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Dorset NHS trusts embark on shared digital transformation journey
Peter Gill
26 September 2017
Since being appointed as an NHS England vanguard in 2015, Dorset has undertaken an ambitious digital transformation programme to create a single shared data platform across our three trusts – the One Acute Network) – as well as other county-wide health and social care facilities.
A key part of Digitally Transformed Dorset (DTD) is a region-wide Shared Care Record, a project that I lead . This article outlines some of the challenges, successes and benefits along the way to developing this environment.
Creating the One Acute Network
At the heart of the acute network is the creation of common hardware, utility, connectivity and software platforms to link up community, primary and acute networks in support of all the Sustainability and Transformation Plan (STP) tiers.
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With the largest IT budget among federal agencies, HHS security functions labeled ineffective
Sep 29, 2017 9:42am
Like other federal agencies, HHS has more work to do when it comes to IT security.
The Department of Health and Human Services spent $13 billion on information technology in 2016, far more than any other federal agency.
But HHS still hasn’t implemented security functions that the Government Accountability Office deems “effective.”
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Donald Trump's cabinet health secretary Tom Price resigns
Anna Edney
Published: September 30 2017 - 12:43PM
Washington: Embattled US Health and Human Services Secretary Tom Price has resigned amid an uproar over his use of private and military jets at taxpayer expense while heading one of the US's largest government agencies.
Price, 62, quit after it was revealed by Politico that he took more than two dozen private flights at taxpayer expense as well as trips to Europe, Africa and Asia on military aircraft, at a total cost of more than $US1 million. It comes a day after he said he would reimburse the government for the flight and as the HHS department's Office of Inspector General and Congress launched investigations.
Price is the first cabinet secretary to leave the administration, though President Donald Trump's volatile White House has already seen the departure of several top staffers.
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Senate unanimously passes bill expanding Medicare telehealth services
Published September 28 2017, 7:08am EDT
The Senate has unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which expands access to telehealth services for Medicare beneficiaries living with illnesses like cancer, diabetes and Alzheimer’s disease.
“The CHRONIC Care Act will mean more care at home and less in institutions,” said Sen. Ron Wyden (D-Ore.), ranking member of the Senate Finance Committee. “It’ll expand the use of life-saving technology. It places a stronger focus on primary care. It gives seniors—however they get Medicare—more tools and options to receive care specifically targeted to address their chronic illnesses and keep them healthy.”
The legislation expands the number of originating sites from which Medicare beneficiaries can have a telehealth assessment with a nephrologist, including freestanding dialysis facilities and the patient’s home, while allowing these telehealth visits to be conducted from the expanded list of sites without restrictions because of geography.
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Senate unanimously passes bill expanding Medicare telehealth services
Published September 28 2017, 7:08am EDT
The Senate has unanimously passed the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017, which expands access to telehealth services for Medicare beneficiaries living with illnesses like cancer, diabetes and Alzheimer’s disease.
“The CHRONIC Care Act will mean more care at home and less in institutions,” said Sen. Ron Wyden (D-Ore.), ranking member of the Senate Finance Committee. “It’ll expand the use of life-saving technology. It places a stronger focus on primary care. It gives seniors—however they get Medicare—more tools and options to receive care specifically targeted to address their chronic illnesses and keep them healthy.”
The legislation expands the number of originating sites from which Medicare beneficiaries can have a telehealth assessment with a nephrologist, including freestanding dialysis facilities and the patient’s home, while allowing these telehealth visits to be conducted from the expanded list of sites without restrictions because of geography.
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How to improve clinical documentation
As health systems work to get the most from their physicians' EHR charting, experts say it’s important to focus on the right metrics while working toward greater buy-in from doctors.
September 27, 2017 11:06 AM
Hospitals and health systems trying to survive and thrive under value-based reimbursement realize that optimal clinical documentation is key to ensuring quality care and optimizing revenue cycle management.
Giving good feedback to physicians as they chart their care every day, helping them to log their diagnoses and treatments with accuracy, specificity and completeness is an essential skill for the era of accountable care.
Clinical documentation improvement specialists are trained to have a firm grasp the clinical details of high-quality care and to be able to spot gaps in electronic health record charting. Technology – natural language processing, machine learning – can help in big ways, but good CDI also definitely depends on good person-to-person communication and collaboration.
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HIT Think Why being a late EHR adopter isn’t a bad thing
Published September 28 2017, 3:30pm EDT
Last month, the Office of the National Coordinator for Health IT released the first nationally representative survey on electronic health record adoption and health information exchange among skilled nursing facilities.
The report found that, despite an uptick in adoption, SNFs continue to lag behind acute care settings in EHR and HIE use, underscoring the challenges of effectively implementing records technology in post-acute care settings.
While many may view being late to the EHR/HIE game as a negative, it can also be viewed as an advantage for long-term care providers. After all, late adopters have the unique opportunity to learn from hospital settings and other early adopters.
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E-health : the French hold on to their personal data
Published the 28.09.2017 at 18h13
The e-health, yes, but not at any price. According to a survey carried out for the Observatoire Cetelem (1), the collection of personal health data is an inevitable passage for a majority of the French people. But they are increasingly suspicious about the use that will be made. They refuse massively that private enterprises operate.
This refusal, the respondents have a rather positive view of e-health, that is to say, the numerical aspects related to health. 8 in 10 say that it will facilitate exchanges between health professionals, in the framework of a course of coordinated care, for example. They also believe that it can help in medical monitoring of patients. Use particularly interesting for patients with a chronic condition.
Without surprise, the French find their interest in the development of e-health. Tele-consultation and other consultation systems, remote help limit their own movements, they argue, more than 70 %. And why not, some people’s dreams, participate in the fight against the medical deserts.
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Artificial Intelligence Use by Healthcare Providers Lags. But Not for Long.
Jonathan Bees, September 27, 2017
Only a small percentage of healthcare organizations use a software platform with AI capability, but potential for strong growth exists within the next three years.
Healthcare analytics is evolving from analyzing what has happened (descriptive) to anticipating what will happen given past data (predictive) and, in its most powerful iteration to date, expecting what will happen plus providing proactive solutions based on those predictions (prescriptive).
So, what comes next?
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Johns Hopkins develops electronic triage tool to better prioritize ED patients
Published September 27 2017, 7:21am EDT
Johns Hopkins researchers have developed an electronic triage tool to help emergency departments quickly and more accurately determine those patients who are critically ill and to assign priority treatment levels.
The e-triage tool identifies relationships between predictive data and patient outcomes by leveraging an algorithm based on a systems engineering approach and advanced machine learning more commonly used in industries outside of healthcare, such as defense, finance and transportation.
“Machine-based learning takes full advantage of electronic health records and allows a precision of outcomes not previously realizable,” says Gabor Kelen, MD, director of the Department of Emergency Medicine and professor of emergency medicine at the Johns Hopkins University School of Medicine. “Decision aids that take advantage of machine learning are also highly customizable to meet the needs of an emergency department’s patient population and local healthcare delivery systems.”
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In wake of hurricanes, every CIO should revisit their HIE
In a medical crisis, clinicians need to know people’s medications, allergies, and medical histories to safely care for patients in shelters and to manage transfers between care settings.
September 25, 2017
We watched with sadness as Hurricane Harvey has flooded first southeast Texas and then Louisiana. We have seen the spirit of the American people at its best. Volunteers from around the country brought their own boats to rescue residents while thousands have donated money and supplies. There have been more than 25,000 water rescues.
Hospitals are meant to operate and care for patients 24/7 through a disaster. But they too were impacted by the rising waters.
I watched on TV the evacuation of patients from Baptist Hospital in Beaumont, Texas after the city lost its water supply. Without clean water, the hospital had to close and transfer 190 patients.
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10 stubborn cybersecurity myths, busted
As common half-truths and misperceptions plague information security, we separate truth from fiction and outline steps to take in order to make your healthcare institution safer.
September 26, 2017 09:13 AM
The state of healthcare cybersecurity is bad enough without a host of inaccurate information floating around the industry. Hackers honed in on healthcare’s technology weaknesses in 2016, pummeling the industry with massive spear phishing campaigns and ransomware attacks. And 2017 has been even worse.
Cybercriminals are becoming more sophisticated, and malware and other attack methods have followed. The most recent and perhaps fearsome trend, in fact, is the destruction of data, seen with June’s Petya attacks that caused permanent damage to corporations and health systems.
As much as hackers are fine-tuning their techniques, it’s time for healthcare leaders to clear away the cobwebs and begin to impart real change in their organizations to stop the cycle.
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Security threat: Most medical professionals have used someone else’s EMR password, study finds
Sep 27, 2017 10:40am
A new study is likely giving the folks in charge of privacy and security at healthcare organizations fits.
The study (PDF), published in Healthcare Informatics Research, found that nearly three-quarters of medical professionals (73%) said they have used another staff member’s password to access an electronic medical record (EMR) at work. The biggest culprit? Medical residents. All of the residents in the survey (100%) said they had at one time used someone else’s password with their consent.
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Using Information Governance to Protect, Recover Patient EHR Data
An information governance plan can protect patient EHR data from potential disasters or assist in its recovery.
September 25, 2017 - Leadership from a large healthcare system is stressing the importance information governance (IG) in preventing unavailable, incomplete, or inaccurate patient EHRs.
In a post on Journal of AHIMA, Director of Catholic Health Initiatives EHR Compliance Lori Richter addressed how disparate EHR systems, lack of consistent policies and procedures, and poor technology can negatively impact patient health record availability and use.
The American Health Information Management Association (AHIMA) defines IG as an organization-wide framework for managing information throughout its lifecycle and supporting the organization’s strategy, operations, regulatory, legal, risk, and environmental requirements. IG ensures information is reliable and actionable.
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Survey: 5 healthcare technologies ranked by patient use, interest
September 26, 2017
Almost one-third of patients have used text message appointment reminders in the past year, according to a survey out of Tempe, Ariz.-based University of Phoenix College of Health Professions.
The University of Phoenix College of Health Professions conducted the national survey of 2,201 adults via online interviews.
Here are five healthcare technologies, ranked by number of respondents who have used the service in the past year.
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Lost in Thought — The Limits of the Human Mind and the Future of Medicine
In the good old days, clinicians thought in groups; “rounding,” whether on the wards or in the radiology reading room, was a chance for colleagues to work together on problems too difficult for any single mind to solve.
Today, thinking looks very different: we do it alone, bathed in the blue light of computer screens.
Our knee-jerk reaction is to blame the computer, but the roots of this shift run far deeper. Medical thinking has become vastly more complex, mirroring changes in our patients, our health care system, and medical science. The complexity of medicine now exceeds the capacity of the human mind.
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New effort seeks to aid small doc practices with cyber security
Published September 25 2017, 3:52pm EDT
HITRUST has teamed up with the American Medical Association to offer a series of workshops in 50 cities focused on educating physicians and small practices on risk management and security.
The organizations have scheduled 14 workshops, with cities and dates available here. Issues to be covered include performing cyber and HIPAA risk assessments, fundamentals of good cyber hygiene, implementing cost-effective and manageable cyber security solutions, and lessons learned from other practices.
The need for practices to do security risk assessments is particularly high, because part of the Merit-based Incentive Payment System (MIPS)—one of the payment approaches under MACRA—mandates that physician group practices have an assessment to measure security risks and then document steps to prevent data losses.
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Smartphones for self-managing depression: Time for a reality check
Apps can help certain patients but there are considerations doctors and hospitals should understand from the onset, research suggests.
September 25, 2017 10:47 AM
A report in World Psychiatry, the journal of the World Psychiatric Association, found that smartphone apps can help people with milder symptoms.
Helping people with depression manage their care is among the most promising uses for smartphones and health apps though, to date at least, the possibility has raised more questions than definitive answers.
But a new analysis that began with 1,517 records screened down to 18 unique randomized clinical trials with patients between the mean ages of 18 and 59 years old across 22 distinct mental health interventions delivered by smartphone can at least begin to answer some of the pressing issues.
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HIT Think Why providers need a policy on patients recording physician encounters
Published September 26 2017, 12:49pm EDT
A patient walks into a physician’s exam room with an ever present smartphone or another digital device. The patient is especially concerned for the information that could be discussed during this visit and wants to be sure that they can remember everything that is discussed and presented during the visit. With that in mind, when the physician walks into the room, the patient asks, “Can I record this visit?” With that question, the physician is not sure how to respond.
Traditionally, the response would often be an absolute refusal to permit recording of a visit. Fears over liability or misapplication of the information at a future time were primary drivers for the response. The liability fears can be summarized as follows: a recording can capture everything that is said; some piece of information could be misstated or mistakenly left out; the missing information was a key issue and was arguably connected to some harm the patient suffered; after suffering the harm the patient listens to the recording and decides to do something against the physician; and lastly the patient uses the recording against the physician in the legal action.
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10 ways nursing education programs use technology
The majority of nursing education programs have introduced technology into their curriculum in a variety of ways, according to a Wolters Kluwer Health survey.
The survey, which information and services solutions provider Wolters Kluwer Health developed with the Washington, D.C.-based National League for Nursing Center for Innovation in Simulation and Technology, comprises results from in-depth telephone interviews and online surveys with nursing faculty and administrators.
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Study: Most healthcare execs consider telehealth a priority
September 25, 2017
Hospital executives are increasingly prioritizing telemedicine for delivering care services as the industry shifts from fee-for-service to value-based care.
Fifty-one percent of the executives and caregivers Reach Health surveyed, in fact, said telemedicine is a high priority and 36 percent ranked it as a medium priority. Only 13 percent responded that telehealth is a low priority today.
For its report, the “2017 U.S. Telemedicine Industry Benchmark Survey,” Reach Health also asked 436 executives and caregivers which telemedicine projects are already highly successful. More than half ranked improving outcomes, engagement and satisfaction as such, while 26 percent responded that efforts to reduce costs are highly successful and 18 percent said the same about reducing readmissions.
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https://www.specialtypharmacytimes.com/news/e-prescribing-allows-pharmacists-to-improve-patient-care
E-Prescribing Allows Pharmacists to Improve Patient Care
Laurie Toich, Assistant Editor
Publish Date: Friday, September 22, 2017
Technology has taken hold in nearly every aspect of day-to-day life, even when it comes to healthcare. Increasingly, physicians are forgoing traditional paper forms and opting for a streamlined digital approach.
A new survey conducted by the American Society of Health-System Pharmacists (ASHP) found that technology that improves medication use have been implemented in nearly all hospitals in the United States. The broadly-implemented technologies include electronic health records (EHRs), computerized prescriber-order-entry (CPOE) systems, and barcode-assisted medication administration systems
Included in the ASHP National Survey of Pharmacy Practice in Hospital Settings: Prescribing and Transcribing—2016 were 392 hospitals based in the United States.
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Senate won't vote on ObamaCare repeal bill
Senate Republicans have decided to not vote on their latest ObamaCare repeal legislation, signaling a collapse in their last-ditch effort to kill off President Obama's signature law.
"We don't have the votes so it's probably best we don't do the vote," said Sen. Steve Daines (R-Mont.) after the GOP conference met at its regular weekly luncheon. "We've lost this battle, but we're going to win the war."
The last-ditch bill sponsored by Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.) would dismantle ObamaCare’s insurance subsidy program and Medicaid expansion and convert their funding into block grants to states.
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Most Medical Staff Have Improperly Used EMR Passwords
Alexandra Wilson Pecci, September 26, 2017
Nearly three-quarters of participants claimed to have used another medical staff member’s password to access an EMR at work.
A majority of medical staff surveyed have accessed an EMR system using a password improperly supplied by a fellow medical staffer, finds a new study published in Healthcare Informatics Research.
Researchers, from Ben-Gurion University of the Negev, Harvard Medical School, Duke University, Hadassah-Hebrew University Medical Center, and the Interdisciplinary Center in Herzliya, Israel, say theirs is the first study to examine EMR access among medical providers.
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IT is slowing doctors down, says expert
Helen Puttick, Scottish Health Correspondent
September 27 2017, 12:01am, The Times
Most tasks that use new technology in the NHS take longer now than they did on paper, according to an expert adviser on digital healthcare.
Charles Swainson, a former medical director who assists the Scottish government on IT in the health service, said systems were cumbersome, poorly organised and varied between different areas.
Speaking at a debate on the future of Scotland’s health service in Edinburgh, Professor Swainson said the NHS had invested enormous sums of money on digital services “but perhaps with less impact than hoped”. He added: “The interface between clinicians and the technology is appalling. It is usually slow, it is counterintuitive. Most tasks take longer than they did using paper.”
ONC dials back meaningful use certification program
Two big changes: EHR makers are now able to self-declare compliance with specific criteria and ONC will not audit random surveillance practices.
September 21, 2017 11:19 AM
The Office of the National Coordinator for Health IT on Thursday revealed two changes to its certification criteria that officials said are designed to reduce the burden on industry and make the meaningful use program more efficient.
The first is making more than half of test procedures self-declarable and the second is more discretion around randomized surveillance of certified health IT products.
Elise Anthony, director of policy at ONC, and Steven Posnack, director of ONC’s Office of Standards and Technology, wrote on the Health IT Buzz blog that 30 of the 55 criteria were intended to support CMS Quality Payment Program and those are now self-declaration only.
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Despite deregulation, we won't let EHR makers run wild, ONC chief promises
New criteria for vendors are meant to ease burdens and ultimately pass cost-savings down to the hospitals and systems that buy electronic health record software, Donald Rucker says.
September 22, 2017 01:08 PM
"Our experience is that people will report if there are issues with their product," said ONC Chief Donald Rucker.
The Office of the National Coordinator for Health IT’s plans to change the ONC Health IT Certification Program has sparked some important questions. Wouldn’t allowing vendors to now simply say they're in compliance, rather than prove it in an ONC-Authorized Testing Laboratory, pave the way for EHR vendors to essentially flout the rules? And what’s to prevent more certification problems such as the eClinicalWorks $155 million settlement?
Or as Andre Thenot tweeted Thursday, "ONC switches to pinky-swear instead of actual compliance testing. #whatcouldpossiblygowrong."
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SEC, Equifax breaches highlight steps orgs should avoid in breach disclosure
Serious missteps in how Equifax is handling its breach should inform healthcare organizations on what not to do it if happens to them.
September 22, 2017 02:43 PM
In what’s being called one of the worst breaches in U.S. history, the Equifax breach of about 143 million records is being marked by some serious missteps.
Hackers managed to pilfer Social Security numbers, driver’s licenses and credit card numbers for some, in addition to other sensitive details of a large portion of the population. But what’s most concerning is how the company is handling the breach.
It’s also important to note this is the second breach for Equifax this year. In May, the company notified the public that hackers exploited Equifax TALX payroll division between April 2016 and March 2017. A flaw allowed hackers to reset the 4-digit PIN numbers used by payroll managers, by answering a few simple questions.
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Mental health experts across the globe say psychiatrists should ‘embrace’ digital health
Sep 25, 2017 12:12pm
Mental health experts commissioned by the World Psychiatric Association say “the digital psychiatry revolution has arrived."
A commission of mental health experts from around the world says psychiatric care in the digital age will rely on the ability to integrate new technology into the rapidly evolving specialty.
The Commission on the Future of Psychiatry, created by the World Psychiatric Association and The Lancet Psychiatry, outlined critical opportunities to navigate the 21st century in a paper published by The Lancet. A major aspect of that approach will be a broader integration of digital health tools that will be a key resource for mental health providers.
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Nurses, Physicians Use Personal Devices Even When BYOD is Prohibited
September 21, 2017
by Rajiv Leventhal
Some seven in 10 (71 percent) hospitals now allow BYOD (bring your own device) in the workplace, according to a new survey, which also found that some healthcare professionals use personal devices for work even when BYOD is not allowed.
The research, from Spok, Inc., included responses from more than 350 healthcare professionals. The 2017 research indicated that 71 percent of hospitals allow BYOD, compared to 58 percent in 2016. The researchers said, however, that the apparent increase may be an artifact of participant self-selection to take a BYOD-specific survey, but it does match their industry experience and interactions with customers where they see the majority of hospitals allowing physicians to use their personal devices.
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COMMENTARY
The ABCs of Telemedicine: It's More Than Just Picking Up the Phone
Interviewer: Laurie Scudder, DNP, NP; Interviewee: Ernest L. Carter, MD, PhD
September 25, 2017
Medscape: My name's Laurie Scudder. I am the editor of Medscape Family Medicine. I'm here at the American Academy of Family Physicians Family Medicine Experience (FMX) in San Antonio, Texas. I'm delighted to be joined today by Dr Ernest Carter.
Ernest L. Carter, MD, PhD: I am Dr Ernest Carter. I'm a physician who's been practicing for more than 30 years, and I'm the deputy health officer in Prince George's County, Maryland. I'm also a bioengineer and I've been involved in telemedicine now for more than 25 years.
Medscape: Dr Carter, that's a good segue to my first question, which is: What is telemedicine? We hear terms like "telehealth," "e-health," "virtual medicine." What are all of those terms? Are they all the same or different?
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Enjoy!
David.
