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Privacy and Security Expert, Entrepreneur
Race To Centralize Your Medical Info Creates A Single Point For Hackers
Posted: 10/04/2014 1:50 am EDT Updated: 10/04/2014 1:59 am EDT
Several provinces in Canada are racing to centralize databases with your sensitive health records in them, providing you no choice to participate in such a system or any transparent explanation of the risks of these ehealth initiatives.
The popular pro-argument is the slight convenience for travellers over a phone call to your doctor, but the risks are not being shared, and they are significant.
Not only are the provinces tripping over each other to be online first, the federal Infoway initiative encourages this increasing risk to your privacy.
Let's start with the information security risks. Every bank in the country, with the world's leading information security teams protecting them, have been hacked several times. This is little risk to us as the users because if any transactions show up on our account that aren't ours, we can call the bank, and they will take responsibility, removing the risk.
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Love, Hate HIT
OCT 2, 2014 12:21pm ET
Physicians use a lot of health information technology systems, and their experiences with those systems vary widely. Some are relatively easy to use and provide real value; others drive them crazy on a daily basis.
Carlos Sesin, M.D., a rheumatologist with three-physician Vanguard Rheumatology Partners in Miami Beach, started his career happy with health IT, in turn had a nightmarish EHR experience that soured him on the technology, but once again is an HIT fan.
Sesin started the practice in 2004 with his wife Charmaine Hamada, an R.N. They bought an electronic health records system from SOAPware, and loved it. The EHR, paired with a disparate practice management system, was rudimentary but worked well. But with meaningful use looming in 2009, Sesin started looking for a bigger vendor with an integrated PPM/EHR on a single platform.
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Fridsma: Health IT Requires Different Types of Interoperability
OCT 3, 2014 7:25am ET
At a minimum, there are three types of interoperability required to achieve an interoperable health IT ecosystem, according to Doug Fridsma, M.D., ONC’s outgoing chief science officer.
Speaking this week at AHIMA’s 2014 conference in San Diego, Fridsma made the case that health IT requires all three types of interoperability--semantic, syntactic, and information exchange. “If you exchange the information and the codes don’t match or it’s a proprietary set of codes, you’ve got the information but you have no idea what those codes mean,” he argued. “Semantic interoperability is about the vocabularies and syntactic interoperability is about the structure.”
The end result, Fridsma said, is to have the ability of systems to exchange information and to use the information that has been exchanged, while taking advantage of both the structuring of the data exchange and the codification of the data including vocabulary—with the receiving systems able to interpret the data.
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Tool Boosts Accuracy, Cuts Dosing Time in Pediatric Emergencies
OCT 2, 2014 4:32pm ET
Research concludes that a web- and mobile-based medication reference tool from Raleigh, N.C.-based eBroselow increased the accuracy of medication doses prepared during simulated pediatric emergencies by almost 25 percent.
In addition, prepared doses were done with a “complete elimination of clinically significant errors” and on average were completed eight minutes faster than when using standard dosing references, according to the results of a study published in the Journal of Pediatric Pharmacology and Therapeutics.
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Go easy on Stage 3 MU, says JASON group
Posted on Oct 03, 2014
By Mike Miliard, Managing Editor
It's imperative for the success of interoperability that Stage 3 meaningful use be less stringent, giving health IT vendors the necessary latitude to develop innovative products, according to a draft report from ONC's joint HIT Policy and Standards Committee JASON task force.
In a draft of the JASON task force's final report, due to be submitted to the Office of the National Coordinator for Health IT, the group – co-chaired by Micky Tripathi, CEO of the Massachusetts eHealth Collaborative, and David McCallie, senior vice president of medical informatics at Cerner – confirms what most of us already suspect: that Stages 1 and 2 have failed to foster interoperability "in any practical sense."
This is blamed on a lack of a comprehensive nationwide architecture for health information exchange, ingrained EHR technology and business practices – and more systemic impediments, such as lack of incentive for data sharing.
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The Standards Committee work ahead
Posted on Oct 02, 2014
By John Halamka, CareGroup Health System, Life as a Healthcare CIO
On October 15, the Policy Committee and Standards Committee will meet to review the draft interoperability roadmap that will guide our work in the post-meaningful use era.
The draft to be presented is a work in process and will be iteratively improved over the next 4 months with multi-stakeholder input. Clarifying the Modern Healthcare story, October 15 will include a straw man for Federal Advisory Committee reaction, not a finished plan.
We’ll also hear an important presentation from the JASON task force, translating the general recommendations in the JASON report into actionable policy and technology next steps, especially around the need to extend interoperability from the sending/receiving of CCDA documents to also enable the data-element level query capabilities of well defined, secure application programming interfaces (APIs), likely using HL7’s Fast Healthcare Interoperability Resources (FHIR).
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Geisinger finds telemedicine cuts readmissions, costs for heart failure patients
October 3, 2014 | By Susan D. Hall
Heart failure patients participating in a Geisinger Health Plan telemonitoring program were significantly less likely to be readmitted to the hospital, according to a study to be published in the December issue of Population Health Management.
The researchers calculated the program saved $3.30 for each dollar spent to implement the program.
There were 541 participants in the study, which incorporated Bluetooth scales with an Interactive Voice Response (IVR) solution to assess weight changes and ask specific questions about their symptoms. The questions, including about shortness of breath, swelling, appetite and prescription medication management, were designed to detect indicators of worsening conditions.
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Health app market to reach $6.7 billion by the end of 2014
The mobile health market is expected to be valued at $6.7 billion by the end of 2014, according to a report from research firm Visiongain.
London-based Visiongain defines mobile health as “the practice of medicine and health services, through mobile devices” and analyzed smartphone and tablet apps for its report. Apps included in the report range from free apps all the way to premium apps that have diagnostic features.
“Austerity measures have forced many health departments around the globe to rein in their spending and find more cost-effective ways of operating,” Visiongain explains in its summary. “Enabling them to diagnose, monitor, and communicate with patients remotely, mHealth promises extensive cost-savings for healthcare professionals and institutions. This new industry will also pay dividends to network operators, software developers, and data platform management providers who may turn their core competencies onto the medical field.”
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What's the Prognosis for Apple HealthKit?
- By Chandra Steele
- October 3, 2014 11:00am EST
Google and Microsoft haven't fared so well at playing doctor. What does that mean for Apple?
Apple's HealthKit got off to a bumpy start, when bugs delayed the launch of apps that sync up with Cupertino's Health app within iOS 8. It's now ready for primetime, but can HealthKit overcome the issues that have plagued other e-health services like Google Health and Microsoft HealthVault?
Paging Dr. Google
Google Health was a way for users to centralize their personal health information. Introduced in 2008, it was an opt-in system where users could add data from medical providers, insurance companies, pharmacies, and related healthcare agencies. Google inked deals with CVS and provided links to the Withings scale, but Google Health suffered a few maladies right from the start.
Google Health was a way for users to centralize their personal health information. Introduced in 2008, it was an opt-in system where users could add data from medical providers, insurance companies, pharmacies, and related healthcare agencies. Google inked deals with CVS and provided links to the Withings scale, but Google Health suffered a few maladies right from the start.
It didn't integrate with every healthcare provider or insurance company. The gatekeepers of patient health information struggled with what to share and consumers were just getting acquainted with the idea of access to their own digital health records.
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FDA Guidance Targets Medical Device Security
OCT 1, 2014 1:52pm ET
The Food and Drug Administration has finalized guidance on cybersecurity issues that medical device manufacturers should consider when submitting a device for FDA approval.
Such guidance could change or enhance the types of security functions that will be in devices purchased and installed in provider organizations.
“This guidance provides recommendations to consider and document in FDA medical device premarket submissions to provide effective cybersecurity management and to reduce the risk that device functionality is intentionally or unintentionally compromised,” according to a notice published on Oct. 1.
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Study: Primary-care clinics realize positive ROI from EHRs
October 2, 2014 | By Julie Bird
Primary-care clinics recovered their financial investments in electronic health record (EHR) systems in 10 months on average, a recent study found, in part because EHRs allowed them to see more patients.
Clinic revenue increased with EHR implementation, along with the ratio of active patients per clinical full-time equivalent (FTE) employee, according to the study by researchers at Montreal's McGill University, published in JMIR Medical Informatics.
"Our analysis of the variances in the time required to achieve cost recovery from EHR investments suggests that a positive ROI does not appear automatically upon implementing an EHR and that a clinic's ability to leverage EHR for process changes seems to play a role," the researchers concluded.
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New FDA strategic roadmap includes health IT-related goals
October 2, 2014 | By Dan Bowman
The U.S. Food and Drug Administration this week unveiled a new roadmap that outlines its strategic priorities through 2018.
According to FDA Commissioner Margaret Hamburg (pictured), the plan--which includes many health IT-related goals--was in development for more than a year.
"More often than not today, a drug or medical product that ends up on the shelves of an American drugstore or in our hospitals will come, at least in part, from some foreign source," Hamburg said in a blog post touting the roadmap. "Nearly 40 percent of finished medicines that Americans now take are made elsewhere, as are about 50 percent of all medical devices. … These and other new challenges and transformative developments in global science, technology and trade are rapidly altering the environment in which we work to fulfill our broad public health mission. In order to continue to carry out that mission, we need a set of clearly defined priorities and goals, as well as the strategies for reaching them."
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Confed wants e-mental health strategy
2 October 2014 Lis Evenstad
The Department of Health and NHS England should create a national strategy for e-mental health and invest in a national programme to support this, says a report by NHS Confederation.
The report, entitled ‘The future’s digital - mental health and technology’, surveyed the members of the Confederation’s Mental Health Network about their current use and plans for utilising technology.
It found that although organisations were clear that technology could be used to improve patient care, there was a lack of a sense of “future vision and the right skills” in the workforce.
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JASON Task Force: Narrow Scope of MU Stage 3 to Interoperability
October 1, 2014 by David Raths
Group suggests ONC lead charge on coordinated architecture, public APIs
A task force is preparing recommendations for the Office of the National Coordinator for Health IT suggesting that in order to place a greater emphasis on interoperability, the scope of meaningful use Stage 3 should be significantly narrowed.
The ONC JASON Task Force is a response to a white paper written by the JASON initiative within the McLean, Va.-based Mitre Corp., and funded by the Agency for Healthcare Research and Quality. That paper concluded that the lack of interoperability among the data resources for electronic health records (EHRs) is a major obstacle to the effective exchange of health information. The paper recommended that CMS use Stage 3 meaningful use to embark upon the creation of a truly interoperable health data infrastructure.
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Digitizing the Ivory Tower of Academia
Thursday, October 2, 2014
For the past half century, academia has sometimes been considered an "Ivory Tower," with some considering the university as an impractical and self-indulgent institution disconnected from society and reality. To counter, in the early 1980s, the federal Bayh-Dole Act promoted a surge in "academic commercialization" through an exodus of ideas out of higher education and into the marketplace.
Flash forward to today and some academicians have argued that "the seduction of academia by the marketplace" has gone too far by compromising free-thinking minds that are now beholden to capitalist demands. While many can debate the pros and cons of this controversial culture, our small laboratory on the 5th floor of the old hospital at the University of California-Los Angeles has embraced the ideology that marketplace and academia, collectively, can foster advancements in policies and innovations.
The digital health arena is a prime example of where meaningful collaborations between industry and academia can spur on a paradigm shift in the health care system towards a preventive, patient-centered approach by leveraging technology.
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CIO sings the praises of HL7 analytics
Posted on Oct 01, 2014
By Mike Miliard, Managing Editor
Wes Wright, chief information officer at Seattle Children’s Hospital, says a new analytics tool that unobtrusively monitors the performance of his HL7 transactions "gives me peace of mind."
Seattle Children's is unique, says Wright, in that it's a "smaller hospital, in terms of bed size," but serves a four-state region: Washington, Alaska, Montana and Idaho. It offers critical, highly-advanced care to a large geographic area.
"We're a tertiary, almost quaternary care hospital," he says. "It's a really specialized pediatric hospital."
On top of that, Wright is in charge of a 1,200 person research institute – "the fifth leading NIH grant recipient for pediatric research," he says.
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Digital health investments continue to rise
October 1, 2014 | By Katie Dvorak
So far in 2014, $5 billion has been invested into digital health, according to a new report by StartUp Health. The funding made in the first three quarters of this year has already surpassed the total invested in 2013, according to StartUp.
"We are living in an extraordinary moment in history where big data, sensors, genetics, connected mobile devices are making it possible for entrepreneurs to reimagine what's possible in healthcare," Unity Stoakes, president and co-founder of StartUp Health, said in an announcement.
For 2014, some of the biggest investments include Privia Health, Preventice, Proteus Digital Health, NantHealth and Flatiron Health, according to StartUp Health.
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HIMSS: Road to coordinated care has become rocky
October 1, 2014 | By Katie Dvorak
The Healthcare Information and Management Systems Society reached out to the U.S. Department of Health and Human Services to create a plan to address health IT issues facing the nation's healthcare system.
In a letter sent to HHS Secretary Sylvia Mathews Burwell on Sept. 30, HIMSS Chairman Paul Kleeberg and President H. Stephen Lieber said the Office of the National Coordinator for Health IT's plans to revise the Federal Health IT Strategic Plan open up the doors for collaboration between HIMSS and ONC.
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AHIMA issues information governance framework
October 1, 2014 | By Susan D. Hall
AHIMA has released a framework for healthcare information governance at its annual convention in San Diego, calling for commitment to managing information as a strategic asset.
It's part of AHIMA's ongoing effort to stress the importance of information governance, which it called an "undeniable imperative" in a recent white paper.
"We need to step up in healthcare as they've done in banking and retail," AHIMA CEO Lynne Thomas Gordon recently told Hospitals & Health Networks. Future success, she said, will "boil down to who has the best data" and what's being done with it.
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Doctors Find Barriers to Sharing Digital Medical Records
As a practicing ear, nose and throat specialist in Ahoskie, N.C., Dr. Raghuvir B. Gelot says that little has frustrated him more than the digital record system he installed a few years ago.
The problem: His system, made by one company, cannot share patient records with the local medical center, which uses a program made by another company.
The two companies are quick to deny responsibility, each blaming the other.
Regardless of who is at fault, doctors and hospital executives across the country say they are distressed that the expensive electronic health record systems they installed in the hopes of reducing costs and improving the coordination of patient care — a major goal of the Affordable Care Act — simply do not share information with competing systems.
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25 Years Of Health IT: Highs & Lows
9/30/2014 01:53 PM
IT has transformed the business of healthcare over the past quarter century. Take a look at some of the major consequences -- good and bad -- of health IT's growth.
When the US government began charting an ambitious course to modernize healthcare and prepare a foundation for the future, it faced its share of detractors and advocates. With the clarity of the passing years, both have been proven right and wrong.
Technology experts are driving success and will overcome the challenges, executives agreed.
"The industry has rapidly deployed the dramatic changes and innovated as a result of the last several years after the Affordable Care Act," said Ash Shehata, partner in the Global Healthcare Center of Excellence at KPMG. "IT has been at the center of the transformation."
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Federal HIT Strategic Plan to Look Beyond Meaningful Use
SEP 30, 2014 7:15am ET
The government is working on a “refresh” of the Federal Health IT Strategic Plan to advance technology beyond electronic health records. That’s the word from National Coordinator for HIT Karen DeSalvo, M.D., who spoke Monday at the opening session of the AHIMA 2014 conference in San Diego.
“That plan is one of our responsibilities laid out in the HITECH Act,” DeSalvo told the audience of health information management professionals. “The last one was developed in 2011. As you can imagine, it was more focused on the HITECH-era work of meaningful use. With our federal partners, we have been working together for the last few months to think about setting new priorities for the next five years for this country.”
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DeSalvo strikes interoperability chord
Posted on Sep 30, 2014
By Bernie Monegain, Editor
ONC chief Karen DeSalvo, MD, promised an audience of AHIMA members that the government would act "fast into interoperability." She drew applause when she added, "We cannot wait for 10 years to get this done."
DeSalvo emphasized that every other industry has already achieved interoperability.
The message resonated with the 2013 AHIMA conference audience whose work is dedicated to making sure healthcare data is accurate and secure. In their work, they have seen up close the difference accurate, accessible data makes to patient care.
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Poor interoperability a significant barrier for ACOs
September 25, 2014 | By Susan D. Hall
Though designed to improve care by sharing data from various sources, poor interoperability remains a huge barrier to accountable care organizations (ACOs), according to a survey from Premier and the eHealth Initiative.
In fact, all 62 ACOs responding to the online poll reported that access to data from external sources was a challenge for their organization.
"Even when ACOs have successfully adopted and merged HIT systems, they aren't able to effectively leverage data and analytics to derive value out of their investments," Keith J. Figlioli, Premier's senior vice president of healthcare informatics and member of the Office of the National Coordinator's Health IT Standards Committee, said in an announcement.
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Third-party report GP software launched
29 September 2014 Sam Sachdeva
GP practices are being offered free access to software that creates and electronically sends reports for insurance companies and other third-party organisations, automatically redacting sensitive information.
The Intelligent GP Reporting software, developed by Niche Health and launched this week, has already been adopted by insurers Legal & General.
Guy Bridgewater, managing director of Niche Health, told EHI the inspiration for the software is the significant amount of time that GP practices spend manually preparing the reports, redacting information and sending them to insurers.
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Patients need 'control panel' for data
26 September 2014 Sam Sachdeva
The rise of big data cannot be stopped so patients must be able to make “fine-grained” decisions about how their clinical information is shared and used, a GP has argued.
Dr Marcus Baw suggested to EHI that giving patients a “control panel” to let them to decide how their data is used might be one way to address concerns about data sharing, and to reduce the burden of consent on GPs and other care providers.
The future of GP databases and the information they contain will be one of the topics of discussion at the BCS Primary Healthcare Specialist Group’s 34th annual AGM and conference next month.
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PHRs focus of IT strategy - Williams
24 September 2014 Sam Sachdeva
Personal health records systems are set to be a significant part of the National Information Board’s upcoming informatics strategy, Health and Social Care Information chief executive Andy Williams has said.
The long-awaited strategy is set to be released later this year, outlining a ten-year plan for how to make the most of data and technology in healthcare.
The board is comprised of representatives from a number of health organisations including the Department of Health, NHS England and the HSCIC.
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Informed women more likely to skip prenatal testing
By Deborah Kotz
| Globe Staff September 29, 2014
While most pregnant women get noninvasive genetic testing to screen for chromosomal abnormalities, such as Down syndrome, in their fetuses, some might choose to skip the testing if they are fully informed about the upsides and downsides.
In a new study involving 710 pregnant women that was published last week in the Journal of the American Medical Association, researchers found that those who were shown an interactive computer program educating them about prenatal testing were more likely to skip noninvasive screening blood tests and ultrasounds. They were also more likely to skip invasive testing, such as amniocentesis, that involves using a needle to draw DNA-containing fluid from a woman’s womb and carries a small risk of miscarriage.
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Data Analysts Say They Can Save Billions in Healthcare
Laird Harrison
September 26, 2014
SANTA CLARA, California — Powerful new software can save billions in healthcare costs by analyzing data to target therapies more precisely, programmers say.
"We believe this has the potential to revolutionize the way we can use healthcare data for treatment choices," said Louis Monier, chief executive officer of the data analytics company Kyron.
Kyron and other companies presented their ideas here at the Health 2.0 Annual Fall Conference.
Many of the programs discussed search existing information sources for connections that human researchers might have overlooked.
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Health IT's Future: 9 Issues To Watch
9/29/2014 09:06 AM
Expect the pace of innovation to pick up as healthcare providers increasingly leverage IT to improve patient care, make competitive gains, and save costs.
They've forged a strong foundation, but technologists and health professionals have more to do to fulfill the vision of a cost-effective, consumer-oriented, patient-engaged industry.
"Future systems will support clinicians and patients as they work together toward wellness," said Joe Frassica, chief medical informatics officer and chief technology officer/vice president for Philips Patient Care and Monitoring Solutions at Philips Healthcare. "These systems will provide increasingly personalized and real-time insights and advice for clinicians and patients and will come to be trusted partners in the care of patients."
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These Algorithms Reduce Readmissions
Scott Mace, for HealthLeaders Media , September 30, 2014
Using glycemic management software that integrates with its EHR system, a Virginia hospital system has achieved a 79% improvement over the national average for hyperglycemia rates.
Doctors and nurses following the standard of care in hospitals aren't just paying more attention to analytics. These days, the algorithm can be the cornerstone of superior care.
Consider the tricky process of controlling the glycemic levels of patients with diabetes.
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A security threat worse than Heartbleed
Posted on Sep 29, 2014
By Mike Miliard, Managing Editor
The Health Information Trust Alliance has put out a word of warning about Shellshock, a system vulnerability it says could wreak much more damage than the infamous Heartbleed bug.
The HITRUST Cyber Threat Intelligence and Incident Coordination Center, known as the C3, announced this past week it has been tracking the remote code execution vulnerability, which it says can allow hackers to bypass commands and execute arbitrary code, leaving OS X and Linux machines open to attack.
"We base the assessment that Shellshock is a more serious vulnerability than Heartbleed due to the ability of potential perpetrators to use the exploit to craft malicious code that enables them to gain complete control of a compromised server," write HITRUST officials in their dense and detailed threat report.
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Feds ramp up tech efforts for Ebola
Posted on Sep 29, 2014
By Government Health IT Staff
Amidst the deadliest Ebola outbreak in history, which has claimed the lives of some 3,000 people thus far, government entities in the U.S. and abroad are moving to harness personnel and technologies to better manage the outbreak.
The U.S. Centers for Disease Prevention and Control, in fact, projected that the number of infected people could potentially double every 20 days if nothing is done – a figure that could skyrocket to 1.4 million by January's end.
And if that "if nothing is done" scenario seems hyperbolic, the World Health Organization has said it needs "a 20-fold increase" in the number of public health workers to effectively manage the virus and treat infected patients.
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Health 2.0: The Customer Is King
Monday, September 29, 2014
SANTA CLARA, CALIF. -- Placing more care decisions in the hands of consumers and personalizing that experience is a major theme in health application and product development today, as evidenced at the 8th annual Health 2.0 conference, held in Santa Clara, Calif., last week.
However, providers, payers and government regulators may tap the brakes on this trend, as they continue to worry about patient safety and privacy in the new digital realm.
A survey by Medscape and WebMD released at the conference indicated that while the majority of physicians and patients (63% and 64%, respectively) agree that the smartphone can be a useful diagnostic tool in regards to blood tests, just one-third of physicians said they would use a smartphone to perform an ear or eye exam and about a half of patients would do so. The survey included 1,102 patients and 827 physicians.
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Enjoy!
David.
