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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Royal Free: ‘No changes to data-sharing’ as Google absorbs Streams
Royal Free
London has confirmed that there will be no changes to its data-sharing
agreement with DeepMind after Google absorbs its Streams technology.
Oven Hughes –
November 22, 2018
The trust
said it would remain in control of the information generated by the app, used
to detect early signs of acute kidney infection (AKI), adding that “nothing
will change without our consent”.
A Royal Free
spokesperson said: “Patient safety and patient confidentiality is our absolute
priority and Streams is governed by the strictest guidelines and laws – as is
all of the information we handle.”
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GP at Hand receives green light in NHS England safety assessment
Hammersmith
and Fulham Clinical Commissioning Group (CCG) has relaxed restrictions on GP at
Hand after a review by NHS England concluded that it met key national safety
standards.
Owen Hughes –
November 19, 2018
Board papers
posted by the CCG reveal that previous restrictions stopping individuals with
more complex medical needs registering with the online service have been
lifted, though the papers note that the requirement to de-register from a local
practice to use the service “may not be clinically appropriate” for some
patients.
NHS
England said it would work with Hammersmith and Fulham CCG to ensure that
service continued to meet the needs of patients.
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Davey Winder: NHS cybersecurity needs to be less Captain Picard, more
Locutus of Borg
On the same day the health and social care
secretary addressed the annual meeting of International Association of National
Public Health Institutes (IANPHI), his vision for putting prevention at the
heart of the nation’s health was published.
Davey Winder
22 November 2018
I couldn’t
help but wish Matt Hancock was talking about NHS cybersecurity, and my mind
raced with thoughts of Star Trek when Captain Picard was transformed into
Locutus of Borg. I’ll explain why in due course.
Both
the publication date of 5 November and the
document subtitle – ‘Our vision to help you live well for
longer’ – made me want to light up the night sky with the message that
breach protection is better than post-breach cure. Not that there ever seems to
be an actual cure post-breach; just the application of a plaster or two and a
quick slurp of whatever security medicine is available and affordable to take
away the pain until the next attack.
In
that
IANPHI speech, Hancock spoke about the use of AI in
‘predictive prevention’ for improving health outcomes.
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Ukrainians to get doctor's notes, prescriptions, medical history online
from 2019
13:25, 23 November 2018 Ukraine
Over 1,000 medical institutions in Ukraine are already
connected to the eHealth electronic system. REUTERS
Ukrainians will be able to get doctor's notes, prescriptions
or medical histories online from 2019.
Ukraine's healthcare reform gaining momentum: Free X-rays,
e-records The Ministry of Health said this task would become a priority in
2020, according to a morning TV show, "Snidanok z 1+1."
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Apple in Talks to Give Veterans Access to Electronic Medical Records
Under plans being discussed, Apple would create software allowing
veterans to transfer health records to iPhones
By Ben Kesling and Tripp Mickle
Updated
Nov. 21, 2018 3:28 p.m. ET
Apple Inc. AAPL
-0.05% is in discussions with the Department
of Veterans Affairs to provide portable electronic health records to military
veterans, a partnership that would simplify patients’ hospital visits and allow
the technology giant to tap millions of new customers, according to people
familiar with the effort and emails reviewed by The Wall Street Journal.
Under the plans being discussed, Apple would create special
software tools allowing the VA’s estimated nine million veterans currently
enrolled in the system to transfer their health records to iPhones and provide
engineering support to the agency. Apple in January announced its foray into the electronic-records field with a feature that allows patients to import and store medical
information.
Top VA officials, as well as associates from President Trump’s
Mar-a-Lago Club, discussed the project last year in a series of emails reviewed
by the Journal. The emails show how the Trump administration wrestled early on
with the project’s goals.
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Survey: Most health informatics executives see ‘big tech’ as a threat
Nov 21, 2018
10:08am
Healthcare
informatics executives are feeling a pinch of anxiety heading into next year
thanks to a growing interest in healthcare from the world's foremost technology
companies.
Seven
in 10 health IT executives are “somewhat concerned” about technology companies
like Google, Amazon and Apple encroaching into the healthcare space, according
to a new
survey by the
Center for Connected Medicine, jointly operated by GE Healthcare, Nokia and the
University of Pittsburgh Medical Center.
Quantitative
and qualitative polls conducted over the course of several months focused on
informatics leaders in the C-suite, including chief informatics officers, chief
medical informatics officers and chief nursing informatics officers spanning
nearly 40 health systems.
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10 health IT happenings we're thankful for in 2018
From
innovations and emerging technology to the promise of regulatory relief for
hospitals, healthcare has plenty to be grateful for this week and year round.
November 21,
2018 12:56 PM
As
the 2018 holiday season kicks off and people across the country gather to
reflect on everything they have to be thankful for, there's the traditional
core of family, friends and food, of course. In the health IT space we also
have plenty of reasons to give thanks: new innovations, encouraging progress on
longstanding challenges and more.
Let's
take a look at some of the most important and encouraging health IT
advancements that we're grateful for this week.
1. The
future will be data-driven, patient-centric and outside a hospital.
The practical futurist Michael Rogers sketched
what
care delivery might look like in the late 2020s. Among his prediction:
booths bearing smart sensors, 8K screens so patients can interact with
clinicians, and diagnostic devices, among other cutting-edge tech.
2.
Interoperability just had a big moment. CommonWell just this
week implemented Carequality's nationwide connection that means hospitals
participating to either
can
access data from any other member, regardless of which EHRs are used. Micky
Tripathi, CEO of Massachusetts eHealth Collaborative and a board member of both
CommonWell and The Sequoia Project overseeing Carequality called the
development "
a
signature moment for nationwide interoperability."
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CommonWell, Carequality link seen as basis for nationwide interoperability
Published
November 21 2018, 6:58am EST
Healthcare
stakeholders see last week’s announcement linking CommonWell Health Alliance to
the Carequality framework as a watershed moment on the road to achieving
nationwide interoperability.
At
its core is the Carequality framework, providing for trusted national exchange
through common “rules of the road,” defined technical specifications, as well
as a participant directory.
Jitin
Asnaani, executive director of CommonWell Health Alliance, describes the
collaboration as a “golden spike” moment for health IT in which “two of the
largest interoperability communities have come together and are now going to be
enabled to exchange data with each other—which is amazing for patients and
providers alike.”
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Survey: Demise of PACS has been greatly exaggerated
Published
November 21 2018, 5:20pm EST
Current
trends in radiology imaging continue to shift at a rapid pace. However,
predictions about the demise of picture archiving and communications systems
are unfounded.
That’s
among the findings of a survey of nearly 300 radiologists and medical imaging
leaders by Reaction Data, a research and consulting firm.
“The
rumors of PACS death have been greatly exaggerated,” according to Reaction
Data. “PACS have been, and still is, very much the hub of the radiology
department.”
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HIT Think Providers aim to find the right formula for precision medicine
Published
November 21 2018, 2:30pm EST
The
transformative promise of precision medicine is often cited as the driving
reason why healthcare organizations need to begin their own clinical genomics
programs. But has precision medicine technology reached a point where
pioneering provider organizations can realize a return on their investments?
Finding
the path forward is critical to success in delivering the benefits of precision
medicine to patients. A new study from KLAS,
Precision
Medicine Provider Validations 2018 – Part 2, asks providers what vendors
have to offer and what best practices are moving precision medicine forward for
them.
Nearly
three-quarters of the providers interviewed for the study do not believe the
electronic medical record will play a primary role in the future of precision
medicine, with several citing inherent deficiencies within EMRs as root causes.
Respondents believed that peers looking to begin a journey into precision
medicine should focus on niche vendors that have the experience and
capabilities needed to address the specific challenges inherent in precision
medicine.
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More than 100 digital health and care tools evaluated against key
standards for NHS Apps Library
November 14,
2018
Approximately
120 apps are currently being evaluated by NHS Digital and two external
assessors against key standards to be added to an NHS resource of trusted
digital health and care tools for patients, citizens, healthcare professionals,
and commissioners.
The
NHS
Apps Library currently includes 75 different apps and tools. The
assessment process, which looks at clinical safety, accessibility, usability,
and technical stability, along with other areas, can reportedly take from one
to three months, depending on their functionality.
NHS
Digital is working with third-party evaluators Our Mobile Health and ORCHA to
manage demand. However, the apps that have been evaluated so far have all
failed to get through the assessment the first time.
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Are EMRs alleviating preventable medical errors yet?
In the
decade-and-a-half since the startling “To Err is Human” report, it’s still hard
to discern whether billions invested in electronic medical records are
improving patient safety.
November 20,
2018 08:39 AM
Health
systems have made significant investments in digitizing their operations
primarily through the deployment of the electronic medical record (EMR). The
EMR platform, in fact, holds the promise of being the foundation to address the
many clinical shortfalls documented in the Institute of Medicine (IOM) 1999
landmark report “To Err is Human: Building a Safer Health System.”
The
report identified that as many as 98,000 people die in U.S. hospitals each year
as a result of preventable medical errors. The source for a significant
percentage of these errors is the lack of appropriate patient data available to
clinicians at the point of patient care.
With
more than 15 years since the IOM report, the question is: “Have these EMR
investments made a difference in reducing the reported eye-opening
outcomes?"
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Center for Connected Medicine polls top health systems about 2019
priorities
Cybersecurity
is still the big one. But interoperability and telehealth are not far behind
for leading organizations' technology goals.
November 20,
2018 10:22 AM
The
Center for Connected Medicine polled IT executives across 38 health systems for
its
2019
Top of Mind survey. Cybersecurity continues to be the biggest concern
across the industry, with telehealth and interoperability not far behind.
Those
topics arguably represent something of a return to basics after last year's #2
and #3 items: consumer-facing technology and predictive analytics.
WHY IT
MATTERS
The CCM, which is run jointly by UPMC, Nokia and GE Healthcare, partnered with
The Academy for the new survey, polling tech execs – CIOs, CMIOs, CNIOs – to
get a sense of the the state of the industry: the challenges that exist, and
how C-suite leaders will be tackling them in the year ahead.
While
it continues to be a top area of spending and development, cybersecurity
breaches still cause "reputational and financial harm" to even large
organizations. The survey finds only 20 percent of respondents are confident
about being able to recover from a security breach. Executives say education
and training are the biggest weak points; a concern that will only grow as IoT
and connectivity demands increase.
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Congress Facing Pressure to Pass Telehealth Bill for Senior Care
Connected care advocates are pressuring Congress to pass the RUSH Act,
which aims to increase telehealth and telemedicine services in senior care
facilities.
And
they want it done soon.
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Health Data Exchange Helps Identify Disparities in Hypertension Care
New research shows healthcare organizations that engage in health data
exchange may be better able to identify disparities in hypertension care.
November
19, 2018 - Health data exchange may be enable healthcare organizations to
identify common disparities in hypertension care across facilities for
better-informed quality improvement efforts and more effective practice-based
interventions.
Selby
and his team standardized EHR data collection from three California health
systems participating in the San Francisco Bay Collaborative Research Network.
Participating health systems included one academic health system and two
county-run primary healthcare systems. Two health systems part of the study
used Epic EHR, while one used an eClinicalWorks system.
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Top considerations for specialty-specific practices when adopting an EHR
Written by Dr. Arnold Levy, advisor of gMed, Inc., a Modernizing
Medicine company | November 19, 2018
As
every physician can likely attest, providing your patients with quality care
while simultaneously staying on top of the rapid pace of innovation in the
healthcare space can be daunting.
Further
compounding this challenge is the headache of endless paperwork, which can not
only take away from time with patients, but can also lead to physician burnout.
To reduce this burden, many physicians use next-generation software, such as
electronic health record (EHR) systems, to decrease the time spent on reporting
and paperwork. With the healthcare industry’s recent shift toward value-based
care, practices are putting an emphasis on patient outcomes, resulting in new
reporting requirements. Gastroenterology, for example, is adopting specific
measurement parameters to demonstrate positive patient outcomes after
treatment, and must provide access to clinical data registries.
With
that said, quality and value can be difficult to measure if specific parameters
aren’t being utilized. This is where a streamlined, sophisticated EHR system
can be beneficial. Below are some of the top factors to consider when selecting
an EHR system to help make the right decision for your practice.
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Cybersecurity, Telehealth and Interoperability “Top of Mind” for IT Execs
in 2019
November 19,
2018
by Heather
Landi, Associate Editor
As
health system leaders look ahead to the challenges and opportunities of the
coming year, they are increasing their spending to defend against cyberattacks,
expressing optimism about reimbursement for telehealth services, and feeling
anxiety about Apple, Amazon and Google entering the health care space,
according to a new survey.
The
second annual
survey,
conducted by the Pittsburgh-based Center for Connected Medicine (CCM) in
partnership with the Health Management Academy, reflects the opinions of
healthcare C-suite leaders from nearly 40 major U.S. health systems across the
country about their IT priorities for the year ahead. CCM is a collaborative
health care executive briefing center jointly operated by GE Healthcare, Nokia
and UPMC. The Alexandra, Va.-based Health Management Academy is a membership
organization consisting of executives from the country’s top 100 health systems
focused on sharing best practices.
Conducted
in three parts, the research started with a survey of health system information
officers—CIOs, chief medical informatics officers (CMIOs) and chief nursing
informatics officers (CNIOs— in May 2018 to determine the top areas of health
IT for 2019. A quantitative survey was conducted in July 2018 with questions
focused on cybersecurity, telehealth and interoperability. In September 2018,
qualitative interviews were completed with 18 C-suite executives, including
chief executive officers, chief operating officers, CIOs and CMIOs.
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Hospitals, insurance companies leak more health data than hackers
Hospitals,
insurance firms, physician offices, and similar companies leak more personal
health data than hackers, a new study has revealed. According to researchers
with two major US universities, more than half of personal health data breaches
resulted from problems with the medical providers themselves rather than an
external force, such as hackers.
The
findings come from researchers with Johns Hopkins and Michigan State
University; the study has been published in JAMA Internal Medicine. According to the
research, internal issues with providers result in more data leaks than
external forces. Negligence, not hackers, is behind a substantial percentage of
personal health info making its way into unauthorized hands.
A
previous study published last year found almost 1,800 instances of big patient
data breaches in the span of seven years. As well, 33 US hospitals were found
to have suffered multiple “substantial” data breaches during that time.
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Geisinger surgical redesign seeks to reduce opioid use
Published
November 20 2018, 5:13pm EST
On
the heels of a successful pilot test last year, Geisinger Health in
Pennsylvania is implementing an enterprise-wide surgical redesign program to
decrease the use of opioids.
In
June 2017, Geisinger launched a pilot test called ProvenRecovery, a surgical
redesign initiative to expedite healing, improve pain management and reduce
opioid use.
During
the pilot, Geisinger achieved an 18 percent decrease in opioid use across the
organization, while at the same time neurosurgery and colorectal surgery
patients had their hospital stays cut in half, which drove $1.5 million in
savings.
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HIT Think Tips for protecting your data when losing an employee
Published
November 20 2018, 2:30pm EST
Companies
spend a lot of time talking about staff retention, when perhaps they should be
equally concerned about data retention. Most employers would be surprised to
learn that departing internal employees can pose a much bigger threat to their
business’s data security than external hackers.
Alarmingly,
87 percent of employees who leave a job take with them data they created at
that job, and 28 percent take data that others had created, according to a
survey
from Biscom. Eighty-eight percent take corporate presentations or strategy
documents, 31 percent take customer lists and 25 percent take intellectual
property. A
survey by Osterman Research also found one in five
ex-staffers uploads these sensitive and confidential files to an external cloud
service specifically for the purpose of sharing them with others.
The
former employees’ motivations range from simply wanting to keep a copy of their
work to wanting to use the data destructively, or to gain a competitive or
financial advantage. Earlier this year, for example,
Tesla
reported that an ex-employee stole gigabytes of data and shared some of it
with various news outlets, causing Tesla to suffer losses in business and
profits, as well as damage to its reputation.
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5 Telehealth Insights from CMS' Seema Verma
Telehealth is changing the face of healthcare, and Medicare must
adapt, said the CMS administrator.
Innovation
is vital to the evolution and sustainability of the American healthcare system,
and the Centers for Medicare & Medicaid Services (CMS) is working to be
part of the transformation, according to its administrator.
In
a
speech
on Thursday to the Alliance for Connected Care Telehealth Policy Forum for
Health Systems, CMS Administrator Seema Verma spoke about how "relentless
innovation is a crucial driver in creating value across all industries."
She addressed the role of telehealth in the future of healthcare and
reimbursement progress for 2019. In addition, she talked about how Medicare can
serve as a barrier to innovation, as well as what CMS is doing to help patients
control their healthcare data and resolve interoperability issues.
CMS
has been working to create a foundation of innovation, she said. "It's
part of our larger vision of moving to a system that is value based—that
rewards value over volume by bringing the best to patients. When we start
paying for value, we will foster innovation as providers look for ways to
compete for patients by providing the highest quality care at the lowest cost."
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Health Systems Work with Epic on Electronic Patient-Reported Outcomes for
Oncology
November 18,
2018
by David
Raths, Contributing Editor
With eSyM
app, patients will provide feedback to their cancer care team via the EHR
Six
U.S. healthcare systems are sharing a $9 million grant to research introducing
electronic patient-reported outcomes (ePROs) into the routine practice of
oncology providers to improve symptom management and to decrease hospitalizations.
The
National Cancer Institute, in association with the Beau Biden Cancer Moonshot
Initiative, recently announced the funding of the collaboration, the SIMPRO (Symptom
Management IMplementation of Patient Reported Outcomes
in Oncology) Research Center. The SIMPRO team will work with Epic, the EHR
system used by all six participating institutions, which are New
Hampshire-based Dartmouth-Hitchcock, Dana-Farber/Brigham and Women’s Cancer
Center in Boston, Baptist Memorial Medical Center in Memphis, Lifespan Cancer
Institute in Rhode Island, West Virginia University Cancer Institute, and Maine
Medical Center in Portland.
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Theft and disclosures account for most healthcare data breaches. But
hackers took 3 times as many records
Nov 19, 2018
2:19pm
Over
the last decade, healthcare organizations have been far more likely to report a
data breach due to theft or an unauthorized disclosure.
Hacking,
meanwhile, is much less common. But attackers make off with far more
patient records.
In
a new study
published
in JAMA Internal Medicine on Monday, researchers analyzed 1,138 healthcare
breaches reported to the Department of Health and Human Services between 2009
and 2017. Two-thirds of those incidents were the result of theft—typically
by an outsider or unknown party—or unauthorized disclosure, such as mailing
mistakes that inadvertently disclosed sensitive information.
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Why Toby Cosgrove thinks voice recognition is healthcare's next 'killer
app'
Nov 19, 2018
8:03am
In addition to new technologies like
artificial intelligence that are already gaining a foothold in healthcare,
former Cleveland Clinic CEO Toby Cosgrove, M.D., said he thinks the next big
technology in healthcare will be voice recognition.
“Voice recognition is the killer
app,” said Cosgrove, who was offering his perspective on the future of
healthcare delivery and innovation during the U.S. News & World
Report Healthcare of Tomorrow conference on Friday. Cosgrove, who now
advises Google on its healthcare initiatives, was offering his first-hand look at how
tech can transform the industry, even though Google itself is still settling on
the exact role it wants to play.
Of course, these voice recognition
tools are already being developed and improved by Silicon Valley’s biggest
names, including Google, Amazon and Apple, with tools such as Google Home,
Alexa and Siri. But their applications could offer the path to
simplifying the administrative burdens caused by electronic health
records, Cosgrove said.
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Telehealth is not just a rural healthcare issue, Verma says
Published
November 19 2018, 7:21am EST
The
Centers for Medicare and Medicaid Services is intent on removing restrictions
that prevent Medicare providers from leveraging telehealth services to improve
health outcomes for beneficiaries.
Speaking
at last week’s Alliance for Connected Care Telehealth Policy Forum for Health
Systems, CMS Administrator Seema Verma pointed out that Medicare’s rules and
governing statutes have often served as barriers to leveraging telemedicine.
However,
with enrollment in Medicare Advantage eclipsing 20 million people last year,
she said that the agency understands that it must embrace telehealth technology
to reduce healthcare costs by lowering readmissions rates, as well as
unnecessary hospital visits through better care coordination.
-----
Amazon takes first steps to expand PillPack online drug presence
Published
November 19 2018, 7:39am EST
Amazon
is slowly expanding efforts to build online retail pharmacy operations in a
growing number of states.
The
online retailer is finally making moves to expand PillPack, which it acquired
this past summer, according to analysts at Jefferies, an investment banking
firm.
Amazon
is beginning to seek licenses for PillPack to operate in more states beyond
those that PillPack had at the time of the acquisition, says Jefferies
analysts, who have been tracking Amazon’s efforts to gain additional licenses,
which states issue to enable pharmacy organizations to sell drugs within their
borders.
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AHA: Standards for capturing social risk factor data in EHRs need work
Published
November 19 2018, 7:28am EST
The
Department of Health and Human Services should support efforts to create
standards for capturing social risk data in electronic health records.
That
information is critical for providing effective care to patients, according to
the American Hospital Association. The national organization included the suggestion
in response to an HHS request for information on provider and health plan
approaches meant to improve care for Medicare beneficiaries with social risk
factors.
The
AHA contends that while social risk factors—such as access to food, and safe
and stable housing—can impede a person’s ability to maintain or return to a
state of health, collecting social risk factor information in the EHR and using
it to shape the care plan is a complex and dynamic process.
-----
ECRI practice guidelines to replace AHRQ clearinghouse
Published
November 19 2018, 5:10pm EST
The
ECRI Institute is looking to pick up the slack from the now-defunct National
Guideline Clearinghouse by continuing to offer providers evidence-based
clinical practice guidelines.
Funding
cuts to the Agency for Healthcare Research and Quality forced AHRQ to shutter
the National Guideline Clearinghouse in July.
While
ECRI developed and maintained the National Guideline Clearinghouse for 20
years, it has to start from scratch in order to fill the gap.
-----
HIT Think How does Google want to apply artificial intelligence in
healthcare?
Published
November 19 2018, 2:30pm EST
Recently,
DeepMind's leaders announced its healthcare team will be combined into Google
to help them become the "AI-powered assistant for nurses and doctors
everywhere."
Observers
say the move is part of a broader effort within Google to boost collaboration
and communication among health projects.
In
a statement, DeepMind leaders said the company has "made major advances in
health care in AI research," including advances related to "detecting
eye disease more quickly and accurately than experts; planning cancer
radiotherapy treatment in seconds rather than hours; and working to detect
patient deterioration from electronic records."
-----
Why Apple is on a slow death spiral
In
August 2018, Apple stock hit an all time high of US$233.47, today it is 20%
lower and it is unlikely to reach its August peak ever again. Why? In a
nutshell, Apple is no longer an innovator.
Whatever
one may think of Steve Jobs, there can no longer be any doubt that he was the
driving force behind the company he co-founded. Under Jobs’ two stints at
Apple, it introduced the Mac, Mac OS, Mac OS X, iPod, iTunes, iPad, Apple TV,
iPhone, iOS, Siri (acquired in 2010) and the App Store.
Between
1985 when Jobs was forced out of Apple and his return in 1995, Apple stopped
innovating and was on the verge of bankruptcy. Since the death of Jobs in 2011,
Apple has given us the Apple Watch, a product of limited appeal, and not much
else.
-----
Need to Train Nurse Practitioners About Telehealth? Use Robots
The RoboAPRN program gives APRN students experience in telehealth
and mental healthcare.
KEY TAKEAWAYS
·
Telehealth should be part of APRN education.
·
Robotics help give APRNs autonomy when providing
telehealth services.
·
Telehealth can help increase access to
behavioral health services.
As
telehealth becomes increasingly more common in healthcare, the need to train
providers in this technology and care delivery is also rising. So how can
nursing school educators train their APRN students about telehealth in an
effective way?
Use
robots.
-----
Enjoy!
David.
