Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, July 01, 2017

Weekly Overseas Health IT Links – 1st July, 2017.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Healthcare AI poised for explosive growth, big cost savings

Accenture report expects robot-assisted surgery, virtual nursing assistants, workflow tools and more offering huge potential to make patient care more efficient.
June 22, 2017 03:03 PM
Artificial intelligence "is rewiring our modern conception of healthcare delivery," according to a new Accenture report that shows an array of clinical AI applications are already well on their way to saving the industry $150 billion over the next 10 years.
In the shorter term, the report forecasts a 40 percent compound annual growth rate between now and 2021, with acquisitions of AI startups proceeding at a feverish pace.
The technology represents "a significant opportunity for industry players to manage their bottom line in a new payment landscape," according to the report, which examined 10 different AI applications, ranked by their potential for cost savings.
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How Kaiser Permanente tied its EHR, CPOE and bar code tools together to cut medication errors

Hint: The health system achieved a 98.5 percent compliance rate for caregivers scanning medication and patient wristbands.
June 22, 2017 01:46 PM
Medication errors have dropped and the number of nurses using bar code medication administration systems and physicians using computerized order entry systems has soared at Kaiser Permanente, which implemented a barcode system for medication management and an electronic health record system with built-in CPOE to accomplish these goals. 
Achieving these goals also helped the health system meet medication error reduction standards promulgated by The Leapfrog Group.
Kaiser’s assistant medical director of quality and clinical analysis Benjamin Broder, MD, explained that minimizing medical errors and improving the safety of ordering and administering medications takes people-centered techniques and cultural adjustments on top of requisite technologies. 
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These 3 simple formatting changes could put a dent in EHR patient safety concerns

Jun 23, 2017 9:52am
EHR displays require consistency and clarity to avoid confusion that can lead to medical errors.
Mounting concerns about the impact of electronic health records on patient safety have forced providers and developers to take a deeper look at some of the inherent flaws in their systems.
This year, EHR management topped the ECRI Institute’s list of top ten patient safety concerns, and experts have noted that most hospitals don’t have a formal health IT safety committee to address issues within EHRs. Including health IT team members in daily clinical safety huddles, where EHRs are a common concern, is one proven way to quickly and effectively address emerging issues.
But some of those defects could be resolved with simple changes to the way information is displayed. According to a report (PDF) released this week by the HIMSS Electronic Health Record Association, alert modifications, along with simple formatting adjustments, could have a sizable impact on patient safety.
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Google to remove medical records data from search results to combat leaks

Private medical data will be removed, taking away a tool cybercriminals could use to extort hospitals, patients.
June 23, 2017 01:12 PM
Google has made changes to its personal information policy, including one big one for the healthcare industry: The search giant on Wednesday began removing private medical records from its search results.
Without receiving requests for removal, Google has now started removing what it labels the “confidential, personal medical records of private people.” The most recent change to Google’s removal policy came in 2015 when the company said it would delete “nude or sexually explicit images that were uploaded or shared without your consent.”
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Girls as young as eight being groomed by cosmetic surgery games

Laura Donnelly
22 June 2017 • 6:01am
Girls just eight years old are being targeted by cosmetic surgery apps, with “revolting” new tactics used to groom an ever-younger market, experts have warned.
A report by the Nuffield Council on Bioethics says under 18s should be banned from getting fillers, botox or plastic surgery and calls for sweeping restrictions on online games which promote such ideals.
An inquiry by the independent body found children and teenagers were being targeted by online games, including plastic surgery simulators which show them how their body could be altered.
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5 takeaways from Stanford Medicine’s report on the present and future of digital health

Jun 22, 2017 at 6:08 AM
A new report from Stanford Medicine looking at the present and future of digital health draws some interesting conclusions on the impact virtual visits, wearables and predictive analytics will have on how healthcare is delivered in the future. Naturally, there are a good few challenges that stand in the way between the current state of healthcare innovation and the more fully evolved version that lies ahead, potentially.
Wearables will be provided by medical centers
Given that Stanford’s own research has quantified the merits of biosensors in wearables to detect symptoms of possible illness, such as Lyme disease, it stands to reason that it would envision medical centers playing a larger role in providing these devices, rather than technology companies. Wearables have become more sophisticated with the integration of biosensors and span a wide range of applications from cardiology and diabetes to quantifying the effects of medication, such as Proteus Digital Health.
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Only 18% of rural patients use a patient portal, athenahealth finds

Written by Jessica Kim Cohen | June 21, 2017 | Print | Email
There's a geographic disparity in patient portal adoption, according to an analysis by athenahealth.
Thirty-three percent of urban patients are registered on patient portals, according to the company's analysis of 5.5 million patients who visited an athenahealth practice between January 2016 and August 2016. By contrast, 21 percent of suburban patients and 18 percent of rural patients use patient portals.
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VA replacement of legacy EHR could cost as much as $16B

Published June 22 2017, 7:07am EDT
The Department of Veterans Affairs needs Congress to fund VA’s IT modernization to keep its legacy systems from failing and to replace its decades-old electronic health records system.
VA officials this month announced that they plan to replace the Veterans Health Information Systems and Technology Architecture (VistA) with the same commercial off-the-shelf EHR from Cerner that the Department of Defense is currently implementing
“This will ultimately put all patient data in one shared system, enabling seamless care between VA and DoD without the manual and electronic exchange and reconciliation of data that we currently do in our separate systems,” VA Secretary David Shulkin, MD, testified on Wednesday before a Senate appropriations subcommittee.
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TIMES INVESTIGATION

‘It’s the mother lode’: inside the black market for stolen records

A vast hacked database available online for just £2 has been linked to Russia
Louis Goddard, Times Data Team
June 23 2017, 12:01am, The Times
 “800 million cracked email and password combinations from tons of hacks,” wrote one user of a shady online hacking forum in October last year. “It’s the mother lode.” On offer was a huge database of stolen credentials for sale for the equivalent of about £2.
The price was low because the database had been circulating for months. It had apparently been lifted from an invitation-only Russian forum dedicated to cybercrime, where through private message boards it may have changed hands for considerably more.
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West Suffolk identifies data errors in discharge summaries

West Suffolk Hospitals NHS Foundation Trust has identified technical problems with its Cerner EPR, known locally as e-Care, leading to inaccuracies in discharge letters automatically sent to local GPs.

Laura Stevens

Jon Hoeksma

21 June 2017
The trust has launched an on-going investigation into the data errors in discharge letters, which it initially rated as a potentially ‘catastrophic/major harm’ risk, though the trust says no patient is believed to have been harmed. Manual checking of discharge summaries has been introduced while the investigation is carried out.
West Suffolk is one of 16 hospital trusts that have been prioritised for national health IT investment through the GDE programme, to become a reference site for other NHS trusts to follow. The trust went live with its new Cerner EPR last May, in a programme locally known as e-Care.
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What are the key data analytics faced by NHS digital leaders?

Identifying the key data analytics challenges faced by NHS CIOs will be the focus of an interactive workshop on day two of the Health CIO Summer School, 14 July.

Jon Hoeksma

22 June 2017
In advance of the workshop Daniel Ray, director of data science at NHS Digital, who will be jointly leading the session, spoke to Digital Health News editor Jon Hoeksma, about what he believes some of the challenges are, and invites NHS IT leaders to share their views using the embedded poll to support the session.
“What we want to try and find out in advance of the workshop are what are the big data analytics challenges that people face, and how can we help support organisations to overcome them,” explains Ray.
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5 ways to accelerate healthcare innovation and delivery system reform

Jun 22, 2017 11:02am
Innovations could help produce a more efficient and effective healthcare delivery system but only if the industry creates conditions that allow new models to thrive and clear a pathway to spread and scale reforms.
That’s the underlying message of a new report, “Accelerating Innovation in Health Care: Five Game-Changing Ideas to Clear the Way, by the Aspen Institute’s Health Innovation Project. The report is the result of off the record discussions with dozens of executives from Fortune 500 companies, provider organizations, and insurance companies; and leading innovators, researchers and academics.
In order to drive reforms, “the most pressing task at hand is to create fertile ground in which the seeds of innovation can grow, especially by stimulating market demand for change,” according to the report announcement.
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HIT Think What can healthcare providers do about the rising number of security breaches?

Published June 19 2017, 3:58pm EDT
The data breach problem in healthcare has entered crisis mode. In 2016, 36 percent of all breaches and 44 percent of all records compromised were healthcare-related. Those breaches resulted in the theft of 15.4 million healthcare records.
The phishing attacks being used to perpetrate these breaches are nothing new. They were a leading cause of data breach incidents for the eighth consecutive year, according to the Identity Theft Resource Center.
Cybercriminals are going after electronic health information simply because it offers personal information that can be re-used for many different types of fraud, including claims, Health Savings Accounts, Flexible Savings Accounts and more. In addition, because some health providers aren’t using sophisticated security controls, personal demographic information can be used to bypass password reset functions for account takeover.
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Mount Sinai Creates Imaging Data Warehouse for Precision Medicine

Mount Sinai's imaging data warehouse will allow precision medicine researchers to access deidentified big data on more than 1 million patients.

Jennifer Bresnick

Director of Editorial
jbresnick@xtelligentmedia.com
June 20, 2017 - Mount Sinai Health System has created a centralized imaging research warehouse (IRW) able to integrate clinical images with deidentified electronic health record (EHR) data.
The project, developed by Mount Sinai’s Translational and Molecular Imaging Institute (TMII) and supported by the National Institute of Health, will allow researchers to access imaging and other clinical data on more than 1 million of the health system’s patients. 
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Patient Safety, PHI Security Key in HHS Cybersecurity Role

A House Subcommittee hearing reviewed the HHS cybersecurity role, focusing on recent Department reports required under the Cybersecurity Act of 2015.

Elizabeth Snell

June 21, 2017 - The recent WannaCry ransomware attack shows how patient safety, along with PHI security, need to be key focus areas in the HHS cybersecurity role, according to the House Subcommittee on Oversight and Investigations.
In a hearing held earlier this month, the Subcommittee reviewed two reports that Congress required HHS to produce under the Cybersecurity Act of 2015. The hearing also examined how the nation can learn from recent large-scale cybersecurity issues to improve the reports’ effectiveness and applicability.
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HIE helps reduce some therapeutic medical procedures

Published June 21 2017, 7:01am EDT
Lack of access to patient health records at the point of care often leads to repetition of medical procedures. However, health information exchange significantly lowers repetitions of therapeutic medical procedures, while diagnostic procedures are not impacted.
That’s the finding of a recent study examining the impact of HIE on diagnostic medical procedures as well as therapeutic medical procedures performed in office settings.
Saeede Eftekhari, co-author of the study and a Ph.D. candidate in the business school at the State University of New York at Buffalo, notes that the repetition of medical services by providers is one of the major sources of healthcare costs in this country.
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How 3 hospital breaches went undetected for more than 3 years

Security firm’s discovery highlights why hospitals struggle to detect these lapses in security.
June 20, 2017 02:28 PM
Three healthcare information security incidents that happened more than 36 months ago were just discovered in May — highlighting the fact that hospitals continue struggling with breach detection. What’s more, the incidents were caused by employees.
“All three of these events were, unfortunately, due to insiders, two of which seemed to be bad actors who were accessing records over time, and one was attributable to insider error,” said Robert Lord, co-founder of security firm Protenus. “These types of events often get discovered by accident or during infrequent audits.”
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UVA Health System speeds stroke response by bringing telehealth into the ambulance

Jun 21, 2017 9:30am
Telestroke units at UVA Health System can connect with stroke victims on the way to the hospital.
The University of Virginia Health System is shaving down the time it takes to get stroke victims necessary treatment by connecting them with neurologists before they even arrive at the hospital.
Building on its robust telestroke initiatives, the health system has recently connected EMS providers with the hospital’s stroke team while a patient is in the ambulance to reduce the time it takes to receive treatment. The treatment takes the form of a clot-busting drug known as TPA, Karen S. Rheuban, M.D., director of the University of Virginia Center for Telehealth told members of a Senate Subcommittee on Communications, Technology, Innovation and the Internet on Tuesday. 
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Hospital Impact: A crash course in how to speak geek for health information management professionals

Jun 21, 2017 3:32pm
While it's important to learn some key technical terms to converse with IT professionals, don't jump right to the jargon; instead, relate your needs concisely and completely.
Has this ever happened to you? You ask the vendor that provides your clinical documentation improvement (CDI) software: “Can you send a copy of the answered query back to our EMR?” And you get back the answer: “Our SaaS solution can send a copy of the completed query over a VPN to your HIS as the payload inside an HL7 ORU message.”
No, this is not another example of “technically correct but totally uselessas I’ve discussed in the past. This is an admittedly extreme example of the kind of technical jargon that might confront a health information management (HIM) professional in today’s modern technology-laden environment.
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3 ways to avoid a medical malpractice lawsuit

Jun 20, 2017 7:46am
Patients who feel their doctor cares are less likely to file a malpractice lawsuit.
It may be a relief for doctors to know that few malpractice lawsuits actually go to a full-blown jury trial, as most claims are settled out of court.
Nonetheless, a malpractice lawsuit can have devastating results and there are steps physicians can take to avoid being sued in the first place, according to Diagnostic Imaging. Here’s three of the suggestions to prevent a lawsuit:
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Clinicians see conflicts in patient access to mental health notes

Published June 20 2017, 7:03am EDT
OpenNotes, the effort to provide patients with online access to their clinical notes through a portal, has gotten mixed reviews from Veterans Health Administration mental health clinicians who perceive it as both challenging and beneficial.
Some clinicians view OpenNotes as an opportunity to better partner with patients, while others say they believe that it has the potential to undo their therapeutic relationships with patients, according to results of a recent study. In addition, many clinicians say they are uncomfortable with OpenNotes and acknowledge that this discomfort could affect documentation practices.
For the study, researchers interviewed 28 VHA mental health clinicians and nurses at the VA Portland Health Care System to get their perspectives on the use of OpenNotes in behavioral healthcare through the VA’s MyHealtheVet patient portal.
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Epic and M*Modal team up to use AI for EHR workflow

Jun 19, 2017 at 2:36 PM
Franklin, Tennessee-based M*Modal has enhanced its artificial intelligence solutions to support Verona, Wisconsin-based Epic’s NoteReader Clinical Documentation Improvement tool.
NoteReader CDI utilizes the M*Modal Computer-Assisted Physician Documentation technology.
M*Modal’s CAPD technology analyzes each documentation and clinical note. It then uses machine learning to offer physicians insights and give quality and compliance improvement suggestions.
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Survey: 77 Percent of Consumers Interested in Virtual Doctor Visits

June 19, 2017
by Heather Landi
Up to 77 percent of consumers would consider seeing a provider virtually—and 19 percent already have, according to a Virtual Visits Consumer Choice Survey from the Washington, D.C.-based The Advisory Board Company.
The results suggest that the health care industry has largely underestimated and, to date, failed to meet consumer interest in virtual care.
“Across industries, consumers have become accustomed to using virtual technology for both real-time and asynchronous interactions. Health care providers can no longer wait to catch up," Tom Cassels, national strategy partner at Advisory Board, said in a statement. "Providers have designed care access around their own convenience and will increasingly find patients willing to pay for their own convenience and alternatives to driving to physician offices for medical expertise."
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DHS: Health care sector is most prone to ransomware

  • By Mark Rockwell
  • Jun 19, 2017
Health care, financial services and IT infrastructure are among the most frequent targets of ransomware in the nation's critical infrastructure sectors, according to the Department of Homeland Security.
A DHS memo issued to critical infrastructure providers in early June provides a vulnerability matrix for 11 of the 16 critical infrastructure sectors the agency is charged with protecting.
The memo doesn't address malware vulnerabilities for the government facilities, food and agriculture, the defense industrial base, nuclear reactors, materials and waste or critical manufacturing sectors.
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Data on Social Needs May Redefine Precision Healthcare

Tinker Ready, June 15, 2017

Data derived from the non-medical drivers of a patient's health can improve quality of care and enrich the utility of so-called intelligent machines.

The small crowd at Tuesday's "On the Front Lines of Healthcare" event in Boston included a patient activist, a state health systems analyst, and even a doctor who was in town for a gastroenterologist meeting.
But the gathering, held in an airy space on 33rd floor of a downtown high rise, was not a professional or academic meeting. Organized by The Atlantic and the STAT, a national science and medicine publication, the public event offered an ambitious overview of a range of weighty issues.
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Using Data Analytics to Change Behavior

June 12, 2017 ‐ PSQH
By Nicole Karchner, PharmD
Data-driven initiative helps increase nurses’ engagement in smart pump safety improvement
The data-analytics application works in conjunction with the smart pump system to create a continuous  quality loop to strengthen patient safety, opportunities for improvement, and data-driven insights.
The introduction of “smart pumps” 15 years ago began a new era in IV medication safety. Many of the medications infused directly into a patient’s bloodstream (sedatives, insulin, anticoagulants, opioids) pose a high risk of patient harm; in fact, IV medication errors are twice as likely to cause patient harm compared to medications delivered via other routes (American Society of Health-System Pharmacists, 2008). A simple mistake in programming a pump—pressing “603” instead of “6.3,” or “25,000” instead of “2,500”—can deliver a massive, even fatal, overdose. With smart pumps, if infusion programming exceeds hospital-established limits, the dose-error-reduction software (DERS) generates an alert that must be addressed before infusion can begin. By using the safety features on smart infusion pumps, nurses can help improve patient safety and avert the medication errors associated with the greatest risk of harm: IV administration errors at the point of care (Wilson & Sullivan, 2004; Williams & Maddox, 2005; Fields & Peterman, 2005; Maddox, Danello, Williams, & Fields, 2008).
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How Cerner won the biggest EHR deal ever, twice

With the massive DoD EHR modernization project still getting off the ground, the company scoops up a complementary contract for the VA that may dwarf it in size.
June 06, 2017 03:23 PM
It's been almost two years since Cerner was awarded the most lucrative electronic health record contract in history by the U.S. Department of Defense. Now, as champagne pops in Kansas City celebrating its new U.S. Department of Veterans Affairs win, we remember what, for its time, was a pretty big deal.
On July 29, 2015, Cerner – along with bid partners Leidos and Accenture – secured the much-coveted DoD Healthcare Management System Modernization contract, more than two years after it was first announced in 2013.
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HIE provides hospital with vital patient data after ransomware attack

Published June 19 2017, 6:51am EDT
A health information exchange in Western New York provided critical help after a recent ransomware attack on the Erie County Medical Center in Buffalo, N.Y., which crippled operations at the 602-bed hospital.
HEALTHeLINK, the regional HIE, enabled ECMC clinicians to access vitally important healthcare data while its electronic health record system was down in the hours, days and weeks after the devastating April 9 malware incident.
ECMC’s IT department detected the file-encrypting ransomware on that Sunday morning and, as a precautionary measure, shut down the hospital’s Meditech EHR, email and website, among other IT systems.
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Data security survey reveals overconfidence, lack of preparedness

Published June 19 2017, 7:09am EDT
Many organizations are still overly confident about their data security programs, but in fact they are ill-prepared to defend against a significant cyber-attack.
That is the finding of a new study by Sapio Research, which surveyed organizations in the United States and Great Britain on cyber security-related issues.
The study called this conflict a case of those organizations being “gravely optimistic about their ability to deter or cope with malicious attacks, despite the majority experiencing a breach over the last year and nearly one-fourth experiencing more than 10.”
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FDA chief outlines digital health strategy for post-market medical device regulation

The agency is working on creating a third-party certification program that would allow low-risk products to be marketed without FDA premarket review.
June 16, 2017 02:55 PM
Food and Drug Administration Commissioner Scott Gottlieb, MD, mapped out the agency’s Digital Health Innovation Plan on Thursday, which will provide post-market guidance to how the FDA intends to regulate digital medical devices.
Gottlieb zeroed in on health-related apps, which he stressed the importance of the FDA to instate supporting policies and regulatory tools to “encourage safe and effective innovation.”
“In this rapidly changing environment, ambiguity regarding how FDA will approach a new technology can lead innovators to invest their time and resources in other ventures,” Gottlieb wrote in a blog post.
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Hospitals want to use Amazon’s voice recognition software, but real-world hurdles remain

Jun 19, 2017 12:42pm
Hospitals see the potential for Amazon's voice recognition software, but HIPAA compliance is still a big hurdle.
Hospitals from Boston to Los Angeles are interested in using Amazon’s voice recognition software to improve clinical care, but privacy laws and limited engagement are holding back widespread adoption.
Health systems like Boston Children’s Hospital and Cedars-Sinai Medical Center in Los Angeles have been exploring ways to integrate Amazon’s Alexa into the clinical environment, according to CNBC, in some cases using it to improve compliance with surgical safety checklists. Silicon Valley venture capitalists are also keen on health apps that could be integrated with Amazon’s platform.
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Without an all-in-one solution, health systems vary in their approach to population health IT

Jun 19, 2017 9:49am
When it comes to managing population health tools, health organizations vary widely.
Healthcare organizations that have successfully integrated population health management tools have paved the way for other providers. But even with a basic roadmap, no two approaches are the same.
Although health systems can benefit from a core set of guidelines, population health initiatives also rely on a degree of flexibility, according to a recent report published by Chilmark Research.
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GAO: VA pharmacy system needs data exchange capabilities

Written by Julie Spitzer | June 15, 2017 |
The Department of Veteran Affairs needs to modernize its pharmacy system to improve patient safety, according to a Government Accountability Office report released June 14.
The GAO analyzed documents describing the VA's pharmacy system and actions the VA has taken to achieve interoperability with the Department of Defense. Its goal was to determine whether the VA had a functional pharmacy system that adequately exchanged data with DOD.
The office found the VA's pharmacy system lacked interoperability — specifically, it was unable to electronically exchange prescription data with non-VA providers and pharmacies. The pharmacy system also did not have clinical decision and workflow capabilities that could improve clinicians' and pharmacists' abilities to provide care and it did not maintain a regular medication inventory.
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This 'smart pill' can help Rush patients remember their meds

Robert Holly Blue Sky Innovation
June 16, 2017
Forget to take your medication? Now you can get a reminder to find your pills — sent by the pill itself.
Chicago’s Rush University Medical Center has become one of the few health care providers in the United States to use a grain-of-sand-sized sensor that, after being swallowed, can alert patients when they’ve forgotten to take medication.
Developed by Proteus Digital Health, the FDA-approved sensor is made from microscopic quantities of copper and magnesium. Powered by the human body (no batteries or antennas required), the tiny sensor turns on after reaching patients’ stomachs, where it begins sending signals to a Band-Aid-like, Bluetooth-enabled patch worn on the torso. The patch then decodes those signals into meaningful health information and sends it to users and physicians in an app.
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HIT Think What can healthcare providers do about the rising number of security breaches?

Published June 19 2017, 3:58pm EDT
The data breach problem in healthcare has entered crisis mode. In 2016, 36 percent of all breaches and 44 percent of all records compromised were healthcare-related. Those breaches resulted in the theft of 15.4 million healthcare records.
The phishing attacks being used to perpetrate these breaches are nothing new. They were a leading cause of data breach incidents for the eighth consecutive year, according to the Identity Theft Resource Center.
Cybercriminals are going after electronic health information simply because it offers personal information that can be re-used for many different types of fraud, including claims, Health Savings Accounts, Flexible Savings Accounts and more. In addition, because some health providers aren’t using sophisticated security controls, personal demographic information can be used to bypass password reset functions for account takeover.
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Precision medicine: Hype today but the promise is even bigger than we think

I caught a glimpse of the future of healthcare this week: artificial intelligence, gene surgeons, an emerging FHIR- and phone-based architecture and more.
June 16, 2017 12:23 PM
Precision medicine is more hype than reality right now — but, at the same time, the incredible potential it holds for the future is even greater than all the buzz teases today.
That’s what I came away with from the Precision Medicine Summit in Boston this week.
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Is your hospital hacker bait? Here's how to change that

Device cybersecurity, cyber-hygiene and risk management can ensure attackers are repelled by your systems.
June 14, 2017 12:56 PM
Ransomware hits slowed during the first quarter of 2017, and that’s good, right? Wrong. This indicates hackers are retooling, rapidly improving delivery techniques and, in fact, looking for the next stage of profitable malware.
With a new report from PhishMe finding that, in reaction to ransomware slowing at least recently, cybercriminals are upping the ante, healthcare CIOs and CISOs need to be implementing cybersecurity best practices to not only thwart attacks and protect data today but in lockstep to transform themselves into less appealing targets. 
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Enjoy!
David.