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, October 06, 2018

Weekly Overseas Health IT Links – 6th October, 2018

Here are a few I came across last week.
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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Has blockchain’s time come in health and social care?

The Emperor’s New Clothes, a genuinely transformative breakthrough, or something in between? Gareth Baxendale considers the blockchain, and the potential it may – or may not – have to transform healthcare.
DHI Admin – 25 September, 2018
In 1837, Hans Christian Andersen wrote ‘The Emperor’s New Clothes’, a short story about two weavers who create a beautiful new suit of clothes they say are invisible to those who are unfit for their positions, stupid, or incompetent.
But in reality they make nothing at all, instead making everyone believe the clothes are simply invisible to them. When the emperor parades before the people in his new suit of clothes, no-one dares to say that they do not see any clothes on him for fear they will be seen as stupid.
It’s now 10 years since the person or group known as Satoshi Nakamoto conceived the idea of blockchain – an ‘incorruptible’ digital ledger that can be programmed to record all manner of transactions – and so some might question whether it can still be classified as an emerging technology that is destined to change the world.
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Swedish authorities complete assessment of Natural Cycles app

Swedish authorities have completed their assessment of a ‘contraceptive app’ after a hospital discovered a number of unwanted pregnancies among women who relied on it.
Hanna Crouch – 27 September, 2018
Natural Cycles was referred to Sweden’s Medical Products Agency (MPA) after claims that 37 out of 668 women seeking an abortion at one of Stockholm’s largest hospitals from September to December 2017 were relying on the app as a method of contraception.
In response, the MPA asked Natural Cycles to clarify the risk of unwanted pregnancy in the instructions for use and in the app, which last month received clearance by the Food and Drug Administration (FDA) in the US.
The company was also asked to make some updates to the procedure for tracing and handling of software versioning.
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Q&A: Former White House CIO Theresa Payton on why security pros should buck conventional wisdom

It's time to think creatively when designing to secure the human rather than securing technology, said the former star of the CBS series Hunted.
September 28, 2018 09:04 AM
Anyone reading the headlines about data breaches, hackers and worse-case cyber scenarios can be forgiven for thinking the situation is hopeless. But it's not. The time has come, however, for infosec pros executives to change how they design security to begin with by focusing on the human, not the technology.
That's the assertion of Theresa Payton, the former CIO at the White House, star of the CBS series Hunted, and currently founder and CEO of security firm Fortalice.
I spoke with Payton ahead of our HIMSS Healthcare Security Forum in Boston, which takes place Oct.15-16, and where she will be the keynote speaker.
Q: What motivates you in your career protecting data and combating cybercriminals?  
A:
I feel like at this point in my career – based on all the blessings of experience – I've been trained and lead to really avenge the wrongs in the world and make them right. Whether that's working for the U.S. government or private sector companies and trying to prevent them from being hacked or coming in on an incident response and getting them back up and running and figuring out who did it so we can turn it over to law enforcement.
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Here's what innovators really need from EHR makers to move healthcare forward

APIs are a great start, but so much more goes into building an app and winning customers.
September 28, 201809:07 AM
Healthcare is on the verge of open APIs and data, developer programs from leading software vendors, and an even bigger rush of upstarts and entrepreneurs looking to create digital health tools that usher in a new generation of care delivery fit for consumers by focusing on patient experience.
As exciting as that is, however, there are a few things innovators really need to overcome the prevailing sense that the industry must move faster.
Big electronic health record vendors such as Allscripts, athenahealth, Cerner, eClinicalWorks, Epic and most recently Meditech have third-party developer programs, with varying degrees of participation and success. In the meantime, innovators have the opportunity to create apps for other companies platforms as well.
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Tech Giants Launch New AI Tools as Worries Mount About Explainability

About 60% of 5,000 executives in IBM survey expressed concern with AI’s ‘black box’

By Sara Castellanos
Sep 26, 2018 11:27 am ET
Concerns about transparency and ethics in artificial intelligence are mounting, prompting cloud services companies to launch new tools that explain the decision-making behind their AI algorithms.
Executives in regulated industries such as accounting and finance say it’s crucial that both data scientists and non-technical business managers understand the processes behind an algorithmic decision. That knowledge could have far-reaching impacts in guarding against potential ethical and regulatory breaches, especially as enterprise-level AI algorithms become widespread.
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In Senate hearing, tech giants push lawmakers for federal privacy rules

Another day, another hearing of tech giants in Congress.
Wednesday’s hearing at the Senate Commerce Committee with Apple, Amazon, Google and Twitter, alongside AT&T and Charter, marked the latest in a string of hearings in the past few months into all things tech: but mostly controversies embroiling the companies, from election meddling to transparency.
This time, privacy was at the top of the agenda. The problem, lawmakers say, is that consumers have little of it. The hearing said that the U.S. was lagging behind Europe’s new GDPR privacy rules and California’s recently passed privacy law, which goes into effect in 2020, and lawmakers were edging toward introducing their own federal privacy law.
Here are the key takeaways.
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Investing in IT: 4 big obstacles leaders face

Written by Alia Paavola | September 26, 2018 | Print  |
At Becker's Hospital Review's 4th Annual Health IT + Revenue Cycle conference in Chicago Sept. 21, four healthcare industry experts discussed the top obstacles health system leaders face when trying to invest in IT. They also offered several solutions.
1. Budget. For many hospitals the IT department budget is lumped in with the entire capital budget. This is problematic because implementing a new IT system or program that benefits the entire health system can get  expensive and far exceed the budgeted amount, said Dawn Blandford, CIO of Leitchfield, Ky.-based Twin Lakes Regional Medical Center.
"One way we mitigated this and got the approval to separate the IT budget from the rest of the departments was aligning more with the CFO … [and] establishing an IT governance to discuss the budget from the top down ... and present the return on investment to get the board to sign off," Ms. Blandford said.
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NIST says providers need more awareness of IoT security risks

Published September 28 2018, 3:49pm EDT
Many healthcare organizations are not fully aware that they use a large number of Internet of Things devices that increase breach risks.
That must change, according to the National Institute for Standards and Technology, one of the nation’s oldest physical science laboratories and a part of the Department of Commerce.
“It is important that organizations understand their use of IoT because many IoT devices affect cybersecurity and privacy risks differently than conventional IT devices do,” according to a draft document released by NIST to collect insights on IoT issues from stakeholders during a public comment period set to close in October.
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HIT Think How providers can better compete with tech giants in healthcare

Published September 28 2018, 4:00pm EDT
The drumbeat is building for vast changes in the U.S. healthcare ecosystem.
Amazon just bought online pharmacy PillPack to disrupt drug distribution. Cigna’s merger with Express Scripts got the go ahead from federal regulators. CVS is buying Aetna. And the aforementioned Amazon is also bringing their retail and data crunching power to their non-profit formed with JP Morgan and Berkshire Hathaway to tackle healthcare costs.
Even the new Apple watch has an FDA approved built-in EKG-scanner, and Apple is gaining traction with its health record app, which brings together hospitals, clinics and Apple’s health app to make it easy for consumers to see their medical data from multiple providers.
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Yes, Healthcare's Data Breach Problem Really Is That Bad

HCA News Staff
SEPTEMBER 25, 2018
Over an eight-year span, healthcare organizations reported 2,149 data breaches affecting 176.4 million records to the federal government, with almost every year bringing more privacy incidents, according to new research.
The findings, published today by the JAMA Network, further support the argument that healthcare is particularly vulnerable to hackers. The rise of electronic health records appears to have worsened the situation, placing patients at risk and healthcare providers, insurers and other stakeholders in ethical and legal hot water, according to the study authors, who are affiliated with the Center for Quantitative Health at Massachusetts General Hospital in Boston.
“Although networked digital health records have the potential to improve clinical care and facilitate learning [in] health systems, they also have the potential for harm to vast numbers of patients at once if data security is not improved,” authors Thomas H. McCoy Jr., M.D., and Roy H. Perlis, M.D., M.Sc., wrote.
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What innovation looks like at a medium-sized hospital

Mobile, Alabama-based Springhill Medical Center keeps a focus on physician and patient engagement as it works to drive process improvements and stay competitive.
September 27, 2018 10:50 AM
Springhill Medical Center, a 250-plus bed hospital based in Mobile, Alabama, exists in a crowded and competitive market. The for-profit, privately-owned hospital operates near nine other groups across two counties managed by five different providers.
For that reason, Springhill is always looking for innovative ways to maintain its competitive advantage – to provide a good patient experience and to keep its own physicians happy.
"Being the only for-profit, we have to be hitting on all 12 cylinders, that's for sure," said Springhill Chief Information Officer Mark Kilborn. "We have to be ahead of the game – we have to make it easy for physicians to practice here at Springhill, because if they don't like the way we do things, all they have to do is drive down the street."
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Survey: 62 Percent of Docs Use Speech Recognition, But Cite Concerns About Accuracy

September 26, 2018
by Heather Landi, Associate Editor
Two-thirds of physicians are currently using speech recognition technology with their electronic health record (EHR) solution, yet 23 percent have no plans to adopt speech recognition, according to a Reaction Data survey about the use of speech-enabled EHRs.
Reaction Data, a market research firm focused on the healthcare and life sciences industries, surveyed 300 physicians to gauge where speech recognition technology is going in healthcare and what providers’ plans are for speech recognition, as well as which vendors are being used most. Among the respondents, 18 percent were pediatricians, 18 percent were classified as “other,” 9 percent were family medicine physicians, 8 percent were internal medicine doctors, and the remaining percentage made up of a number of specialties, including orthopedic surgeons, neurology, psychiatry, anesthesiology, surgery, emergency medicine and even chief medical officers (CMOs).
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Social determinants of health data doesn't improve health predictions, study finds

Written by Jessica Kim Cohen | September 26, 2018 | Print  |
Socioeconomic status may influence a patient's health, but researchers don't need this information to develop accurate predictive models, according to a study published in JAMA.
Researchers from Durham, N.C.-based Duke University used machine learning — a type of artificial intelligence — to develop risk models to predict health events through the use of EHR data, neighborhood socioeconomic status data or both.
The researchers trained the models on data from more than 90,000 patients, including EHR data from adults who lived in North Carolina's Durham County and visited the Duke University Health System and the Lincoln Community Health Center, both in Durham, N.C., between 2009 and 2015. They linked this information with neighborhood socioeconomic status data based on census tracts.
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EHR Tools Collecting Social Determinants of Health Data Need Work

Inefficiencies may inhibit the benefits of EHR tools documenting social determinants of health data.

September 26, 2018 - Integrating social determinants of health (SDH) data into EHR systems may help providers address the economic and social risks that negatively affect patient health.
However, a recent Annals of Family Medicine study by Gold et al. identified several barriers inhibiting the integration of SDH data into EHR clinical documentation.
A team of researchers from Kaiser Permanente, OCHIN, Multnomah County Health Department, Cowlitz Family Health Center, and University of California San Francisco implemented a suite of EHR tools designed to collect SDH data at three Pacific Northwest community health centers as part of a pilot study testing the effectiveness of EHR-based SDH documentation.
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Digital pills come under fire for privacy, patient-provider issues

Published September 27 2018, 7:39am EDT
There is no evidence that digital pills, prescription medications with ingestible wireless sensors, are beneficial to patients and, in fact, the technology poses a danger to the provider-patient relationship.
That’s the contention of researchers at the University of Illinois at Chicago who caution that, despite the Food and Drug Administration’s 2017 approval of the first drug in the U.S. with a digital ingestion tracking system, it is premature for providers to allow this new tool into clinical settings.
These “smart” pills are designed to digitally track if patients have ingested their prescription medications in an effort to ensure drug regimen compliance.
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HIT Think Why the CMS push for interoperability could make an impact

Published September 27 2018, 5:54pm EDT
The Centers for Medicare and Medicaid Services in July announced an overhaul to the requirements surrounding the exchange of electronic health information. Beyond interoperability, CMS is also focusing on telecommunications technology with planned reimbursements for virtual care.
The proposed Calendar Year 2019 Physician Fee Schedule also supports items such as brief, non face-to-face appointments via telecommunications, clinician evaluation of patient-submitted photos and expanded Medicare-covered telehealth services, all geared toward driving further innovation in patient care.
These initiatives reinforce the growing role of interoperable systems, as well as the emphasis on more efficient and more patient-centric care. What CMS is proposing are changes to boost digital information sharing through improved electronic health records (EHR) interoperability and patient access to health information.
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Predicting Illness is One Step Closer to Reality

By Mandy Roth  |   September 27, 2018

HHS funds further research of a wearable device that could warn of early illness.

It's a device the size of a key fob that measures breathing, heart rate, sleep, and movement. It can be attached to clothing such as undergarments, requires no recharging, and will survive cycles through the washer and dryer.
The U.S. Department of Health and Human Services (HHS) is hoping that one day this easy-to-use monitor will issue early warnings that the individual wearing it is about to become sick. The implications for health systems managing population and chronic health initiatives is obvious: early detection and treatment of illnesses such as the flu could prevent hospitalizations, improve outcomes, and lower costs.
San Francisco-based Spire received a $62,200 grant from HHS to further gather data from these devices and discover, through artificial intelligence, if patterns exist that can predict the onset of illness. The total cost of the project is $88,860, with Spire providing the retaining funds.
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Microsoft says care coordination and secure messaging tools are coming to its Teams platform

The software giant will enable caregivers to communicate and integrate with EHR systems.
September 26, 2018 10:06 AM
WHAT HAPPENED
Microsoft is holding its Ignite conference this week, and the company teased a forthcoming care coordination tool that is in early stages of development – as well two secure messaging features it's creating as part of an effort to tailor Teams for specific industries.
WHY THIS MATTERS
Microsoft's Teams platform is a direct competitor to Slack's collaboration tools. But if it the vendor is really moving into the care coordination space it will also encounter a wealth of best-of-breed care management technologies already on the market. And as electronic health record vendors focus on population health modules and features, they too are building out care coordination capabilities.
THE BIGGER PICTURE
Microsoft and its traditional IT rivals are bringing more and more products to the healthcare market. Just last month, in fact, Microsoft aligned with Amazon, Google, IBM, Salesforce and Oracle at a White House event to ease existing interoperability barriers with cloud, FHIR and other HL7 techs and specs.
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Survey says consumers are willing to share their healthcare experiences online

A new survey of over 1,000 U.S. adults who have a physician found 51 percent share their personal healthcare experiences online via platforms such as Facebook and Google.

Sep 25, 2018 at 5:20 PM
A new survey of over 1,000 U.S. adults who have a physician found 51 percent share their personal healthcare experiences via online ratings, review sites and social media.
Called the “Healthcare Consumer Insight & Digital Engagement” survey, the study was conducted by OnePoll from July 11-13, 2018 and commissioned by Binary Fountain, an online reputation management platform.
Diving a bit deeper, the survey found 70 percent of all millennials and 68 percent of “young millennials” (those between the ages of 18 and 24) have shared their healthcare experiences online.
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Commentary: The way companies look to fend off cyberattacks needs a rethink

Companies whose operations are less digitally reliant tend to take a reactive stance towards cybersecurity, says one cybersecurity expert.
25 Sep 2018 06:29AM (Updated: 25 Sep 2018 06:30AM)
SINGAPORE: Companies are paying billions of dollars for fines and damages caused by cyberattacks. The number of breached records is skyrocketing and regulators around the world are tightening laws and penalising negligence, with minimal tolerance for laxity. 
The most recent SingHealth hacking incident and last year’s attacks on NUS and NTU show that Singapore is just as vulnerable as other developed countries. 
Cyberattacks and cybercrime are very real, and they happen every day.
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Healthcare Cybersecurity Is a Top 2019 Executive Challenge

Healthcare cybersecurity will be one of the top 10 challenges facing healthcare executives next year, according to a new poll by the Healthcare Executive Group.

September 25, 2018 - Healthcare cybersecurity will be one of the top 10 challenges, issues, and/or opportunities facing healthcare executives next year, according to a new poll by the Healthcare Executive Group (HCEG).
Healthcare cybersecurity covers such issues as protecting the privacy and security of healthcare consumer information to maintain consumer trust in sharing data, the HCEG explained.
For the poll, the HCEG board and other thought leaders presented a list of more than 25 topics to participants in HCEG's annual forum.
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Stanford report urges medical practices to ‘junk the fax,’ focus on EHR training and workflows

Sep 26, 2018 2:25pm
In an ideal world, clinicians would have virtually no interaction with a patient’s EHR.
Instead, doctors and nurses would spend the majority of their time with patients and EHR data would be populated with “little or no effort.” Vital signs would be instantly uploaded by an automated assistant, artificial intelligence would offer personalized treatment options and relevant data would flow seamlessly through the rest of the system.
That’s the vision of EHRs in the year 2028 as described in a new report from Stanford Medicine based on input from industry experts that attended a June symposium hosted by the medical school.
It’s also a far cry from where the industry is today.
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JAMA study examines variation in type, extent of health data breaches over time

Sep 26, 2018 8:10am
Healthcare data breaches have increased considerably since 2010, new research shows. But the entity that is targeted plays a major role in the magnitude of a given breach. 
The majority of breaches in healthcare over the last seven years—70%—have involved providers. By contrast, only 13% have involved health plans, according to a new study in the Journal of the American Medical Association (JAMA)But while those provider breaches exposed 37.1 million records, plan breaches exposed 110.4 million—nearly three times that number. 
All told, healthcare data breaches compromised 176.4 million records between 2010 and 2017. 
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Study: Health Plans Account for Majority of Breached Patient Records

September 25, 2018
by Heather Landi, Associate Editor
Mass. General study analyzes numbers, trends in health care data breaches nationwide, 2010-2017
Health plans accounted for the greatest number of patient records breached over the past seven years, according to an analysis of U.S. health care data conducted by two Massachusetts General Hospital (MGH) physicians. 
Their report, published in JAMA, examined changes in data breaches during a period when electronic health records were being widely adopted across the country. 
While the largest number of data breaches took place at heath care providers—hospitals, physician offices, and similar entities—breaches involving the greatest number of patient records took place at health plans.
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Medical device error messages may tip off hackers on vulnerabilities

Published September 26 2018, 5:31pm EDT
Hackers are using error messages emitted by connected medical devices to gain insight into a provider organization’s network and vulnerabilities.
The gambit shows how hackers are finding creative ways to target medical devices, and providers need to recognize these threats before real harm is caused, says Xu Zou, co-founder and CEO at Zingbox, which operates an Internet of Things analytics platform.
Zingbox researchers have identified this new trend in cyberattacks. It’s easy to gain access to error messages from a device, says Daniel Regalado, principal security researcher at Zingbox. For example, if an application tries to connect to a server that eventually times out, it frequently triggers an error message that contains a wealth of information for hackers.
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HIT Think How cyber insurance can better protect providers from hacking costs

Published September 26 2018, 6:04pm EDT
Cybersecurity threats pose enormous risks for healthcare providers, including significant liability, operational disruptions, reputational damage, regulatory scrutiny, shareholder lawsuits, patient dissatisfaction and significant cleanup costs.
However, many organizations are not fully prepared for current or future threats. A 2017 study by KLAS Research and the College of Healthcare Information Management Executives (CHIME), found that only 16 percent of the providers surveyed reported that their cybersecurity program was “fully functional.” Another 41 percent reported that their security program was developed or starting to function, and 43 percent reported that their cybersecurity program was developing or not developed.
Clearly, a fully functional security program is critical to managing cybersecurity risk, yet even sophisticated cybersecurity programs are not an absolute guarantee against losses. Insuring against loss is prudent, with per capita cost of data breaches in the global healthcare industry averaging $408, and data breach costs for all industries averaging almost $8 million, according to a 2018 study by Ponemon Institute.
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5 Need-to-Know Leaps in Telehealth

By Mandy Roth  |   September 25, 2018

Learn about the next generation of programs from leading health systems.



KEY TAKEAWAYS

·         Reimbursement progress paves the way for innovation.
·         An enterprise approach helps health systems achieve scale, enhance margins, and optimize resources.
·         Technology developments enable further specialty growth.
·         Telehealth can address ED overuse and support population health initiatives.
The stars are aligning for the next phase of growth in telehealth. Many states have resolved parity issues, CMS is proposing payment changes in 2019 to accommodate telehealth visits, and Next Generation ACOs include a telehealth waiver.
With significant progress on the reimbursement front, the door to innovation swings further open.
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Apple vs Android poll results: Hospitals divided on which innovation strategy is best

Open source? Proprietary? Both? Readers reveal which innovation tactics they take.
September 25, 2018 08:29 AM
For our Focus on Innovation in September we tapped into a matter of some debate among health IT developers: Whether to pursue an open source style when building new software, à la Android, take Apple’s more proprietary tack – or pick the best of both?
We asked readers which innovation strategy they embrace and, it turns out, there’s an even split on favoring an Android-style approach and a combination of both at 39.2 percent each. Of the 102 anonymous respondents, 17.6 percent opted for Apple's "walled garden" tactic, on the grounds that they themselves prefer to be proprietary.
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Groups to develop online suicide risk prevention tool for EDs

Published September 25 2018, 3:16pm EDT
Two national organizations are beginning work to create an online suicide risk assessment and treatment tool for emergency department use.
The push will come as a result of a new program developed by the American Foundation for Suicide Prevention and the American College of Emergency Physicians. The organizations are developing an on-line suicide risk assessment and treatment tool to guide delivery of emergency suicide prevention services.
When completed, the tool, called iCAR2E, will be available for free to emergency departments across the nation.
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HIT Think Why EHRs need more bananas and fewer oranges

Published September 25 2018, 3:11pm EDT
Physicians are people, too, as it turns out.
Well of course they are, you say, perhaps while acknowledging that we may have expected doctors to perform superhuman feats because television feeds us a steady diet of doctors as boy geniuses, adult geniuses, other types of geniuses and personally troubled but ethically unassailable walking Greek tragedies.
In the real world, we know that doctors these days are engaged in very human struggles to pay off massive medical school bills, walk the gauntlet of residency and stave off the demons that come with a high-demand profession.
But where physicians arguably seem most like the rest of us is in terms of behavioral change. When doctors get something stuck in their brains, the evidence suggests, they have as much trouble getting it out as anyone else.
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Are Universal EHRs Key to Healthcare Value, Trust, and AI Adoption?

Countries with universal electronic health records appear to be further along the maturity curves of consumer trust, data integration, and even AI adoption.

September 24, 2018 - Healthcare providers in the United States generally don’t harbor very warm feelings for their electronic health records (EHRs).
Despite efforts from vendors and regulators to improve the experience of interacting with these foundational health IT systems, dissatisfaction and frustration with usability issues and fragmented information are still causing users’ blood to boil.
It may seem counterintuitive, therefore, to suggest that expanding the industry’s reliance on EHRs is actually the key to making EHR use less stressful and more useful – but that is exactly what the 2018 Future Health Index, commissioned by Philips, seems to indicate.
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CIO's guide to creating a dashboard for tracking innovation projects

The key performance indicators, measurable processes, implementation data and demonstrable value are what makes an effective innovation dashboard.
September 24, 201808:00 AM
Beth Israel Deaconess Medical Center tracks innovation on its information systems strategic plan dashboard. Innovation is represented on the dashboard in green. Credit: Beth Israel Deaconess Medical Center
Dashboards are excellent tools for healthcare CIOs and other executives to keep track of projects, strategies and progress. But what about tracking an organization’s innovation? Can that be done? And can it be done on a dashboard?
The answer is yes. And forward-looking healthcare providers including Beth Israel Deaconess and NewYork-Presbyterian have innovation dashboards, or larger project dashboards on which innovation is also tracked. It’s important for executives to know if they’re attempting to stay out in front of the field, and if they’re succeeding in doing so.
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Patient appointment scheduling jumps 131% with new IT at UAB Medicine

This case study examines how patients are spending 273 percent more time booking appointments on the UAB Medicine website, a big win for the goal of boosting patient access.
September 24, 2018 01:18 PM
THE PROBLEM
Health system UAB Medicine, with its flagship 1,157-bed UAB Hospital on the University of Alabama at Birmingham campus, needed to solve what it called “the patient access paradox” – where patients are told to wait weeks, if not months, to see a caregiver despite the fact that as many as 30-40 percent of appointment slots are actually empty or poorly used across the health system.
PROPOSAL
UAB Medicine began searching for a vendor that shared its vision and goal of getting every patient to the right provider the first time – and to solve the crippling supply and demand mismatch problem that challenged the health system. Multichannel patient access technology vendor Kyruus proposed it could enable UAB Medicine to optimize patient access across all points of entry into the health system, with the same provider data appearing in each channel.
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HIT Think How data integration is key to improving healthcare decision making

Published September 24 2018, 1:02pm EDT
Data is everything in healthcare. It is the fundamental requirement for developing an in-depth picture of the industry, and opening the door to understanding performance, outcomes, costs and efficiency (or a lack thereof).
Researchers want data to conduct studies and discover breakthroughs. Finance teams require it to develop spending forecasts, and determine overall financial performance and organizational health. Suppliers and manufacturers use it to get a robust understanding of product information. Clinicians want to draw on data to improve patient care, procedures and therapies.
With so much potential at the industry’s fingertips, most healthcare professionals list data and analytics for improved decision making as a top priority. The vast amounts of data locked within systems can offer insights that will help the industry not only address critical business and operational challenges, but also help ensure the effective delivery of patient care.
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Stakeholders join to promote easier patient access to their data

Published September 24 2018, 7:43am EDT
A coalition of healthcare organizations and technology companies have developed a prototype tool to make it easier for patients and families to get copies of their medical records.
While the HIPAA Act gives individuals or another designated person the right to receive copies of their health information, providers and payers haven’t always made that task easy, typically requiring the filling out of paperwork and erecting barriers, such as excessive fees, to obtaining electronic formats of the data that can be placed in an app or other location.
The new tool, called the Health Record Request Wizard, was built by technology vendor X4_Health with funding from consumer advocates, as well as additional financial support from the Commonwealth Fund.
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Teladoc goes global: 4 things to know

Written by Jessica Kim Cohen | September 20, 2018 | Print  | Email
Teladoc Health launched Teladoc Global Care, a virtual care service that connects patients with relevant medical care worldwide, Sept. 20.
Here are four things to know about the service:
1. Users can access Teladoc Global Care through Teladoc's app. On the service, users — whether traveling or living outside the U.S. — can speak with a physician who speaks their language and can guide them through the local healthcare system.
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11 Ways Medical Practices Can Get More Out of Their EHR Systems

Industry experts convened by the Stanford University School of Medicine outlined how medical practices can improve their EHR systems.

September 21, 2018 - A new Stanford University School of Medicine white paper informed by feedback from healthcare industry experts offers medical practices 11 recommendations for improving the effectiveness of their EHR systems.
Stanford curated the recommendations during a healthcare industry symposium held June 4, 2018.
By implementing these suggestions, industry experts anticipate EHR systems will have an overall positive affect on the healthcare industry by 2028.
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Trump launches new national cyber strategy

President Trump has signed off on a long-awaited national cyber strategy that aims to guide how the administration handles offensive and defensive cybersecurity and cyberthreats, Trump’s National Security adviser, John Bolton, told reporters in a briefing Thursday.
Why it matters: In the absence of an overarching cybersecurity doctrine, government agencies have been limited in how they can legitimately deter foreign adversaries and respond to cyberattacks — even as the attacks are escalating exponentially.
The context: This comes at a time when the administration has been bleeding cyber talent and facing criticism for its approach to election security — it eliminated the role of cybersecurity coordinator earlier this year, and the FBI has been losing cyber talent as well.
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HHS urging providers to use telemedicine for medication-assisted opioid treatment 

Sep 24, 2018 9:02am
HHS is pushing providers—particularly those in rural areas—to take advantage of telemedicine to increase access to medication-assisted addiction treatment (MAT). 
But providers seeking to prescribe these medications require waivers, which can hinder access, especially in remote areas where doctors with these qualifications are in short supply. 
So the Department of Health and Human Services and the Drug Enforcement Administration have worked together to ease these restrictions. Doctors can now prescribe buprenorphine, one of the most commonly used drugs for MAT, through a virtual platform, when before these clinicians had to be physically present with patients to offer these prescriptions. 
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With support from health IT groups, a new ‘wizard’ looks to streamline patient medical records requests

Sep 24, 2018 1:57pm
Anyone who has ever tried to get their medical records knows: It’s not easy.
Christine Bechtel, the co-founder and president of X4 Health knows about the complexities first hand. Three years ago, she tried to get her medical records from her doctor in an electronic format. She was stymied when the office’s request form didn’t provide the option, despite a 2013 change to HIPAA that requires providers to give medical records in an electronic format to those that request it.
“I literally printed off a copy of the federal register [HIPAA rule] to prove my right to records in electronic format and dropped it on their desk,” Bechtel told FierceHealthcare. “It made quite a thud.”
Now, X4 Health and 13 other healthcare and technology groups are hoping to fix what has become a pervasive issue in healthcare with a so-called “wizard,” a medical records request prototype that streamlines the process for both patients and medical records professionals.
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Enjoy!
David.

Friday, October 05, 2018

It Rather Looks Like The South Australian ePAS Program Is Nearing Some Final Outcome.

These appeared last week:
First:

SA Health review: EPAS must be overhauled or scrapped

Adam Langenberg, Political reporter, The Advertiser
September 26, 2018 6:56pm
THE health system’s trouble-plagued electronic patient record system will be overhauled or scrapped altogether, after an SA Health review “confirmed” concerns about its operation.
Three health experts will determine if issues with the electronic patient administration system (EPAS) can be “addressed adequately” after a review found it couldn’t proceed in its current form.
SA Health chief executive Chris McGowan said the panel would also consider whether the problems were so significant that EPAS needs to be scrapped entirely.
“The independent expert panel will now look at options regarding the future of the
EPAS roll out and will be consulting with stakeholders on the options,” SA Health chief executive Chris McGowan said.
“The expert panel needs to determine if the issues raised with EPAS can be addressed
adequately in order for it to meet the expectations of users in the future.”
Dr McGowan ruled out returning to a paper record system.
The four options that will be considered by the expert panel are:
CONTINUING with a significantly modified EPAS
ROLLING out the modified EPAS in the Central and Southern local health networks, before assessing requirements for other health networks
OBTAINING a “fit-for-purpose” patient administration system and pairing it with an electronic medial record
SCRAPPING any further rollout of EPAS and returning to the market for a new solution
More here:
Then:

SA Health may scrap over-budget health app

By Justin Hendry on Sep 27, 2018 3:03PM

Extra funds aren't turning around sick EPAS patient admin system.

South Australia’s troubled electronic patient administration system (EPAS) is set to be overhauled or discontinued altogether after an independent review confirmed longstanding concerns with the rollout.
In an update on the review into the system that kicked off in June, SA Health revealed that continuing the current implementation approach had been “ruled out” by the review panel.
Chief executive Chris McGowan said the review's diagnostic phase had confirmed concerns with the rollout of the system, which remains accessible by only 25 percent of the state's hospital beds.
EPAS has suffered numerous problems since it was introduced by the former Weatherill Labor government in 2013, including numerous delays, usability issues and cost overruns.
The state was most recently forced to spend another $49 million to upgrade the system, bringing the total cost of the project to over $470 million. The project was originally budgeted at $408 million.
However around 75 percent of that revised budget has now been spent.
Next steps
Despite concerns with the rollout of the system, the review exposed “strong views” from users about returning to paper-based systems. The review panel has ruled out a return to those manual processes.
The panel will now consider a range of other option for the system that could change as the consultation phase progresses.
More here:

EPAS: SA clinicians welcome decision to scrap current system, but wary of costs

Adam Langenberg, Political reporter, The Advertiser
September 27, 2018 11:09pm
SOUTH Australia must avoid another health budget black hole as a result of overhauling the state’s trouble-plagued electronic patient record system, a medical union says.
SA Salaried Medical Officers Association president Laura Willington supported an overhaul of the “clunky” electronic patient assessment system (EPAS), but questioned how it could be done without a significant funding injection.
“The issue (with EPAS) is there’s so much that needs to be overhauled and there’s already been so much money spent on it,” Dr Willington said. “At some point, you’ve got to stop spending good money after bad.”
The Advertiser revealed yesterday that SA Health had decided against proceeding with EPAS in its current form following a review.
A three-member expert panel will now consider four options, including significantly modifying EPAS, as well as scrapping the rollout entirely and going back to the market.
Dr Willington said the report “vindicated” her union’s concerns that EPAS was not fit for purpose.
Australian Medical Association SA president William Tam said hospitals needed a “safe, user-friendly” system that increased productivity.
Lots more here:
So it rather seems SA is planning for something new.
There is only one problem and this sentence encapsulates the issue.
“Australian Medical Association SA president William Tam said hospitals needed a “safe, user-friendly” system that increased productivity.”
A system of this sort takes a long journey and requires a serious investment in very adequate hardware, considerable expertise in implementation in all its aspects, highly skilled project and change management and a great deal of money. What Dr Tam is talking about is a long term dream!
There must also be a rock solid preparedness of all staff to work constructively with the system provider over a very extended period. Getting a quality implementation of the software from say Cerner or Epic is a very considerable effort and achievement. All the Eastern States now have some examples that show success is possible - with time, effort and money.
The bottom line is that success has to be something everyone involved wants and is prepared to both work and pay for in both training, effort and money!
Will be a real test of the new SA Government to understand this is what is needed and to execute – or we will be back here again in a few years’ time.
David.

p.s. There is later coverage of the debacle with comments from the vendor Allscripts here:

https://www.healthcareit.com.au/article/we-welcome-review-allscripts-responds-sa-health-says-its-electronic-patient-record-will-be

 "We welcome the review": Allscripts responds as SA Health says its electronic patient record will be overhauled or abandoned.

Lynne Minion | 02 Oct 2018 
 
Enjoy.
 
D.