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FHIR’s normative stage only months away; EHR vendors planning to use it
Published June 10 2016, 8:31am EDT
Industry stakeholders are starting to see light at the end of the interoperability tunnel, as major electronic health record vendors look to incorporate HL7’s emerging Fast Healthcare Interoperability Resources (FHIR) standard in their products.
With the normative version of FHIR slated for release in the spring of 2017, vendors are expected to soon implement the application programming interface (API) in their EHR systems, say observers.
The normative version of FHIR that will be available next year will be stable enough for large vendors to incorporate it into their platforms, asserts Chuck Jaffe, MD, CEO of HL7, speaking at last month’s Workgroup for Electronic Data Interchange Annual National Conference in Salt Lake City.
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Researchers: Patient safety a concern for EHR use by UK docs
Jun 10, 2016 8:16am
Some clinicians view electronic health records as more negative than positive when it comes to patient safety, according to a new study in BMC Medial Informatics and Decision Making.
The researchers, from the University of York and elsewhere, wanted to determine how the implementation of an EHR system affects patient safety in England's National Health Service (NHS). Most patient safety information was coming from the U.S., whose health system is different economically, organizationally and structurally. They interviewed 19 NHS clinicians in a maternity unit at an NHS teaching hospital in the north of England during the first year of its implementation of an EHR in 2014.
They found that significantly more challenges with the system were reported than benefits, with clinicians reporting perceived and actual increased risks to patient safety. For instance, there were concerns that the clinicians would make inputting errors due to lack of typing skills. The interviewees also expressed concern that the data being added was less detailed and accurate, since it took longer to type.
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Evidence Lacking on Efficacy of Home Health Devices
Tinker Ready, June 9, 2016
Researchers find no evidence that smart homes and home health monitoring technologies "help address disability prediction and health-related quality of life, or fall prevention."
Researchers have found no evidence that smart homes and home health monitoring help prevent falls or health-related quality of life for the elderly.
While internet-linked devices and home health monitoring have the potential to improve care for the elderly, a review of existing evidence in the current issue of the International Journal of Medical Informatics found limited evidence of some benefits, but concludes that more research is needed into their efficacy.
The research comes after two disappointing studies that found little change in outcomes with some forms of home monitoring.
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John Halamka: Why HIT vendors are stuck in a Catch-22
Jun 9, 2016 12:45pm
Consolidation of both healthcare providers and technology vendors will play a major role in shaping the near future for the health IT industry, according to Beth Israel Deaconess Medical Center CIO John Halamka.
In a recent post to his Life as a Healthcare CIO blog, Halamka writes that in conversations with stakeholders, many foresee a "shrinking" market for software currently geared toward midsize hospitals and small group practices fueled by mergers and acquisitions of those provider organizations.
"Many smaller EHR companies will fold due to declining market share and some established incumbents with older technologies are likely to sell their healthcare IT businesses or reduce their scope," he says.
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Privacy issues pose ongoing challenge to HIEs
Jun 8, 2016 3:18pm
The legal and ethical aspects of healthcare data sharing have long been a concern for Valita Fredland, recently named vice president and general counsel and privacy officer at the Indiana Health Information Exchange (IHIE).
"I think big data raises important ethical and legal questions that in some cases haven't yet been well addressed by regulatory frameworks," she tells HealthITSecurity.com. "It's hard to anticipate some of the things that we're able to do with big data until we've done it. One then has to ask, 'Well, was that the right thing to do with it?'"
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Why providers need to quickly adopt mobile apps
Published June 08 2016, 3:29pm EDT
Some 45 years ago, Pete Townshend, lead guitarist of the fabled rock band The Who, wrote these lyrics:
“...Out in the woods, or in the city, it’s all the same to me.
When I’m driving free, the world’s my home.
When I’m mobile…”
When I’m driving free, the world’s my home.
When I’m mobile…”
The song “Goin’ Mobile” expressed a young man’s desire to move about freely, allowing him to experience the world in which he was traveling.
According to the research firm Statista, Americans have already gone mobile, albeit in a different way than envisioned by Pete. More than 70 percent of the U.S. population will have a mobile smartphone by 2019. That means that two out of every three people carry devices that have millions more times the computing power of the guidance systems used by NASA to get men on the Moon and has graphics capabilities that make those of the famed Cray-1 Supercomputer laughable. They can even go toe to toe with IBM’s Deep Blue computer when it comes to number-crunching ability.
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Developers set to demo the latest FHIR-based applications
Published June 08 2016, 4:17pm EDT
A conference to be sponsored by Health Level Seven International will showcase the organization’s Fast Healthcare Interoperability Resources standard for data exchange and give vendors an opportunity to demonstrate applications using FHIR.
The Ann Arbor, Mich.-based standards organization is planning an FHIR Applications Roundtable on July 27 and 28, at the Harvard Medical School in Boston.
“The roundtable is designed to build interest and get a better sense of what’s going on,” says Wayne Kubick, chief technical officer at HL7. “We think there is more usage than we have heard.”
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Babylon Health launches new AI triage tool
7 June 2016
Babylon Health says it has launched the first AI capable of triaging patients; although the company acknowledges that it doesn’t always agree with clinicians.
Babylon, founded by former Circle chief executive Ali Parsa, offers mobile-based health services that cover about 300,000 users.
The biggest of these is a subscription-based remote GP consultation service, through which patients can arrange a quick phone or video appointment with an on-call GP over their mobile.
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Ewan Davis: Texas grass fertiliser and the postmodernEHR
A postmodernEHR sounds like bullsh*t, right? Well, yes: but it could just be one of the most important developments in the history of the electronic health record…
I love bullshit and, thanks to my daughter's undergraduate thesis on the subject (she got a first! and any comments about genetic predisposition will be ignored) I have picked up an understanding of the philosophical basis for it.
This means such that I can bullshit about bullshit, making me a metabullshiter. It also means that I have a nose for what my father called “Texas grass fertiliser”.
I have to say when I first heard the term ‘postmodernEHR’ this was working overtime. However, as I have learned more about what is meant by this label I have decided that it could be one of the most important developments in the history of the EHR (although it’s still a horribly pretentious term).
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Cost, Hospital Efficiency Still Major Barriers to EHR Adoption
A recent study highlights the persisting effects of cost and hospital efficiency on EHR adoption rates.
Despite potential for incentive payments, cost, as well as other challenges, remains a significant barrier to EHR adoption, finds a recent study published in JMIR Medical Informatics.
In the study, lead author Clemens Scott Kruse, MBA, MSIT, MHA, PhD, examined a bevy of literature regarding EHR adoption in order to determine the various barriers and facilitators that influence providers years following the implementation of the HITECH Act.
The literature review revealed a set of 25 adoption facilitators, which included increased efficiency, hospital size, quality, access to health data, perceived value, and ability to transfer health information.
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Healthcare Cloud Security Concerns Not Impediment to Usage
A recent study found that 77 percent of healthcare organizations plan to increase the use of public cloud services despite significant healthcare cloud security concerns.
Public and private cloud solutions are gaining popularity in the healthcare industry, especially for data storage and network usage, despite issues surrounding healthcare cloud security and PHI data breaches.
Researchers at HyTrust recently published a study that revealed 77 percent of healthcare organizations plan to move more workloads onto a public cloud service even though healthcare data security was a major concern with cloud usage.
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Does blockchain have a role in healthcare?
Published June 08 2016, 6:44am EDT
It’s the technology that’s most closely associated with the Bitcoin, and it’s been playing a growing role in the financial industry.
Now, there’s a growing realization that blockchain technology could help answer many of the vexing questions in healthcare regarding keeping better track of patients’ electronic records and improving the security with which they’re shared.
Other capabilities of the technology could include automating workflows and offering better identity systems, for both patients and providers.
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Geospatial analytics tools bring 'another layer of understanding' to population health
The confluence of new care models and technology are enabling data scientists to pinpoint gaps in access to care, address social determinants of health, and map data that informs tactics to improve outcomes at the patient and population level.
June 08, 2016 11:22 AM
Virginia Long, a predictive analytics scientist at MedeAnalytics, said the industry is at a tipping point where payers and providers can use data in new ways to visualize trends, target intervention programs, or help adjust public policy.
We now live in a world awash in data. And with that proliferation of detailed patient information comes new opportunities to map – literally – new ways forward for better health.
More and more healthcare organizations are realizing that medical data at the point of care only tells a small part of the story.
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Special report: e-prescribing
The roll-out of e-prescribing across the NHS in England is glacial; and the sudden removal of tech fund money has all but halted its advance. Will things change as trusts progress their digital maturity and more government cash is released, asks Daloni Carlisle.
The clinical case for e-prescribing and the return on investment is pretty much proven. It reduces drug errors, improves patient safety, increases efficiency and productivity.
It’s also expensive, time consuming, and difficult to implement. Perhaps it is no wonder, then, that progress on rolling out e-prescribing is at best slow – and at worst glacial.
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E-prescribing use remains extremely low in the NHS
9 June 2016
Levels of electronic prescribing in NHS hospitals remain stubbornly low, with less than a fifth of hospitals making widespread use of inpatient e-prescribing. In addition, trusts that have had e-prescribing systems the longest are making the poorest use of them.
The bleak picture emerges from NHS England’s Digital Maturity Index, which found that despite the focus on e-prescribing in successive IT strategies and two rounds of technology funding, only 19% of NHS hospitals use e-prescribing for 60% or more of inpatient prescribing.
Ann Slee, NHS England’s e-prescribing advisor, told a recent conference that it had also carried out a specific piece of work on the digital maturity of e-prescribing, which found that: “Overall use of functionality is poor.
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Microsoft Finds Cancer Clues in Search Queries
Microsoft scientists have demonstrated that by analyzing large samples of search engine queries they may in some cases be able to identify internet users who are suffering from pancreatic cancer, even before they have received a diagnosis of the disease.
The scientists said they hoped their work could lead to early detection of cancer. Their study was published on Tuesday in The Journal of Oncology Practice by Dr. Eric Horvitz and Dr. Ryen White, the Microsoft researchers, and John Paparrizos, a Columbia University graduate student.
“We asked ourselves, ‘If we heard the whispers of people online, would it provide strong evidence or a clue that something’s going on?’” Dr. Horvitz said.
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Nanaimo doctors say electronic health record system unsafe, should be shut down
By Cindy E. Harnett, Victoria Times Colonist
Nine weeks after rolling out the paperless iHealth system, Nanaimo hospital’s intensive-care and emergency departments have reverted to pen and paper “out of concern for patient safety.”
Photograph by: Sherry Yates Young , Vancouver Sun
Implementation of a $174-million Vancouver Island-wide electronic health record system in Nanaimo Regional General Hospital — set to expand to Victoria by late 2017 — is a huge failure, say senior physicians.
After a year of testing, the new paperless iHealth system rolled out in Nanaimo on March 19. Island Health heralds the system as the first in the province to connect all acute-care and diagnostic services through one electronic patient medical record, the first fully integrated electronic chart in the province.
But nine weeks after startup, physicians in the Nanaimo hospital’s intensive-care and emergency departments reverted to pen and paper this week “out of concern for patient safety.”
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21st Century framework needed for use of HIT in behavioral healthcare
June 7, 2016 | By Katie Dvorak
The use of health IT in behavioral healthcare has fallen behind because of barriers such as lack of data standardization and concerns over privacy, but "opportunities exist to create a twenty-first-century framework for health IT use in an increasingly consumer-driven healthcare environment," according to the authors of a viewpoint published in the June edition of Health Affairs.
One barrier, they note, is the HITECH Act, which provided incentives for implementation of electronic health records. The law didn't address behavioral health explicitly, and excluded organizations focusing on this from eligibility for financial incentives. Thus, "consumers seeking care for behavioral health conditions have not benefited from the quality and safety gains of health IT implementation," write the authors, who hail from the Department of Veterans Affairs, among other organizations.
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How IT fuels stroke care at University of Texas System
June 6, 2016 | By Katie Dvorak
The University of Texas System has several projects underway to help improve care for stroke patients--many of which center on health IT.
One such initiative is the Lone Star Stroke Consortium, made up of researchers across several University of Texas institutions, Patricia Hurn, vice chancellor for research and innovation at the system, tells FierceHealthIT in an interview.
The group represents a lot of capability to conduct outreach and pull in patients from all over the state to be enrolled in clinical trials or research, she says. Much of the outreach is done through telestroke run on a hub-and-spoke model with six major hubs that reach out to treatment centers and hospitals.
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Life |
Biden announces U.S. project to promote cancer data sharing
U.S. Vice President Joe Biden said on Monday the "moonshot" initiative he leads aimed at finding cures for cancer was "the only bipartisan thing left in America" and called for more collaboration among researchers, doctors and government agencies to advance the cause.
Biden was speaking at the American Society of Clinical Oncology meeting in Chicago in conjunction with the launch of a new system to facilitate sharing of genomic and clinical data among cancer researchers to help promote advances in personalized treatment for the many forms of the disease.
The project, known as Genomic Data Commons (GDC), with an operation center at the University of Chicago and funded by the U.S. National Cancer Institute, is a key component of President Obama's national cancer moonshot and Precision Medicine Initiative.
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Lung cancer: Mobile app could extend life expectancy
CHICAGO: A new mobile application could help doctors better provide care to patients with advanced lung cancer, perhaps even extending life expectancy, according to a study presented in the United States.
The app, named Moovcare, enables patient-doctor communication even at a distance, using remote monitoring to quickly detect relapses or complications.
“This approach introduces a new era of follow-up in which patients can give and receive continuous feedback between visits,” said lead author Dr Fabrice Denis, a cancer researcher in Le Mans, France.
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Allscripts, athenahealth top physician practice EHR satisfaction, loyalty rankings
For the third year in a row, both Allscripts and athenahealth have been ranked as the top vendor in user satisfaction among ambulatory providers in Black Book's latest poll — Allscripts for provider groups with 26 or more practitioners and independent practice associations, and athenahealth for physician groups with between six and 10 physicians and groups with between 11 and 25 physicians.
Additionally, Marshfield Clinic Information Services, a wholly owned subsidiary of Marshfield (Wis.) Clinic, made its first appearance at the top of the user satisfaction polls, coming in at No. 1 among users in multispecialty clinics.
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How the Internet of Things will disrupt traditional healthcare
Published June 07 2016, 4:16pm EDT
There are occasional moments in the evolution of business and technology that offer opportunities to re-think the status quo and fundamentally change the way business is done. When the application that intersects business and tech is so compelling that it can justify platform adoption, we sometimes call this a “killer app.”
The irony of the term “killer” in the healthcare context aside, distributed health just may be the killer app that drives Internet of Things adoption in healthcare.
Distributed healthcare is the idea that by physically de-centralizing healthcare services we can provide better care, with greater patient satisfaction, and do so more efficiently. The core hospital environment is very good at providing intensive, highly specialized care for acute conditions, but is inefficient at managing preventative and chronic care. Accordingly, there is a growing trend to manage these care modalities outside of the traditional hospital-based environment.
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Baseline Genomic Data Study Aims to Enroll Children
Scott Mace, June 7, 2016
As Google-spawned Baseline Study enrollment begins, it seeks to enroll a healthy population, a high-risk population, and a population of the already-sick. A Stanford executive hopes to also enroll a pediatric cohort.
As Verily Life Sciences (formerly Google Life Sciences) begins to enroll patients in its Baseline Study this month, one executive at study partner Stanford Healthcare expects to expand the study to children.
In an interview, Dennis Lund MD, chief medical officer of Lucile Packard Children's Hospital Stanford, describes the Baseline Study as "the Framingham Heart Study of the modern world."
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Dutch government to invest €20 million into e-health
Minister Edith Schippers of Public Health is allocating 20 million euros over the next four years to be invested into the promotion of e-health initiatives, she announced at E-Health Week in Amsterdam on Tuesday.
The campaign, called FastTrack eHealth Initiative, is intended to support and guide small and medium businesses in scaling up good e-healt initiatives. The aim is to get promising innovations to the patient more quickly.
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Strategic approach helps providers benefit from portals
Published June 06 2016, 6:58am EDT
The first time Debra Loggia visited her orthopedist, the practice wouldn't allow her to make an appointment until she had signed up for, and signed into, its patient portal. She dutifully did so, and filled out a detailed questionnaire so that her specialist would have all her information in advance. When she arrived at her appointment, the front desk staff handed her an iPad and said she had to fill out all the information again.
"I said, 'No, this is silly—I spent 20 minutes doing it at home!' " says Loggia, senior manager of digital transformation for Ernst & Young. She made them look up her record in the portal. When she vented to her new orthopedist about the incident, he laughed and shook his head, sharing her frustration. While the practice nominally has 100 percent participation in its patient portal, courtesy of its appointment policy, it hasn't led to greater patient engagement.
To compound her problems, Loggia says she has to log into separate portals for each specialist she sees, and there's no single source for all of her information. Her primary care practice, perhaps the logical aggregator, is in no position to play that role. It was recently acquired by a large healthcare system and had to abandon its original portal for the one belonging to its new owner, which—as far as Loggia can tell—has made little effort either to train the staff or to reach out to the patients.
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Deborah Peel: Few protections exist to prevent health data from being shared without consent
June 5, 2016 | By Judy Mottl
Tuesday marks the start of the 2016 Health Privacy Summit, a two-day summit in the District of Columbia that brings together top national and international experts to discuss global health privacy issues and real solutions.
FierceMobileHealthcare reached out to Deborah Peel, M.D., who formed Patient Privacy Rights in 2004, to speak with her about the event and the status of patient privacy rights today. Currently, she says, healthcare data on devices is "open to more people, corporations and government agencies than we think," and not necessarily in a good way.
"It isn't just our doctors, or even just our insurance companies. Employers, researchers, data analytics companies and [others] also use and sell our health data," she says. "There are few protections to keep them from sharing our health data without consent."
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Geisinger EHR analytics project helps predict opioid overdoses
Examining electronic health record data over a 10-year period from Geisinger Health System shows socioeconomic factors have an impact on adverse effects of overdoses.
June 06, 2016 11:06 AM
Researchers at Geisinger Health System examined electronic health record data of more than 2,000 patients admitted to the hospital for overdoses between April 2005 and March 2015. The data – factoring in mental health, marital status, employment status – helps the health system predict which patients are at most risk of fatal overdoses and other complications.
Patients who were married and had private health insurance were less likely to experience such adverse effects, the research shows. But a history of addiction, mental illness and other chronic diseases were all found to be associated with fatal overdoses.
"Our study suggests opportunities for identifying patients at-risk for overdosing," said Geisinger addiction researcher and senior epidemiologist Joseph Boscarino, the study's lead investigator, in a statement. "We've found that patients who are taking a higher dose of prescription opioids combined with psychotropic medicines may need closer monitoring to avoid death and other serious complications.”
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Prescription Monitoring Programs Curb Opioid Prescribing
Nicola M. Parry, DVM
June 06, 2016
Implementation of prescription drug monitoring programs is associated with a substantial reduction in physicians' prescribing of Schedule II opioids during an office visit for pain, a new study suggests.
Yuhua Bao, PhD, from Weill Cornell Medical College, New York, New York, and colleagues used National Ambulatory Medical Care Survey (NAMCS) data to investigate the effects of recent launching of these programs on the prescribing of opioids and other pain medications. The researchers published the results of their study online June 6 in Health Affairs.
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Studies: mHealth Sensors Help Seniors Avoid the Hospital
Two mHealth projects at the University of Missouri are touting the value of sensors in monitoring seniors' activity and sleep patterns at home.
An innovative mHealth program at the University of Missouri is using two different types of mobility sensors to monitor seniors for trending health concerns.
MU researchers are testing radar sensors to measure daily activity levels in seniors at Tiger Place, the university’s independent living community. They’ve also developed sensors that, when placed underneath a mattress, can measure cardiac and breathing activity in sleeping seniors.
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Why EHR implementation is only half the battle
Published June 06 2016, 3:58pm EDT
The adoption of electronic health records technology over the past decade is one of the best feel-good stories for the healthcare IT industry.
This past week, the Office of the National Coordinator for Health IT reported soaring percentages in tracking the adoption of EHRs by U.S. non-federal acute care hospitals. Announced in conjunction with its annual meeting in Washington, D.C., the survey reported that adoption of basic EHRs increased to nearly 84 percent of hospitals. As recently as 2010, only 16 percent of U.S. hospitals had this technology in place.
That’s good news, and ONC notes that it’s more than just having systems installed and gathering dust. It sets certain parameters for what it considers adoption, which include having required functions in place and having those functions used by professionals.
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Why the Economic Payoff From Technology Is So Elusive
Your smartphone allows you to get almost instantaneous answers to the most obscure questions. It also allows you to waste hours scrolling through Facebook or looking for the latest deals on Amazon.
More powerful computing systems can predict the weather better than any meteorologist or beat human champions in complex board games like chess.
But for several years, economists have asked why all that technical wizardry seems to be having so little impact on the economy. The issue surfaced again recently, when the government reported disappointingly slow growth and continuing stagnation in productivity. The rate of productivity growth from 2011 to 2015 was the slowest since the five-year period ending in 1982.
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Enjoy!
David.
