlined common practices that threat actors use to gain initial access to
victim networks.
May 17, 2022
- Cybersecurity authorities from the US, the UK, Canada, the Netherlands,
and New Zealand issued an advisory detailing
initial access tactics that threat actors frequently use to infiltrate victim
networks.
“Cyber actors
routinely exploit poor security configurations (either misconfigured or left
unsecured), weak controls, and other poor cyber hygiene practices to gain
initial access or as part of other tactics to compromise a victim’s system,”
the advisory began.
The statement
highlighted a simple truth—threat actors do not necessarily need elaborate and
sophisticated tactics to successfully take advantage of victims. Basic
misconfigurations and poor cyber hygiene often give threat actors the leverage
they need to exploit their victims.
Addressing
common security weaknesses and implementing a robust security architecture can
help organizations effectively mitigate cyber risk.
Data Modernization Initiative aims to meet lofty goals for public health
Federal
agencies aim to improve health data sharing among state and federal agencies,
but GAO questions progress and others contend the effort is underfunded.
The COVID-19
pandemic highlighted the importance of data sharing – as well as the
frustrating consequences of unpreparedness when public health information is
siloed and cannot be easily exchanged.
Information
sharing woes were recognized early on in the pandemic as an impediment to
successful management. For example, just months into the crisis, hospitals and
public health agencies often had to rely on spreadsheets to exchange critical
public health data. While some public-private initiatives sought to fill
the gap, improvements in data sharing took months to achieve.
Given all the
data sharing difficulties, the government’s ongoing Data Modernization
Initiative, is critical. The Centers for Disease Control and Prevention
launched DMI in 2020 to modernize the sharing of core data and surveillance
information across federal and state public health agencies.
According
information provided by the CDC, the DMI is aiming to “move from siloed and
brittle public health data systems to connected, resilient, adaptable and
sustainable ‘response-ready’ systems” that can get in front of future health
crises. It intends to “deliver real-time, high-quality information on both
infectious and non-infectious threats.”
More than 100 organizations urge Congress to pave way for a national
patient ID
The latest in
a series of efforts, ID advocates ask congressional appropriations committees
to end the ban on government support for a national ID standard.
Dozens of
healthcare organizations are yet again urging Congress to not impede efforts to
create a national unique patient identifier.
In a letter
sent to the House and Senate appropriations committees, some 119 organizations
ask legislators to not include language in any legislative proposal that would
prohibit the Department of Health and Human Services from spending federal
money “to promulgate or adopt a national unique patient health identifier
standard.”
HIPAA,
enacted in 1996, called for creation of a national patient identifier. Since
1999, however, Congress has prevented federal agencies from pursuing an
identifier, citing concern about patient privacy risks. But a growing phalanx
of healthcare organizations says an ID would lead to far better healthcare
coordination, which was lacking in dealing with the COVID-19 pandemic.
Dr. John Lee,
CMIO, Allegheny Health Network
“If you have
dozens of different ways of identifying patients, you don’t have a
system."
The lack of a
uniform patient ID also results in expensive and unnecessary records
duplication that puts patient safety at risk, according to the Patient ID Now
Coalition, which includes the College of Healthcare Information Management
Executives, and others that signed the letter.
What can Europe to do bridge the digital health divide?
The EU is
pushing to move health data online. But can member states — and their citizens
— keep up, asks Frieda Klotz.
May 17, 2022
06:28 AM
Policy-makers
in the EU are promoting an array of digital health programs, such as the
European Health Data Space unveiled earlier this month. But lack of awareness and
knowledge could stymy their impact. Kristine Sørensen, a digital health
literacy expert based in Denmark says digital health literacy varies across
countries, regions — even within families. “I prefer to call it a digital
spectrum,” she said.
Recent
Eurostat
data show that people are increasingly turning to the internet to seek health information online in Europe. But the
rates are uneven. In Finland, 80% of adults sought information about their
health online last year; in Germany just 45%. A 2021 WHO report found that over the past seven years,
despite a slight upwards bump during the pandemic, health literacy in Germany
had actually declined.
Birgit
Bauer is a patient expert and health communication specialist in Germany, who
will speak at a panel on patient empowerment and digital health ecosystems at HIMSS22 Europe in
Finland next month. Many older Germans are hesitant about digital tools, and sometimes
do not even have WiFi. But healthy younger people don’t see a need for it
either, she said.
“When
you come to say, digital health, a lot of them say, ‘I’m healthy. I don’t need
that.’ So they are maybe not so interested in it.”
Over
the last several years, concern has grown among healthcare professionals over
the ways patient data is being used, and just as importantly, how well patients
understand what those uses are.
However,
if a new study
is any indication, a minority of consumers understand the extent of the health
data being shared, and many have only modest levels of concern about these uses
of their health data.
The
study, which was commissioned by Q-Centrix, surveyed 1,191 Americans during
December of last year to look at their attitude and beliefs around the sharing
of patient health data.
On
the whole, the respondents seemed fairly well informed about commercial uses of
other data gathered about them. when asked what type of data is collected and
shared, the majority of respondents datasets knew what data was typically used
in marketing efforts, including personal information such as name, address and
phone number (87%), demographic information (74%) and location tracking (73%).
in contrast, just over 50% selected health information as a type of data being
collected far and wide.
May 16, 2022
- Referential patient matching algorithms demonstrated greater accuracy
than the traditional probabilistic approach, according to a study
published in JAMIA.
Probabilistic
software implements a weighted similarity algorithm that uses blocking
schemes to gather candidates sharing at least a portion of matching fields.
“Candidate
matches are scored attribute-by-attribute using a weighted similarity based on
discriminating power, summed across matching attributes,” the authors
explained.
“The set of
attribute data is evaluated using heuristic rules for specific conditions that
increase or decrease the likelihood of the match and adjust the weighted score
accordingly,” they added. “The system declares the records a match if the final
match score exceeds a configurable threshold.”
Referential
algorithms are similar to probabilistic software, but they use additional
data sources.
CDC: Children with Chronic Conditions More Likely to Use Telehealth
Children
with chronic conditions, like asthma or a developmental condition, were more
likely to use telehealth because of the pandemic, according to new CDC data.
May 16, 2022
- In the second half of 2020, only 14.1 percent of children used
telehealth due to the pandemic, but use was higher among those with asthma, a
developmental condition, or a disability, the Centers for Disease
Control and Prevention (CDC) found.
To assess
telehealth's impact on the pediatric population, the CDC conducted a study that
examined the frequency of use and the types of cases that most often appeared
in virtual settings.
Using
information from a National Health Interview Survey, which included data from
July to December 2020, the CDC studied whether a child participated in a visit
through audio or video platforms and if the virtual visit occurred due to the
COVID-19 pandemic.
In total,
about 12.6 million children, or 17.5 percent, used telehealth in the past 12
months, which included a period before the coronavirus pandemic. Approximately
10.2 million children, or 14.1 percent, used telehealth due to the COVID-19
pandemic, the data showed.
Q-Centrix,
a clinical data management company, conducted its first Health Care Data
Sharing Survey in December 2021, reaching 1,191 Americans. The sample is
representative of the U.S. adult online population, according to the
company.
It
found that most Americans are concerned about their personal data being shared.
However, a greater portion interprets personal data as being names or
addresses, with only about half interpreting personal data as health
information. Nonetheless, most are very or somewhat concerned with how health
information is being shared.
“Hospitals
have an opportunity to educate their patients on how they ensure their data is
accurate, and why that is important for improving outcomes,” Brian Foy, chief
product officer at Q-Centrix, said in a statement. “This not only requires
clinician transparency but also the implementation of modern data solutions
throughout hospitals and health systems to maintain data quality and security.”
Despite
respondents’ concerns, most (71%) are open to sharing de-identified health data
for various reasons, including to improve their own or other patients’
healthcare, for research, to improve hospital services or to advance equity.
The entities with which they would feel comfortable sharing include providers
and pharmacies that have treated them directly. When it comes to whether they
feel comfortable sharing with providers and pharmacies that have not treated
them or insurance companies, more respondents said no than yes.
Is Telemedicine Closing the 'Race Gap' in Primary Care?
FRIDAY,
May 13, 2022 (HealthDay News) -- Here's one way in which the pandemic did not
exacerbate health care disparities: A new study shows that telemedicine has closed the gap in access to primary care
between Black and non-Black Americans.
The
use of telemedicine boomed during the pandemic, so University of Pennsylvania
researchers decided to examine how that affected Black patients' historically
lower access to primary care.
"We
looked through the entire year of 2020, not just the first half of the year
when telemedicine was the only option for many people, and the appointment
completion gap between Black and non-Black patients closed," said study
senior author Dr. Krisda Chaiyachati, an assistant professor of medicine at
Penn Medicine.
"Offering
telemedicine, even though it was for a crisis, appears to have been a
significant step forward toward addressing long-standing inequities in health care access," he said in a
university news release.
The
Cloud Security Alliance this past week released a report outlining the cyber risks faced by healthcare
delivery organizations when it comes to supply chain management.
Experts
from CSA explained that healthcare organizations face two main concerns:
Risk management involving the cyber
supply chain, which includes IT networks, hardware and software.
Risk management involving the
conventional supply chain.
"With
the move to the cloud and edge computing, HDOs are finding it increasingly
challenging to secure their infrastructure," read the report.
"Cyberattacks
target HDOs and their suppliers in this expanded attack surface," it
continued.
WHY IT
MATTERS
As
the report authors noted, cyberattacks can be very costly, particularly as
healthcare organizations and suppliers present juicy targets for bad actors.
A
recent study published in the Journal of Telemedicine and Telecare found that
telehealth can be safe and effective when it comes to managing high-risk
pregnancies.
The
meta-analysis, which examined 12 studies published in
English and Turkish from 2016 through 2021, sought to examine how virtual care
apps could affect maternal and neonatal health outcomes, as well as costs.
"It
has actually been seen that due to the COVID-19 pandemic, the use of telehealth
applications in the monitoring and care of high-risk pregnancies has increased
substantially in antenatal health services," wrote the researchers.
"It
is for this reason that the need arose for a strong evidence-based examination
of the effectiveness of telehealth, and this became the basis for the planning
of the present study," they said.
The latest
version of the ACC's three-year-old series of TRANSFORM studies, being
conducted in Boston and Kansas City, will test whether underserved patients living
with chronic cardiovascular concerns can be better managed through a digital
health platform that includes wearables and AI tools.
The American
College of Cardiology is studying whether digital health technology like
wearables and AI can be used to improve care management for people with chronic
cardiovascular conditions.
The ACC is
partnering with Boston-based Biofourmis on the third and latest phase of its
TRANSFORM study, which was launched in 2019 to “leverage EHR data, office-based
interventions and partnerships to include the pharmaceutical and medical device
industry, health plans, employers, clinicians, and patients.” The latest phase
focuses on improving guideline-directed medication therapy (GDMT) in care
management.
“TRANSFORM3
will provide real-world data on how cardiologists and other clinicians can more
effectively and efficiently manage chronic cardiovascular conditions in
underserved populations,” Megan Welch, MD, TRANSFORM3 investigator team member
and cardiovascular disease fellow at Massachusetts General Hospital, said in a press release issued by Biofourmis. “Through
technology-enabled approaches, we are hopeful that providers will have timely,
meaningful awareness of their patients’ health status and adherence to
guideline-recommended therapies. Ultimately, what we learn from TRANSFORM3
could lead to accelerated adoption of effective, evidence-based care plans that
optimize outcomes and help patients lead longer, healthier lives.”
