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."

Sunday, February 10, 2019

AusHealthIT Poll Number 461 – Results – 10th February, 2019.

Here are the results of the poll.

There Is A Major Crisis In Queensland eHealth At Present With The CEO Having Suddenly Resigned. Do You Think The Root Cause Of The Problems Are Mostly:

Technical 2% (2)

Managerial / Cultural 52% (64)

Corruption Related 28% (35)

Inappropriate Relationship Related 10% (13)

Something Else (Please Comment) 2% (2)

I Have No Idea 6% (8)

Total votes: 124

What an interesting poll. Most seem to think that the root cause of the issues is managerial / cultural with a dollop of corruption alongside..

Any insights on the poll welcome as a comment, as usual.

A more than reasonable turnout of votes!

It must have been a pretty hard question as 8/124 readers were not sure what the appropriate answer was.

Again, many, many thanks to all those that voted!

David.

Saturday, February 09, 2019

Weekly Overseas Health IT Links – 9th February, 2019.

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.
-----

Patient portal helps predict medication discontinuation

Published February 01 2019, 7:19am EST
Researchers say electronic communication between patients and providers via an online portal can indicate their potential for stopping therapy.
A team of researchers at Vanderbilt University Medical Center analyzed messages sent over a 12-year period by more than 1,100 breast cancer patients prescribed hormone therapy at VUMC. The source of the de-identified electronic health record data for their study was the online patient portal My Health at Vanderbilt.
The study—published in the Journal of the American Medical Informatics Association—examined patients’ patterns of messaging with providers, the topics they communicated, and the extent to which this messaging indicated whether a patient will discontinue a prescribed five-year regimen of therapy.
-----

HIT Think Why intelligent EHRs are the next big step in radiology

Published February 01 2019, 4:23pm EST
In November 1895, Wilhelm Röntgen, a German mechanical engineer, professor and physicist, produced an X-ray image of his wife’s hand. It was the first time in history that anyone had detected electromagnetic radiation in a wavelength range.
His pioneering work earned him the first Nobel Prize for Physics in 1901 and opened up the world of medical imaging modalities, including CT and MRI machines. Over time, imaging has become clearer, radiation exposure decreased and our ability to collect CT and MRI data skyrocketed.
Although we have made incredible strides in imaging capabilities in the past 123 years, our capability to generate actionable information from the report has changed very little since Röntgen first conducted his experiment.
-----

Vendors can do more to make EPRs work for clinicians

The frequently-made promise about electronic patient records (EPRs) is that they will cut the amount of time that clinicians spend making notes – so bolstering the time that can be spent on patient care. But, argues Dmitry Garbar, more needs to be done if this promise is to be fully kept.
DHI Admin – 28 January, 2018
In 2016, the Annals of Internal Medicine published a study comparing the amount of time physicians spent entering data onto an electronic patient record (EPR) to the amount of time they spent on direct patient care. The conclusion? For every hour a clinician spends with patients, nearly two are spent on EPR and desk work.
Could this balance be redressed? Could EPRs be improved in such a way to make them quicker and easier to use? Certainly research suggests that poorly designed EPRs can fail to prevent – or even actually lead to – patient harm.
-----

New York HIEs merge to double down on data sharing

HealthlinkNY and HealtheConnections will leverage best practices and team skills of both health information exchanges to improve care delivery, officials said.
February 01, 2019 09:05 AM

Two New York health information exchanges, HealthlinkNY and HealtheConnections, announced plans to merge. The deal follows a September announcement the two made, to accelerate their mutual goal to deliver improved resources to their regions.
WHY IT MATTERS
Combined, the new HIE will increase usage and adoption of health information exchange across New York, said Staci Romeo, executive director of HealthlinkNY.
Romeo noted that the two organizations are the only New York State HIEs that support the Department of Health’s Population Health Improvement agenda through regional collaborative efforts, and the merger will strengthen this.
THE LARGER TREND
Though some have doubted their viability, state and regional HIEs have said not to count them out just yet. Even as EHR vendor-driven networks gain maturity and scope, older and more traditional health information exchanges still have a lot of critical value to bring to the table, said John Kansky, president and CEO of Indiana Health Information Exchange, one of the HIEs that is still standing and self-sufficient.
-----

More e-health can be life-changing for families and society

February 1, 2019 - 06:00

The growth of e-health solutions is not just changing relationships between patients and healthcare workers, but also family and gender structures. More light must be shed on the societal consequences, say social scientists.

What is the impact of the growth of e-health services and technologies? Today, a growing number of patients are followed up on by national health services digitally, with digital tools that they can carry on them or have placed in their living rooms. 
But what consequences has this had for our society? Five social scientists associated with the Norwegian Centre for E-health Research have investigated that question.
They have worked on the subject for three years and recently published their findings in a research article in Social Science and Medicine.
-----

Tool Does Not Help Care Decisions in Prolonged Life Support

Nicola M. Parry, DVM
January 29, 2019
Using a Web-based decision aid did not help surrogate decision makers and clinicians agree on treatment goals for patients receiving prolonged life support, a study published online January 28 in Annals of Internal Medicine shows.
"A personalized decision aid that is grounded in theory, targets surrogate decision makers of patients with prolonged mechanical ventilation, and feeds results back to ICU [intensive care unit] clinicians before a family meeting did not increase prognostic concordance; change decisions about goals of treatment; or improve outcomes of relevance to patients, family members, and clinicians," write Christopher E. Cox, MD, Duke University, Durham, North Carolina, and colleagues.
Because patients receiving prolonged mechanical ventilation typically lack the ability to make their own medical decisions, family members frequently need to act as surrogate decision makers in the care of these patients.
-----

A ransomware attack could cost US economy $89B, researchers warn

Julie Spitzer - Print  | Email
A global ransomware attack could cost the U.S. economy up to $89 billion, according to a new report from the Cyber Risk Management project.
Globally, a massive cyberattack could cost up to $193 billion.
U.S. losses likely would be attributed to a combination of reduced productivity and consumption, IT clean-up fees, ransom payments, and supply chain disruption, according to the report. Researchers also found that, globally, healthcare and retail would be the most affected industrie.
-----

Security remains a top concern for healthcare IT professionals

Published January 31 2019, 7:46am EST
There’s near unanimity among healthcare IT professionals—security is at, or near, the top of their lists of concerns.
Perhaps it would seem that there are more complex challenges for these executives. But hardly any issues are as pervasive or as insomnia inducing.
As healthcare organizations have now widely adopted electronic information systems, that has increased the risks for protecting sensitive patient data. Hackers have learned to monetize their attacks by encrypting data and asking for ransoms. As organizations use more medical devices controlled over networks, they find they are more susceptible to hacking, perhaps endangering patients’ lives.
-----

Data analysis seeks to better understand opioid epidemic

Published January 31 2019, 7:16am EST
The Regenstrief Institute is joining with hc1.com, a cloud-based precision health vendor, to analyze data to uncover the factors that lead to substance use disorder, overdoses and drug-related deaths.
Under phase two of Indiana University’s Responding to the Addictions Crisis Grand Challenge, funding has been awarded to researchers to examine the trajectory of victims of the opioid epidemic.
“By making individual, group and population trajectories within the opioid epidemic understandable and explicit, our project enables insights into the various pathways that the Addictions Crisis Grand Challenges Initiative can affect,” says project leader Titus Schleyer, a Regenstrief research scientist and professor of medicine at the Indiana University School of Medicine.
-----

Better data access helps to cut ER visits at Portland Clinic

Published January 31 2019, 5:49pm EST
Portland (Ore.) Clinic is contracting with an outside vendor to help it collect, organize and dissiminate patient information to providers and other appropriate users.
The clinic is making the move to identify patients who frequently use emergency department services. To get the information it needs, it’s contracted with Collective Medical, a vendor that offers a platform to collect essential patient information.
Health insurers are looking for value-based care that keeps patients healthier, and when they contract with providers, they are demanding better quality of care and outcomes. But providers want something for themselves—quality data that helps them make sure they know what’s going on with their patients, says Jill Leake, population health manager at the Portland Clinic.
-----

HIT Think Four trends that may steal the show at HIMSS19

Published January 31 2019, 5:38pm EST
In less that two weeks, 45,000 health IT professionals, clinicians, executives and “technology superheroes” (a HIMSS’ term, not ours, but one we’re going to run with) will descend on Orlando for the annual HIMSS conference.
Viewed as the pinnacle for new product launches in digital health, the exhibition floor at HIMSS also offers a glimpse of the future and a reflection of the state of healthcare IT today.
As the HIMSS organizers galvanize attendees with their call “champions of health unite,” we channel our inner healthcare IT superhero to give you our take on the top trends we expect to see taking center stage at the show.
Analytics: Age of Ultron
As analysts, we try to tread carefully when touting the buzzwords vendors love to include in their press releases. Big data, blockchain and AI will undoubtedly be used across the consortium of vendors at HIMSS, as was the case last year. While many announced the use of AI algorithms to support their population health management tools, particularly in relation to analytics, there has been little evidence of wide-scale installations, let alone a significant impact on overall business.
-----

Epic takes Best in KLAS awards once again

The EHR vendor wins best Overall Software Suite and in other other categories, while Impact Advisors and Premier score top marks for Overall IT Services and Management Consulting firms, respectively.
January 31, 2019 04:34 PM
For the ninth year in a row, Epic earned the top score for Overall Software Suite in the annual Best in KLAS 2019 Software & Services report.
The Verona, Wisconsin-based health IT giant also scored top marks in the Overall Physician Practice Vendor category, and was best-rated in nine segments, while also winning category leader awards in two others.
In other major categories, Impact Advisors was named the top Overall IT Services Firm. It also won top marks for HIT Enterprise Implementation Leadership and was also the winner in the Clinical Optimization cate. Premier, meanwhile, earned the award of top Overall Healthcare Management Consulting Firm.
-----

8 Digital Health Predictions from HIMSS Forecast

By Mandy Roth  |   January 31, 2019

The report examines how consumer pressure is changing the industry and which trends will gain the greatest traction in the year ahead.

2019 will be a pivotal year for innovation, according to predictions in a report from HIMSS, 2019 Healthcare Trends Forecast: The Beginning of a Consumer-Driven Reformation, along with a need for digital health innovators to demonstrate more tangible results.
The document features input from leaders at HIMSS and its affiliated innovation arms, Healthbox, Health 2.0, and PCHAlliance. The forecast aims to provide perspectives that will lead to better clinical and financial outcomes.
-----

AMIA Calls for Strictly Clinical Documentation in Patient EHRs

The association is calling on HHS to separate billing, regulatory, and administrative compliance from clinical documentation in EHR design.

January 29, 2019 - The American Medical Informatics Association (AMIA) has offered a solution to regulatory and administrative burden — separate the clinical from the financial in EHR documentation.
In response to an ONC draft strategy for reducing EHR- and health IT-related regulatory and administrative burden, the association emphasized the need for EHR clinical documentation to support patient-centered care rather than remain a tool for satisfying requirements not tied to outcomes.
“Given the adoption trajectory and the ongoing evolution in the design of EHRs, we recommend this final HHS-wide Strategy be oriented towards a long-term goal of decoupling clinical documentation from billing, regulatory, and administrative compliance requirements,” wrote AMIA President & CEO Doug Fridsma, MD, PhD.
-----

Healthcare Leaders See 4 Digital Technologies As Game Changers in 2019

Healthcare leaders believe four digital technologies — artificial intelligence, big data analytics, mobile health, and wearables — will be game changers this year, according to Frost & Sullivan.

January 29, 2019 - Healthcare leaders believe four digital technologies — artificial intelligence, big data analytics, mobile health (mHealth), and wearables — will be game changers this year, according to Frost & Sullivan.
The market research firm predicts that the market for healthcare IT applications using artificial intelligence will reach $1.7 billion by the end of 2019, growing at a robust 68.5 percent of compound annual growth rate (CAGR) through 2022.
“AI-powered IT tools that manage payers’ and providers’ business risks in clinical, operational, financial, and regulatory settings will especially find high uptake,” said Frost & Sullivan Transformational Health Industry Analyst Kamaljit Behera.
-----

FDA plans to fully tap real-world data and evidence

Published January 30 2019, 7:30am EST
The Food and Drug Administration plans to exploit claims, clinical and patient-generated data—information not captured through traditional clinical trials—for post-marketing safety surveillance.
“New streams of real-world data gathered from electronic health records, lab tests, wearable devices, insurance claims and even social media can provide important evidence on product safety and effectiveness in settings or populations that may be very different than the information gleaned from registration trials that are used for FDA approval of medical products,” said Commissioner Scott Gottlieb, MD, during a keynote presentation on Monday at the Bipartisan Policy Center in Washington.
“Digital technologies, from our perspective, are one of those promising tools we have for making healthcare more efficient and more patient-focused,” Gottlieb added, while emphasizing that “this isn’t an indictment of randomized controlled clinical trials—far from it—it’s a recognition that new approaches and new technologies can help expand the sources of evidence that we use to make more reliable treatment decisions.”
-----

Study shows growing concern over effectiveness of cyber defense

Published January 30 2019, 5:14pm EST
A sizable gap exists between confidence in cybersecurity programs and their effectiveness, according to a recent study by data management software provider Syncsort.
The company surveyed more than 300 IT and security professionals and found that while 85 percent are either very or somewhat confident in their organization’s security program, 41 percent said their company had experienced a security breach, and 20 percent more were unsure.
-----

AMIA, other groups join call to ease EHR burdens

As the Office of the National Coordinator for Health IT comments period drew to a close, a number of organizations weighed in about how to improve electronic health records platforms.
January 29, 2019 04:14 PM
Comments closed Jan. 28 on the Office of the National Coordinator for Health IT's draft recommendation to make electronic health records more user friendly with support over the recommendations and a host of cautions that included going slow with changes and creating panels to help oversee them.
The comments come a day after Pew Charitable Trusts urged ONC to focus on patient safety in EHRs, pediatric systemss in particular. 
ONC and the Centers for Medicare an Medicaid Services incorporated stakeholder feedback into a draft strategy they released Nov. 28, that included proposals to reducing the time and effort it takes for physicians to enter data into an EHR; reducing the effort and time it takes to meet regulatory reporting requirements, and; helping to improve the overall ease of using EHRs.
-----

HIMSS makes 4 healthcare predictions for 2019

Digital health applications, consumerism, demographic challenges and data governance will be key imperatives in the year ahead, the study shows.
January 30, 2019 04:10 PM
HIMSS today published "2019 Healthcare Trends Forecast: The Beginning of a Consumer-Driven Reformation," a report that features commentary and analysis from leaders across HIMSS, Healthbox, Health 2.0 and PCHAlliance – each of whom have a birds-eye view of industry trends and the levers of change.
By issuing this new annual forecast, HIMSS aims to equip industry leaders – clinicians, solution providers, payers, academics and policymakers alike – with insight and perspectives to inform better clinical and financial outcomes for all.
Four key trends
The report is organized around four key trends: digital health implications and applications, consumer impact, financial and demographic challenges and issues around data governance and policy.
-----

Pew Suggests Boosting EHR Usability, API Use to Cut Clinician Burden

Pew Charitable Trusts urged ONC to improve EHR usability and promote API use to curb regulatory burden on clinicians.

January 28, 2019 - Improving EHR usability and promoting efficient application programming interface (API) use may help to cut down on regulatory burden on clinicians, according to Pew Charitable Trusts.
The organization submitted these recommendations to ONC in response to the federal agency’s draft strategy designed to reduce administrative burden related to EHR use.
The draft, called Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health it and EHRs, is a joint effort between ONC and CMS designed to fulfill the aims of the 21st Century Cures Act.
-----

Digital health looms for the industry, but is it ready?

Published January 29 2019, 7:34am EST
Digital health may be a lot like beauty. It may be in the eye of the beholder, which makes it difficult to describe, but easy to recognize when you see it.
In its essence, digital health aims to use a blend of technologies and new approaches to get care to patients in convenient, cost-effective ways.
For providers used to providing care in traditional ways, digital health carries the prospect of being disruptive. Increasingly, providers see many examples of disruptive digital technology emerging around them, and they know they many of the care delivery approaches they’ve known from the past will be rapidly redefined.
However, many also know they are way behind the curve and will need to catch up.
-----

CVS offers Apple Watch to help customers manage health

Published January 29 2019, 5:50pm EST
CVS Health has a new deal for its customers: active participation in its new health program might help them earn an Apple Watch.
Under a new program that enables CVS to keep track of their activity, send them notices about refilling prescriptions and remind them to stay healthy, participants might be able to learn credits toward an Apple watch.
The partnership with Apple is a part of the drugstore, pharmacy-benefits and insurance conglomerate’s effort to keep a closer eye on its customers, managing their health while making sure they keep using CVS’s services. For Apple, it’s a way to add new functions and customers for the popular wristwatch as the tech company touts its potential as a wellness tool.
-----

HIT Think Why many cybersecurity programs fall short on protection

Published January 29 2019, 5:47pm EST
Healthcare leaders representing high-scoring 2018 Most Wired recipient organizations and supporting CHIME Foundation firms joined CHIME President and CEO Russell Branzell in an executive roundtable discussion about key findings in a report based on the Most Wired survey results. Only 29 percent of survey respondents reported having a comprehensive security program in place, something Branzell described in his role as moderator as “a serious surprise.”
Several roundtable participants shared their thoughts on why this could be. They also offered strategies to grow a cybersecurity-savvy talent pool. The responses have been edited for brevity.
Ken Bradbury, senior vice president and chief technology officer at The HCI Group, said he was not surprised by the result and noted that there is a varying degree maturity for security programs across the industry: “Cybersecurity within healthcare is a high priority but I don’t think there is a clear understanding of all of the prerequisites of achieving security compliance and having a strong security program. That means you need a stable infrastructure; you need governance and leadership that are aligned with the executive team but also with IT. Your CISO (chief information security officer) needs to be really integrated into the organization – not just a pillar but integrated into IT so it becomes a cultural compliance.”
-----

Proposed National eHealth System and Services Act approved by house panel in the Philippines

The landmark measure provides for an organised and structured application of electronic health or "eHealth" integrated in the regular workflow of healthcare facilities.
January 28, 2019 10:30 PM
Last week, the House Committee on Health in the Philippines House of Representatives chaired by Rep. Angelina Tan approved a substitute bill seeking to establish the National eHealth Systems and Services that shall deliver health services through cost-effective and secure information and communications technology (ICT).
WHY IT MATTERS
The landmark measure provides for an organised and structured application of electronic health or "eHealth" integrated in the regular workflow of healthcare facilities.
Specifically, it seeks to utilise ICT to deliver health services which has the potential to be profitable, improve quality, change the conditions of practice, and improve access to healthcare, especially in rural and other medically underserved areas.
-----

New eHealth Digital Service Infrastructure allows first EU citizens to use ePrescriptions across borders and more EU news briefs

January 29, 2019 10:22 AM
New initiative sees EU citizens use ePrescriptions in other EU country. Finnish patients can now get their medicines from pharmacies in Estonia prescribed electronically by their doctors back in Finland through the new eHealth Digital Service Infrastructure, the European Commission announced last week. This applies to pharmacies in Estonia participating in the initiative and all Finnish ePrescriptions.
“People should be able to use their e-prescriptions across borders. Free movement is a founding principle of the EU: we must make it as easy as possible for people to get treatment or medicines when abroad in the EU,” said Andrus Ansip, Digital Single Market vice president. "The next major step will be to simplify patient access to their very own health data, by developing a common format for exchanging electronic health records between EU countries."
-----

Breaking Down Barriers Between Clinical Trials and Clinical Care: Incorporating Real World Evidence into Regulatory Decision Making

Remarks by Scott Gottlieb, M.D. as prepared for the Bipartisan Policy Center conference
January 28, 2018
Good afternoon. 
Digital technologies are one of the most promising tools we have for making health care more efficient and more patient-focused. 
New streams of real world data (RWD) gathered from electronic health records (EHRs), lab tests, wearable devices, insurance claims, and even social media can provide important evidence on product safety and effectiveness in settings or populations that may be very different than the information gleaned from registration trials used for approval. 
This isn’t an indictment of the randomized controlled trial. 
Far from it.
-----

Are Your AI Solutions Secure? 5 Considerations + 10 Questions

By Mandy Roth  |   January 29, 2019

With the growing popularity of AI solutions, health systems need to dig deeper to manage security risk.

When evaluating artificial intelligence (AI) solutions for a health system, cybersecurity may not be one of the first considerations. Perhaps it should be. In an age of increasing security threats, data management by outside parties opens the door to additional risk.
How can health system executives ensure that their AI and machine learning endeavors protect patient data, meet HIPAA compliance, and minimize security threats?  
HealthLeaders spoke to representatives at Clearwater and Digital Reasoning about this issue. The two Nashville-based companies announced a three-year cyber risk partnership today, which fortifies Digital Reasoning's artificial intelligence- (AI) powered solutions with Clearwater's cybersecurity and HIPAA compliance program.
-----

Opinion: Blood pressure measuring smartwatch is a paradigm shift for hypertension management

Brigham and Women's Hospital Resident Dr. Daniel Yazdi outlines the benefits for doctors, patients and digital health disease management programs.
January 23, 2019
Watch-ing your blood pressure, pun intended, is about to have a new meaning. Early 2019 marks the release of the first FDA-approved smartwatch blood pressure cuff. Why is this big news? Hypertension affects about 75 million Americans, one out of three adults. It is the leading cause of cardiovascular disease (heart attacks and strokes), resulting in about 1,000 deaths per day. Only 50 percent of patients have their blood pressure adequately managed, demanding a better solution.
The watch, HeartGuide, will be released by Omron. It measures blood pressure by inflating the wrist band; a mechanism similar to that of a traditional cuff. Apple also submittedpatent in June 2018 for a similar device, so we may see similar features in the next iteration of the Apple Watch.
To appreciate the benefit of a device like this, we need to understand the current limitations of hypertension management: 1) infrequent measurements 2) inherent data variability 3) white coat hypertension 4) non-compliance 5) poor patient-provider follow-up. A smartwatch blood pressure monitor will solve each of these.
-----

More clinical evidence needed to accelerate adoption of AI-enabled decision support: report

Jan 28, 2019 12:30pm
Artificial intelligence-enabled clinical decision support (CDS) has the potential to equip clinicians with the actionable information they need to enhance overall health and improve outcomes. However, regulatory issues, improved product labeling and patient privacy concerns need to be addressed before AI is safely and widely adopted.
In a recent report (PDF), a working group at the Duke-Margolis Center for Health Policy examined the potential benefits and challenges when AI is incorporated into CDS software, particularly software that supports improved clinical diagnosis, as well as barriers that may be preventing development and adoption of this software.
Improved CDS could be useful in reducing diagnostic errors, the Duke-Margolis team noted, as diagnostic errors account for almost 60% of all medical errors and an estimated 40,000 to 80,000 deaths each year, according to the National Academies of Sciences, which also estimates that “nearly every American will experience a diagnostic error in their lifetime, sometimes with devastating consequences.”
-----

Moving beyond medical errors: How EHRs are 'nudging' practices to change certain behaviors

Jan 28, 2019 6:00am
Electronic health records (EHRs) are usually cited for their ability to help diagnose diseases and reduce medical errors. But several health systems are testing how EHRs can be used to target other factors, like patient comfort and drug shortages.
Since EHRs are frequently used to guide patient care, adjusting the output of those systems can have considerable impact on patients—beyond just their immediate health condition.
Consider the University of Chicago Medical Center, which has been experimenting with a study module called SIESTA (Sleep for Inpatients: Empowering Staff to Act) to help patients in hospitals sleep better. The study is aimed at reducing nighttime awakenings for inpatients so they don't experience in-hospital sleep deprivation.
-----

EHRs continue to improve in diabetes care

January 27, 2019
Since their introduction, electronic health records have been shown to enhance disease management and quality of care for adults with diabetes, according to findings published in the Journal of Diabetes Science and Technology. However, improvements can still be made.
“Diabetes is not a static condition. It must be monitored and medications modified in accordance with changes,” Stephanie E. Lessing, MS, of the department of public policy and public affairs at the University of Massachusetts Boston, told Endocrine Today. “Since complex body systems are involved in diabetes progression, patients with diabetes benefit from reminder features that are available in EHR systems. These reminder tools increase the likelihood of providers executing often-neglected but simple practices like foot checks, for example. These small reminders can make a big difference in preventing adverse outcomes and keeping comprehensive records.”
To assess the effectiveness of EHRs and identify opportunities for their improvement, Lessing and colleagues conducted a systematic literature review of 14 studies published from March 2003 to November 2017. All studies were based on randomized or controlled trials or systematic reviews focused on EHR outcomes. Participants in the studies were aged at least 18 years and had a diabetes diagnosis or a prescription for diabetes medication within the previous year. Study outcomes included HbA1c, blood pressure and LDL cholesterol levels.
-----

Insiders caused more than half of healthcare breaches in 2018: 4 notes

Written by Julie Spitzer | January 25, 2019 | Print  | Email
Healthcare is the only industry where data breaches perpetrated by insiders outnumbered those that originated from external sources last year, according to Verizon's "2018 Data Breach Investigations Report."
Verizon analyzed more than 53,000 cybersecurity incidents that occurred in 2018, including 2,216 confirmed data breaches, across nine industries: accommodation, education, financial, healthcare, information, manufacturing, professional, public and retail.
Four of the report's healthcare findings:
1. In 2018, the healthcare industry experienced 536 confirmed data breaches stemming from 750 incidents. This represents the greatest number of confirmed data breaches compared with the other eight industries.
-----

Artificial pancreas smartphone app proves safe, effective

Published January 28 2019, 7:18am EST
A pilot FDA-approved clinical trial has demonstrated the safety and efficacy of the interoperable Artificial Pancreas System, a new smartphone-based application platform.
The iAPS app, which runs on an unlocked smartphone, is able to interface wirelessly with leading continuous glucose monitors, insulin pump devices and decision-making algorithms, according to researchers who presented results of the study in the journal Diabetes Technology & Therapeutics (DTT).
The system was “safe and effective in regulating glucose levels under challenging conditions and is suitable for use in unconstrained environments,” concludes the study, which notes that artificial pancreas systems “close the loop” between a continuous glucose monitor and an insulin pump with an algorithm that adjusts insulin dose to control blood glucose in patients with type 1 diabetes.
-----

HIT Think Why healthcare analytics will deliver more results in 2019

Published January 28 2019, 5:35pm EST
We find ourselves on the cusp of some very interesting dynamics in 2019 from a healthcare technology and innovation perspective.
Advances in artificial intelligence (AI) including machine learning, natural language processing (NLP) and robotics have shown incredible promise in terms of automating repetitive manual tasks as well as improving decision making. Leaders in the healthcare industry—as well as technology vendors—are witnessing this first hand and are planning to integrate AI with next generation analytics platforms to empower executives, clinicians and analysts with unprecedented actionable insights from the board room to the point of care.
Here are some key trends enabled by AI that are empowering stakeholders across the healthcare continuum, from policy makers and executives, to physicians and patients.
AI and analytics integrated with electronic health records (EHRs) will enable superior care delivery and personalized care at a lower cost.
Thanks to the meaningful use stipulations of the Affordable Care Act (ACA), a majority of the healthcare systems in North America have made significant investments in electronic health records. These deployments have often been multi-year initiatives often running over time and over cost, not unlike ERP deployments in other industries. While EHRs have helped hospitals create a central repository of their clinical and financial data, extracting accurate, reliable, and actionable analytics for right time decision-making is a daunting challenge.
-----

Ageing IT systems leave thousands waiting for smear test result

Chris Smyth
February 1 2019, 12:01am, The Times
More than 150,000 women have been left waiting for the results of cervical cancer checks after a backlog in a creaking NHS screening system, the spending watchdog has found.
At one point last year only one in three women got their smear test results within the recommended 14 days, the National Audit Office found.
NHS screening more widely is struggling with dozens of outdated computer systems, leaving people in some parts of the country missing out on checks, according to a report published today.
-----

State and regional HIEs: 'Don't count us out just yet!'

Even as EHR vendor-driven networks gain maturity and scope, older and more traditional health information exchanges still have a lot of critical value to bring to the table, one expert says.
January 28, 2019 09:51 AM
"If you go looking for the people that have the last mile wired and/or have the data available – and in some cases have it in normalized, curated repositories, ready to be exchanged – it's the HIEs," says John Kansky.
Once upon a time, not too long ago, state and regional health information exchanges were really where it was at when it came to interoperability in the U.S. Earlier this decade, the betting was on those HIEs across the country to help build the infrastructure and use cases for nationwide data exchange.
That's why programs such as ONC's State HIE Cooperative Agreement Program disbursed $548 million to 56 awardees in 2010 to help them "develop and advance resources" for interoperability and, eventually, become self-sustainable. As we all know, many of them did just that – but many of them did not.
-----

Weekly News Recap

  • A New York Times report describes how hospitals use “wealth screening” analytics to target affluent inpatients to receive donation pitches
  • Rhode Island’s health department charges four ED doctors with medical misconduct after they voluntarily report imaging errors caused by EHR ordering setup
  • The US uninsured rate rises to a four-year high of nearly 14 percent
  • Nextech acquires SRS Health
  • Researchers note that Medicare patient readmissions within 30 days dropped sharply after CMS started penalizing hospitals financially, but the death rate appears to have increased during the same period
  • Health:Furthur cancels its annual Nashville health festivals after two years
  • Alphabet’s Verily announces that its Study Watch has earned FDA clearance as a medical device for performing on-demand EKGs
  • The VA issues an RFI for a software testing contractor, with 80 percent of the job focusing on Cerner
  • Researchers at Northwestern University develop a wireless, battery-free soft skin patch that analyzes sweat for PH and levels of chloride, glucose, and lactate
-----

Over 150 NHS staff accused of snooping on patients’ records

Andrew Gregory, Health Editor
January 27 2019, 12:01am, The Sunday Times
More than 150 NHS staff have been investigated in the past 16 months for reading patient records without an obvious reason.
In August 2017 Britain’s privacy watchdog threatened “serious consequences” for those found prying into confidential health data without a valid cause, and the Information Commissioner’s Office (ICO) promised prosecutions.
The ICO has since investigated 155 staff for allegedly snooping on medical records. Only seven were prosecuted, according to data released under freedom of information laws. Three escaped with cautions.
-----
Enjoy!
David.

Has Any One Else Noticed It Is Almost Six Months Since The ADHA Board Published A Few Board Notes?

They really seem like they would prefer not to release anything at all!

Last lot were released August 22-23, 2018 and we got very few useful papers then.

They are really a secretive travesty for a Federal Government Agency.

David.

Friday, February 08, 2019

This Total Delete Function In The #myHealthRecord May Just Have A Few Interesting Consequences.

As announced by the Health Minister and reported widely the myHR can now totally lose, never to be recovered, a patient’s record.

New Permanent Delete Function for The My Health Record

01 Feb 2019


Australians can choose to have or cancel a My Health Record at any point in their life, according to new laws that came into place towards the end of January.
The laws aim to strengthen the privacy and security protections within My Health Record. A function has been activated in the My Health Record system that allows a person to permanently delete their record at any time, including any backups.
All records that have previously been cancelled will also be permanently deleted from the system.
If a person changes their mind, they can choose to register for a record to enjoy the benefits of controlling their health information securely in one place to support their health and care.
My Health Record is an online summary of a person’s key health information. It allows them to share and control their health information with doctors, hospitals and other healthcare providers, from anywhere at any time.
Key facts and figures distributed by the Federal Health Department include:
  • 6.45 million Australians currently have a My Health Record;
  • Since July 2018, almost half a million Australians have decided not to wait for a My Health Record to be created for them, and have chosen to have a record created for them;
  • 82 per cent of general practices are now connected to My Health Record;
  • 84 per cent of community pharmacies are now connected to My Health Record. The increase in pharmacy connections has tripled in the past six months;
  • 75 per cent of public hospitals are now connected to My Health Record.
New laws passed by Parliament last year strengthen the legislation prohibiting insurers and employers to access or use My Health Record information, or to ask a person to disclose the information, for insurance or employment purposes under any circumstance.
The new laws also legislate the Australian Digital Health Agency’s existing policy around disclosure to law enforcement agencies – law enforcement agencies cannot access a person’s My Health Record without a warrant or court order.
“Having a My Health Record places the control of a person’s healthcare directly into their hands,” said Professor Meredith Makeham, Chief Medical Advisor for the Australian Digital Health Agency.
"After 31 January 2019, a My Health Record will be created for everyone who has not opted out of the system.
“However, January 31 is not a cut-off date for Australians to continue to have a choice about using My Health Record to manage their health and care.
“The new permanent delete functionality means Australians will always have the choice not to have a record and they can remove all of their data from the My Health Record system. At any time in their lives, they can delete their record — and no copy will be kept.”


Published: 01 Feb 2019
Here is the link:
The issue for me is highlighted in the following. Say a patient in their personal health note section records some clinically useful information which is later used by their doctor to guide an important decision – having discussed the (apparent facts) with the patient.
The GP records the source of the information and acts as seems sensible.
Some year later the patient deletes the record – with the only copy of the patient entered data. A year after that the patient decides they are unhappy with what was done – as it did not work out as they hoped and sue.
The original note is gone forever, and the GP now has only a brief summary of what they claim was the reason for their treatment.
How it plays out from there is anyone’s guess. With other data there are copies in the systems that originally sourced the data but not with the patient notes. It might work out in unexpected ways don’t you think?
David.