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, February 23, 2019

Weekly Overseas Health IT Links – 23rd 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.
-----

Topol Review concludes NHS should ‘focus on building digital workforce’

The NHS must “focus on building a digital ready workforce”, a report by Dr Eric Topol has concluded.

Hanna Crouch 11 February, 2019
The California based cardiologist, geneticist, and digital medicine expert was commissioned by the Secretary of State for Health and Social Care and Health Education England in May 2018, to carry out an independent review into the digital training needs of NHS staff.
The Topol Review, published today, includes three principles to support the deployment of digital healthcare technologies across the NHS.
These are:
  1. Patients should be suitably informed about health technologies, with particular focus on vulnerable groups to ensure fair access
  2. The healthcare workforce needs knowledge and guidance to evaluate new technologies
  3. The adoption of technology should be used to give healthcare staff more time to care and interact directly with patients
-----

A tug of war over LHCREs is underway

When the Local Health and Care Record Exemplars LHCREs were created, the official line is that they would support local direct care and enable population health management and analytics at regional level. But, as Digital Health editor Jon Hoeksma reports, tensions are emerging on whether they should also provide a bridge to a federated Care.data-like national data resource.  
12 February, 2019
What is the core purpose of Local Health and Care Record Exemplars (LHCREs)? Are they to be designed to primarily support the direct delivery of care locally, together with regional population health management and analytics? Or are they a stepping stone to creating normalised data that can be linked together to create a valuable NHS national data asset and capability?
Officially, the line is that LHCREs should support both, starting with an emphasis on local direct care. But Digital Health News has learned NHS England is insisting the projects focus on providing normalised data for national use, potentially at the expense of the local care requirements. And tensions are arising as a result.
-----

Special Report: Cybersecurity

WannaCry put healthcare cyber security in the headlines and on local and national priority lists. But, two years later, have lastings changes truly been made? Or has the momentum been lost? Jennifer Trueland reports.
In the aftermath of WannaCry in May 2017, cyber security gained a higher profile than ever before in the NHS. The topic gained traction at board level in NHS organisations, and governments across the UK announced immediate action to support the NHS to protect itself in the event of a similar attack.
As we approach the second anniversary of WannaCry, however, questions remain over whether lessons of the attack have truly been heeded. In particular, is there a risk that after the initial flurry of initiatives, momentum around cyber security has been lost?
-----

Security ranks highest among provider IT concerns, HIMSS survey finds

Published February 15 2019, 12:33pm EST
Provider organizations see cybersecurity, privacy and security risks as among their top information technology challenges in 2019.
Other key IT imperatives include for the coming months include improving quality outcomes, clinical informatics and clinician engagement, culture of care and care coordination, and process improvement and change management, according to results of the 2019 HIMSS U.S. Leadership and Workforce Survey.
Survey results were based on feedback from 232 respondents working at healthcare provider organizations; another 37 respondents from health IT vendors responded to the survey, and HIMSS reported out results separately for each industry segment.
-----

China could use medical data to blackmail Americans, report says

Published February 15 2019, 2:36pm EST
More in Cyber attacks
Chinese investment in the U.S. biotechnology industry presents a risk to national security, potentially giving China’s government access to patient data.
That access has the potential to be used to blackmail Americans, according to a report for a Congressional advisory commission.
Biotech companies in China have access to technology and data through investments in U.S. companies, partnerships with American universities and recruitment of U.S.-trained researchers, the report for the U.S.-China Economic and Security Review Commission said.
-----

HIT Think Two ways blockchain could have a quick impact in healthcare

Published February 15 2019, 2:53pm EST
The promise of blockchain technology as a practical means of solving elusive healthcare data and transactional challenges has rapidly advanced. For example, a recent Deloitte global survey found that 55 percent of healthcare IT executives strongly believe blockchain will become a “disruptive force” in healthcare.
Nearly half (49 percent) of healthcare executives say they plan to develop or adopt blockchain solutions in their own organizations, according to a new PwC Health Research Institute survey. The key to the success of these blockchain solutions—and, in turn, wider adoption—will center around blockchain implementation, with vendors and healthcare participants partnering on proofs of concept and refining development tools and platforms.
If you are thinking about a blockchain solution for your organization, it’s good to know which solutions are poised to deliver the greatest return on investment. This article highlights two of the most promising uses of blockchain in decentralized healthcare—digital distributed transactional ledgers and smart contracts.
-----

The Promise of Electronic Health Records: Are We There Yet?

By Bob McNellis M.P.H., P.A.
The meeting took place nearly 15 years ago, but I still remember vividly the bold declaration by a former Congressional leader advocating for technological reforms in healthcare.
“Paper kills!” he warned. “Paper records are an utterly irrational national security risk.”
A few days earlier, the violent winds and rain of Hurricane Katrina had roared over the Gulf Coast. Flooding destroyed the health records of thousands of patients. Security concerns about paper-based records reached a fever pitch.
In some ways, it was a turning point. The anguishing loss of irreplaceable personal health care information turned what had been a murmur into a shout: No more delays -- it was time for widespread use of electronic health records (EHRs).
-----

Which Country has the Best Cybersecurity? It Isn’t the U.S.

By Frank Konkel,
Executive Editor
February 12, 2019

A study says the U.S. is above average when it comes to cybersecurity, but it’s not the best nation.

The United States ranks fifth among 60 nations in a study released last week comparing cybersecurity measures across numerous factors, including malware rates and cybersecurity-related legislation.
Japan, France, Canada and Denmark all scored higher than the U.S., according to a study by tech research firm Comparitech.com.  Ireland, Sweden, the United Kingdom, Netherlands and Singapore rounded out the top 10 nations for best cybersecurity.
The firm scored nations based on seven criteria, with a substantial portion of the scores based on the percentage of cybersecurity attacks each nation faced in 2018. Researchers said countries’ preparedness for cyberattacks were scored using data compiled in the Global Cybersecurity Index.
-----

Proposed rules from HHS open door to healthcare API economy

Published February 14 2019, 5:07pm EST
With the federal government’s call for adoption of standardized application programming interfaces, the industry could be poised to move towards a healthcare API economy.
An ecosystem of third party API-enabled apps, running on smartphones and other mobile devices, is envisioned by the Department of Health and Human Services as dramatically increasing consumer access to their electronic health records and other healthcare data.
 “Although the app universe now has over 2 million products, it is nevertheless very difficult to get your personal medical data on your phone—but this is about to change,” according to National Coordinator for Health IT Don Rucker, MD.
-----

DoD and VA still working out how to create single EHR

Published February 14 2019, 7:22am EST
The Departments of Defense and Veterans Affairs are still trying to figure out how to best align their agencies’ respective plans to create a common Cerner electronic health record system.
Speaking on Wednesday at the HIMSS19 conference in Orlando, DoD and VA program officials said coordinating their activities to ensure interoperable EHR systems is a work in progress, emphasizing that the agencies continue to discuss an optimal organizational design that will facilitate coordinated decision-making and oversight when it comes to governance.
Toward that end, the DoD and VA Interagency Program Office is working to establish joint EHR modernization governance bodies to foster coordination and improve communication between the departments.
-----

HIT Think Why soaring potential elevates the role of healthcare IT

Published February 14 2019, 5:07pm EST
Traversing the halls at HIMSS19 can leave attendees feeling overwhelmed, and the challenges facing the healthcare industry, and IT in particular, can be massive and vexing.
However, many of my conversations in Orlando this week can be characterized as being significantly optimistic. There’s no lack of positive vibes that the importance of the industry is on the upswing.
It’s easy to lose sight of the fact that the industry is dealing with problems that are nice to have, far different than the ones that drove people crazy 10 years ago.
What do I mean?
The problem of 10 years ago—why don’t healthcare organizations buy and use electronic health records?
Today’s problem—now we have all this data from electronic health records; what are we going to do with all of this stuff?
-----

Want to see your own eHealth record? Prepare to wait

Saskatchewan wants to expand online access to records, but no target date set

Jennifer Quesnel · CBC News · Posted: Feb 14, 2019 5:00 AM CT | Last Updated: February 14
Right now, just over 1,100 people across Saskatchewan who participated in a pilot project can look at their own health records online, set reminders to take medication, or see their most recent laboratory results.
The rest of the province is stuck waiting, for the time being.
"I think there's a fairly significant appetite [for online access to health records]," said Davin Church, the vice-president of programs and technology at the Saskatchewan Crown corporation eHealth.
-----

After interoperability: FHIR is the gateway for AI

Once the specification gains wider use for data exchange, it will open the doors for more advanced uses of data, including artificial intelligence and machine learning, IBM, Google and Microsoft executives said at HIMSS19. 
February 14, 2019 04:10 PM
ORLANDO — HL7’s FHIR (Fast Healthcare Interoperability Resources) is largely seen as an enabler of health data exchange, which of course it is, but executives at IBM, Google and Microsoft said it will also lay the foundation for artificial intelligence and machine learning.
“Interoperability is the cornerstone of our healthcare strategy — teaching cloud to speak the language of healthcare: HL7, FHIR, DICOM,” said Aashima Gupta, global head of healthcare and life sciences at Google Cloud, during a panel discussion here at HIMSS19 on Thursday.  
Google, in addition to IBM, Microsoft, Oracle and Salesforce, signed a pledge to remove interoperability barriers back in August 2018 during the Blue Button 2.0 hackathon at the White House. And while the companies have yet to provide specific details they said it will involve cloud computing, FHIR and open APIs.
-----

HIMSS Analytics Stage 7 hospitals more likely to report physician satisfaction with EMRs, survey finds

Jessica Kim Cohen –
Hospitals that earned Stage 7 on the HIMSS Analytics EMR Adoption Model are more likely to report physician satisfaction with the systems, according to a report from KLAS Research and HIMSS Analytics.
HIMSS Analytics, a subsidiary of the Healthcare Information and Management Systems Society, uses the EMR Adoption Model to determine the extent to which a hospital has adopted various EMR capabilities. The model runs from Stage 0 to Stage 7, with Stage 7 representing the highest designation.
To assess whether the eight-stage model is indicative of physicians' experiences with the software, KLAS Research and HIMSS Analytics analyzed whether hospitals that have strong EMR adoption — those at Stage 7 — are more likely to have physicians who report user satisfaction with the EMR.
-----

15 Million Patient Records Breached in 2018; Hacking, Phishing Surges

The new Protenus 2019 Breach Barometer found the number of breached patient records tripled from 2017, as healthcare data security challenges increased.

February 12, 2019 - Fifteen million patient records were breached during 503 healthcare data breaches in 2018, nearly triple the amount of reported incidents from the previous year, according to the Protenus 2019 Breach Barometer.
Protenus analyzed the breaches reported to the Department of Health and Human Services, media, or other sources. The researchers had data for 417 of the 503 breaches, which found the number of breaches slightly increased from the 477 reported in 2017.
What’s concerning is that in 2017, 5.6 million patient records were breached compared to the 15 million reported last year. There was also a steady increase in the number of impacted records from the 1.2 million reported in the first quarter, to the 6.3 million reported in fourth quarter.
-----

HIMSS19: ONC, CMS officials outline the framework for interoperability, the use of APIs, FHIR

Feb 13, 2019 8:30am
With the release of several proposed rules on Monday, the U.S. Department of Health and Human Services (HHS) outlined new provisions around advancing interoperability and giving patients easier access to their health data, signaling that open APIs and FHIR will be core components.
The Office of the National Coordinator for Health Information Technology finally unveiled its information blocking rule (PDF), which was sent to the Office of Management and Budget for review in September. The Centers for Medicare & Medicaid Services also released a proposed rule (PDF) on Monday morning, which also takes aim at data blocking. The agency is suggesting that Medicaid, the Children’s Health Insurance Program (CHIP), Medicare Advantage plans, and Qualified Health Plans (QHPs) be required to make enrollee data immediately accessible by 2020.
With the proposed rules—which are separate but connected—ONC and CMS officials have outlined their approach to information blocking, the role of application programming interfaces (APIs) in interoperability and the use of FHIR (Health Level Seven’s Fast Healthcare Interoperability Resources) standards.
-----

How can healthcare improve care for high-need, high-risk patients? Just ask them

Feb 12, 2019 12:53pm
There’s even an acronym for them: HNHC, which stands for those high-need, high-cost patients who it’s estimated make up only 5% of U.S. patients but account for about 50% of healthcare spending.
And while lots of studies have focused on how to manage these patients, researchers at Weill Cornell Medicine in New York City decided to take a different approach. They asked the patients themselves how doctors and healthcare systems can best meet their needs and, in the process, cut costs.
The results were published in NEJM Catalyst and offered five solutions for reducing the high healthcare use among this group of patients.
-----

OIG identifies risks related to NIH’s sharing of sensitive data

Published February 13 2019, 5:00pm EST
The National Institutes of Health does not have adequate controls in place when it comes to permitting and monitoring access to the agency’s sensitive data.
That’s the finding of an audit by the Department of Health and Human Services’ Office of Inspector General.
According to OIG, NIH is the largest public funder of biomedical research agency in the world. However, auditors have identified risks related to the sharing of the agency’s sensitive data.
-----

HIT Think Why ‘the year of the API’ will pose big challenges for providers

Published February 13 2019, 4:46pm EST
Every year, there’s some theme that emerges from the HIMSS annual conference, some technology that gets the lion’s share of the buzz and attention.
Many times, it’s the magic panacea that will just solve everything. It’s the technology that’s ascending on the Gartner hype cycle receiving all the…well, hype.
Last year, it was blockchain technology. The year before, it was artificial intelligence. It’s the magic hammer that will solve every problem—at least all those problems that look like nails. And those annual buzzwords often can involve expensive investment in new technology for providers. Jumping on the hype train usually means having to make a big outlay and take a big risk.
-----

IBM Watson Health’s chief health officer talks healthcare challenges and AI

In a wide-ranging HIMSS19 week conversation with Healthcare IT News, Dr. Kyu Rhee discusses artificial intelligence, value-based care, healthcare quality, and how client health system Health Quest is dealing with PCMH, MIPS, CPC+ and HEDIS efforts.
February 13, 2019 12:34 PM
IBM Watson Health is at the forefront of artificial intelligence in healthcare. The company is tackling a wide array of challenges in the industry, and is working with major provider organizations to do so.
For HIMSS19 week, Healthcare IT News conducted an exclusive interview with Dr. Kyu Rhee, vice president and chief health officer at IBM Watson Health, to discuss the state of health IT and what lies ahead. Dr. Rhee offers frank and in-depth answers that give healthcare CIOs and other executives plenty to think about.
Q: What are the biggest challenges facing healthcare provider organizations today?
A: Healthcare providers are living through an unprecedented era of disruption that has upended the status quo for both administrators and clinicians.
-----

AI in healthcare: Big ethical questions still need answers

Experts from Microsoft, AMA and Cleveland Clinic weigh the serious considerations that must be addressed as AI and machine learning increasingly embed themselves in clinical and consumer applications.
February 13, 2019 11:10 AM
ORLANDO – Seemingly overnight, artificial intelligence has found its way into every corner of healthcare, from patient-facing chatbots to imaging interpretation to advanced analytics applications.
With that sea change comes a host of ethical questions about how, where and to what extent AI and machine learning apps should be deployed. Most of them are still unanswered.
At HIMSS19 on Tuesday, a panel of healthcare and technology experts assessed this new landscape, taking stock of the big opportunities that AI can enable – while also exploring some of the "bright lines that we don't want to cross," as Microsoft Associate General Counsel Hemant Pathak put it.
-----

Epic CEO Judy Faulkner on Apple, docs who actually like their EHRs and Warren Buffett

The EHR vendor’s founder also discusses the state of interoperability, cloud computing and today’s sticking points in health IT.
February 13, 2019
Epic CEO Judy Faulkner has been to many, many HIMSS conferences. So many, she says, that she's lost track. As the company she founded in 1979 turns 40 this year, Faulkner sat down with Healthcare IT News at HIMSS19 for a conversation about interoperability, usability, patient engagement, her own plans for the future and much more.
Q. So, a certain cable TV financial guru suggested recently that Apple should buy your company – which he just seemed to think was a no brainer. What did you think of that?
A. (Laughs.) Well, first of all I had no idea who he is. I've never watched that show. But secondly it was like, "This is really weird!" Thirdly, it was just a shrug: "We're not going to do that." And it was just very gratifying that not a single health system contacted us about it and said they were worried. They all said they laughed.
-----

5 Tech Tools That Could Change the Way Your Hospital Delivers Care

By Mandy Roth  |   February 12, 2019

HealthLeaders examines five healthcare technologies that are useful to patients, while simultaneously creating value for healthcare organizations.


KEY TAKEAWAYS

·         Video highlights of patient encounters improve HCAHPS scores.
·         Wearable monitor may one day predict when a patient is becoming ill.
·         App enhances communication from OR, improving HCAHPS scores.
·         COPD app helps patients self-manage their disease.
·         Mobile device reduces falls at Ochsner by 51%.
This article appears in the January/February 2019 edition of HealthLeaders magazine. We invite you to also read a digital expert's commentary on these tech tools and the trends driving their development.
Sometimes the shortest distance between a patient and an improved outcome is technology. As innovations make their way from novelty solutions to mainstream usage backed by clinical evidence, devices, apps, and gadgets are helping bridge the gap to better healthcare.
-----

Beyond wellness for the healthy: digital health consumer adoption 2018

Results from our fourth national consumer survey (2018 data) on digital health adoption

13 Feb 2019
Description
A publicly accessible report from the 2018 Digital Health Consumer Adoption survey, conducted by Rock Health. The survey consists of 4,000 respondents of US adults aged 18 and over.
2018 findings are compared to previous surveys in 2015, 2016, 2017.
Findings reported here include:
  • increasing use of digital health tools
  • decreasing willingness to share health data with providers and insurers
  • increased use of wearable devices to monitor health conditions
  • high levels of discontinuing to use wearable devices such as fitness trackers
  • increased uptake of telemedicine such as email, text, picture or live video telemedicine
  • low levels of trust in technology companies such as Facebook
-----

HHS Proposes Making EHRs More Portable

Also releases proposed rule on information-blocking

WASHINGTON -- Patients would have access to their electronic health records free of charge and would be able to transfer them more easily from one provider to another under rules proposed Monday by the Department of Health and Human Services (HHS).
"These proposed rules strive to bring the nation's healthcare system one step closer to a point where patients and clinicians have the access they need to all of a patient's health information, helping them in making better choices about care and treatment," HHS Secretary Alex Azar said in a statement. "By outlining specific requirements about electronic health information, we will be able to help patients, their caregivers, and providers securely access and share health information. These steps forward for health IT are essential to building a healthcare system that pays for value rather than procedures, especially through empowering patients as consumers."
-----

Proposed ONC rule requires FHIR interoperability standard

Published February 12 2019, 5:44pm EST
If the Office of the National Coordinator for Health IT has its way, HL7’s Fast Healthcare Interoperability Resources will be the standard to which developers must certify their application programming interfaces.
In ONC’s proposed rule, released on Monday, the agency for the first time has said that it intends to make FHIR a requirement.
Congress required developers participating in the ONC Health IT Certification Program to publish APIs allowing healthcare data to be accessed, exchanged and used “without special effort” as a provision of the 21st Century Cures Act.
-----

HIT Think Why patience for data exchange has run out for healthcare

Published February 12 2019, 5:51pm EST
Patience only can last so long. The big takeaway from yesterday’s rollout of proposed federal rules is that pretty much everyone has gotten tired of waiting for the healthcare industry to get its data exchange act together.
For years now, patients and their families waited. Consumers waited. The federal government waited. Insurers waited. And even providers and vendors waited. There’s been limited success with making interoperability ubiquitous and seamless.
The fact is, moving healthcare information around is still hard work, and for reasons that go beyond the technical.
-----

Top health IT challenges right now? Interoperability, modernization

Health systems are set to focus on declining reimbursements and patient experience, a new study found.
February 12, 2019 09:54 PM
Health system executives agree data sharing between providers, payers and government and industry can have the greatest impact on improving patient experiences, according to an SAP report.
The survey of 100 healthcare CEOs, CFOs and CIOs, conducted by Porter Research on behalf of SAP, indicated health systems this year will focus on addressing cost pressures and improving the patient experience.
WHY IT MATTERS
When asked what the top challenges were to their organizations, healthcare executives listed declining reimbursements and the patient experience as the top two challenges, followed by maintaining and upgrading IT and cybersecurity.
-----

Email fraud attacks up by nearly 500%, report says

PHI puts healthcare organizations at more risk than others, security vendor Proofpoint found in new research.
February 12, 2019 09:45 PM
Healthcare email fraud attack attempts increased by 473 percent over the past two years, according to a report from cybersecurity specialist Proofpoint
WHY IT MATTERS
These highly personalized email attacks try to fool workers and patients to unknowingly surrender their credentials or financial info.
The study found 95 percent of healthcare organizations were targeted by an attack using their own trusted domain, and found wire transfer fraud to be the industry’s most common form of email fraud.
-----

Replace patient letters with emails, health secretary Matt Hancock tells GPs

Chris Smyth, Health Editor
February 13 2019, 12:01am, The Times
The NHS must stop sending letters to patients and use email like everyone else, the health secretary will insist.
Matt Hancock says that email must be the default way of communicating for the health service by 2021, telling doctors that confidentiality concerns are no excuse for sticking with so-called snail mail. Half a million letters were lost in the post in five years and switching over could save lives, he says.
Doctors welcomed the plans but expressed scepticism about shifting wholesale to email within two years. Patient leaders said that vulnerable people who do not use computers must not be left behind.
-----

Doctors snooped into Humboldt Broncos patient records, privacy commissioner finds

'This has been a major tragedy in our province and I’m disappointed that people got tempted,' information and privacy commissioner Ronald Kruzeniski said
Published on: February 12, 2019 | Last Updated: February 12, 2019 2:16 PM EST
REGINA — Saskatchewan’s privacy commissioner has found several people inappropriately gained access to the electronic health records of the Humboldt Broncos team members involved in a deadly bus crash last April.
Sixteen people were killed and 13 were injured in the crash between the junior hockey team’s bus and a semi trailer at a rural Saskatchewan intersection on April 6, 2018.
“This has been a major tragedy in our province and I’m disappointed that people got tempted,” information and privacy commissioner Ronald Kruzeniski said in an interview with The Canadian Press on Monday. “Now that it’s happened … it’s my job to work with others through education and legislative change (to) make the system work.”
-----

This is how AI bias really happens—and why it’s so hard to fix

Bias can creep in at many stages of the deep-learning process, and the standard practices in computer science aren’t designed to detect it.

Over the past few months, we’ve documented how the vast majority of AI’s applications today are based on the category of algorithms known as deep learning, and how deep-learning algorithms find patterns in data. We’ve also covered how these technologies affect people’s lives: how they can perpetuate injustice in hiring, retail, and security and may already be doing so in the criminal legal system.
But it’s not enough just to know that this bias exists. If we want to be able to fix it, we need to understand the mechanics of how it arises in the first place.
-----

Precision medicine: huge promise, high hurdles

At the HIMSS19 Precision Medicine Summit, John Halamka and other healthcare leaders described how policy, technology, clinical processes and patient engagement need to evolve to make it a reality for primary care.
February 11, 2019 02:04 PM
Dr. John Halamka, CIO of Beth Israel Deaconess Medical Center, traveled 400,000 miles in 2018 – jetting all over the world, from China to India to Scotland to Scandinavia.
On those journeys, he's seen how care is delivered in very different ways. In China, for instance (he's been there 35 times), there is no primary care. As a result, patients can self-select any provider, leading to a scattered lifetime record across diverse provider sites.
In India, where active tuberculosis is widespread, access to care is much more difficult, and treatments are often mismatched to illness.
"This is not precision medicine," said Halamka, speaking Monday at the HIMSS19 Precision Medicine Summit.
-----

At HIMSS19, Cerner unveils AI tool to fight physician burnout

Cerner debuts Chart Assist, a new AI-enabled workflow, to join a suite of systems designed to reduce physician burnout, enhance the clinician’s experience and increase productivity.
February 11, 2019 11:40 AM
Cerner today has debuted at HIMSS19 Chart Assist, a new AI-enabled workflow, to join a suite of systems designed to reduce physician burnout, enhance the clinician’s experience and increase productivity.
Cerner’s suite of AI-enabled systems goes beyond traditional processing and focuses on user efficiency to identify gaps and inconsistencies within the patient record, the vendor explained.
These advancements will help providers address patient care and validate diagnoses, ultimately helping to reduce the physician workload, while supporting the financial strength of the health system, the vendor contended.
-----

HIMSS19: ONC unveils long-awaited information blocking rule

Feb 11, 2019 9:35am
As a major conference on health IT gets underway, the Department of Health and Human Services on Monday morning released a hotly anticipated rule aimed at boosting interoperability.
The Office of the National Coordinator for Health Information Technology finally unveiled its information blocking rule (PDF), which was sent to the Office of Management and Budget for review in September.
The rule defines exceptions to data blocking, and fines that may be associated with the practice, and was mandated by the 21st Century Cures Act.
-----

MedStar Health, AMA launch campaign to improve EHR usability, safety

Feb 11, 2019 9:13am
It's been a decade since Congress passed the landmark Health Information Technology for Economic and Clinical Health (HITECH) Act, along with a $40 billion investment in encouraging health IT implementation.
But while adoption of EHRs has come a long way, usability remains stubbornly suboptimal, and that's contributing to clinician burnout and is causing patient harm, health IT leaders say,
“We are at a stage now where there is overwhelming evidence that shows the association between the usability of EHRs and patient safety,” said Raj Ratwani, Ph.D., an EHR safety researcher and director of the MedStar Health National Center for Human Factors in Healthcare, in an interview with FierceHealthcare.
-----

AHA Says Telehealth Expansion Can Help Struggling Rural Hospitals

A new report from the American Hospital Association calls on the federal government to expand opportunities for telehealth and telemedicine to help keep America's struggling rural hospitals in operation.

February 06, 2019 - The American Hospital Association is calling on the federal government to boost telehealth and telemedicine opportunities – including better reimbursement, financial support for new technology and improved access to broadband – for the nation’s struggling rural hospitals.
“Rural hospitals are not just access points for care, they are cornerstones of care for the communities they serve,” AHA President and CEO Rick Pollack said in a press release. “In spite of their unique challenges, providing access to quality care where and when their patients need it will always be the goal of rural hospitals.”
-----

'I hate being a data-entry specialist': 400 physicians on the effects of burnout, EHRs

Alyssa Rege - Print  | Email
Eighty-four percent of physicians said quality time with patients may be a thing of the past, according to a recent survey by Geneia, a healthcare data analytics firm.
The organization conducted a survey of 400 physicians across the nation in January 2015, and conducted a follow up study in July 2018.
Five findings from the follow up survey:
1. The majority of respondents (89 percent) said the "business and regulation of healthcare" has changed the practice of medicine for the worse.
2. Eighty percent of physicians said they are personally at risk for burnout at some point in their career.
-----

New voices at patients’ bedsides: Amazon, Google, Microsoft, and Apple

February 6, 2019
At first it was a novelty: Hospitals began using voice assistants to allow patients to order lunch, check medication regimens, and get on-demand medical advice at home.
But these devices, manufactured by Amazon, Google, Apple, Microsoft and others, are now making deeper inroads into patient care. Hospitals are exploring new uses in intensive care units and surgical recovery rooms, and contemplating a future in which Alexa, or another voice avatar, becomes a virtual member of the medical team — monitoring doctor-patient interactions, suggesting treatment approaches, or even alerting caregivers to voice changes that could be an early warning of a health emergency.
“Why not have a connected speaker in the room listening to conversations?” asked John Brownstein, chief innovation officer at Boston Children’s Hospital, which is piloting dozens of voice applications. Voice technology still remains at the edges of patient care, he added, but the hospital is already using it to improve the efficiency of ICU care and help prepare doctors for transplant surgeries.
-----

Once an insider’s domain, health IT conference embraces consumer tech giants

February 8, 2019
Health care’s digital transformation will take center stage in Orlando, Fla., next week at the industry’s most influential technology conference, a gathering whose exponential growth is a metaphor for the change sweeping through one of America’s biggest economic sectors.
Once a meeting of a few thousand health technology insiders, the annual conference of the Healthcare Information Management Systems Society (HIMSS) now attracts more than 40,000 attendees and some of the world’s biggest companies.
It is a place where the ambitions of Amazon, Google, Microsoft, and other tech giants converge — and sometimes clash — before an audience of doctors, politicians, and hospital executives. As opposed to years past, when the embrace of digital health was more tentative, those audience members are now enthusiastically encouraging the tech companies’ incursions into hospital operations and clinical care.
-----

VA reports 19% increase in video telehealth visits

Published February 11 2019, 3:40am EST
The Department of Veterans Affairs, which already has the country’s largest telemedicine program, conducted more than 1 million video telehealth encounters last year.
The milestone—reached in fiscal year 2018—represents a 19 percent increase in video telehealth visits over the previous year, according to the VA.
Of the 2.3 million episodes of telehealth care conducted from October 2017 through September 2018, about half—1,074,400—were video telehealth encounters, which enable real-time interaction between VA care teams and veterans in a clinic or at home.
-----

Microsoft launches Azure API for FHIR to share data in cloud

Published February 11 2019, 4:39pm EST
The software giant is continuing its support for HL7’s Fast Healthcare Interoperability Resources standard with the release of a new tool to help health systems interoperate and share data in the cloud.
Microsoft’s Azure API for FHIR offers healthcare data exchange backed by a managed Platform-as-a-Service (PaaS) offering and is intended for customers developing solutions that integrate healthcare data from one or more systems of record, according to the vendor.
 “We are thrilled to release this,” said Heather Jordan Cartwright, general manager of Microsoft Healthcare, who notes that the Azure API is the first in a series of tools that are “specifically designed for the management, ingestion, and enrichment” of data in native FHIR resources.
-----

CMS, ONC proposed rules press industry to improve interoperability

Published February 11 2019, 12:19pm EST
The Department of Health and Human Services on Monday released proposed rules to improve the interoperability of electronic healthcare records.
The proposed rules issued by the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT come on the eve of the HIMSS19 conference in Orlando, the largest industry gathering of HIT stakeholders, which kicks off on Tuesday.
In an unprecedented move, CMS is proposing requirements that Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans and Qualified Health Plans in the Federally-facilitated Exchanges must provide enrollees with immediate electronic access to medical claims and other health information electronically by 2020.
-----

Apple will let military veterans access their health records on the iPhone

The long-rumored deal is the latest major collaboration between Apple and a health care system

By Angela Chen@chengela
Military veterans treated by the US Department of Veterans Affairs will soon be able to access their medical records on the iPhone Health Records app, Apple announced today. It’s the latest major collaboration between Apple and a health care system, and a sign of the company’s growing interest in the world of electronic health records.
Electronic health records are a famously contentious sector of the health care system. For many patients, the tangled evolution of e-health technology has led to a fragmented paper trail filled with gaps, which makes it hard to bring their own health information from one network to another and can slow down their treatment. The new collaboration would allow the 9 million veterans served by the VA, which is the largest medical system in the country, to see their aggregated medical records — including conditions, vaccinations, lab tests, medical procedures, and diagnoses — in one place.
-----

Trump administration unveils order to prioritize and promote AI

By Staff Writer on Feb 12, 2019 7:00AM

More resources and investment into research, promotion and training.

US President Donald Trump on Monday will sign an executive order asking federal government agencies to dedicate more resources and investment into research, promotion and training on artificial intelligence (AI), a senior administration official said.
Under the American AI Initiative, the administration will direct agencies to prioritize AI investments in research and development, increase access to federal data and models for that research and prepare workers to adapt to the era of AI.
There was no specific funding announced for the initiative, the administration official said on a conference call, adding that it called for better reporting and tracking of spending on AI-related research and development.
-----
Enjoy!
David.

Friday, February 22, 2019

My Heavens The Queensland Saga Seems To Just Roll On And On!

Lucy Stone has continued the Queensland E-Health Saga this week.
First there was this:

Electronic medical record costing Queensland hospitals millions

By Lucy Stone
February 11, 2019 — 10.20pm
Queensland’s public hospitals are dealing with multimillion-dollar blowouts to install an integrated electronic medical record that clinicians say is flawed and putting patients at risk.
Many Hospital and Health Services are floundering under the booming cost of the health department’s integrated electronic medical record (ieMR) project, while patients at some public hospitals have been affected by increased elective surgery wait times.
The state's Hospital and Health Services are statutory bodies running several hospitals and community health centres within each region, receiving state, federal and their own funding.
A Queensland Health spokesman said many hospitals had spent more than originally predicted as a result of "increased scope, the emergence of new technology, and features requested by clinicians".
The ieMR, the core of Queensland Health’s Digital Hospital project, uploads all patient data to a centralised medical record that is accessible by all doctors and clinicians, across any hospital in the state.
A Brisbane Times investigation, however, has found serious concerns about privacy and patient safety with the Cerner software being installed by eHealth Queensland, the department responsible for the project.
There are documented examples of patient data being entered into the wrong record, wrong blood labelling on test tubes, cervical cancer tests going missing and medications going missing, and alerts issued to clinicians warning of immediate risks to patient safety when using the software.
Queensland Health says the ieMR has reduced average length of stay, unplanned readmissions and the number of serious falls and pressure injuries. Hospitals that install the ieMR have experienced a reduction in medication errors.
Cerner has been repeatedly contacted for comment and while acknowledging emails, has not provided a response.

The letter

In July 2017 senior clinicians at a Queensland hospital wrote to former eHealth Queensland chief executive Richard Ashby to express their concerns about the rollout of the software at their hospital.
Dr Ashby resigned late last month after Queensland Health director-general Michael Walsh referred allegations of an undeclared personal relationship with an eHealth Queensland staff member to the Crime and Corruption Commission.
In December Dr Ashby was stripped of oversight of the ieMR project after an Auditor-General report found the program was at “critical risk” of collapse if another $256 million was not approved by cabinet.
In the letter, clinicians outlined in detail their concerns about having Cerner’s integrated electronic medical record software for operating theatre management, called SurgiNet, installed in the hospital.
SurgiNet allows clinicians and staff to manage patient information before and after surgery, including covering anaesthesia, medications and patient discharge.
“Our objections relate to the introduction of electronic systems, which are so inferior in functionality that they are not only a danger to patients, but also interfere with the workflow of clinicians trying to treat patients,” the letter began.
“As you are aware, large numbers of critical issues affecting SurgiNet were identified after the rollout. Fixes are currently being pursued but are proving to be difficult and costly.”
In a letter obtained by Brisbane Times, dated September 2017, then-health minister Cameron Dick wrote to the clinicians about their concerns.
Mr Dick wrote that Dr Ashby, Mr Walsh and other senior staff in Queensland Health had spoken with the clinicians and the hospital executive board “to discuss the way forward”.
He wrote that Hospital and Health Services would not roll out the integrated electronic medical record unless there was a “high level” of clinical support for the process.
“However it will be made clear that any HHS choosing to retain any legacy systems rather than replacing them with the respective Digital Hospital system may do so; however will need to make local arrangements for the maintenance of the legacy system and also risk-manage the duplication and safety issues that may arise from non-integration,” Mr Dick wrote.
Mr Dick concluded his letter saying said he “looked forward to the constructive partnership” of clinicians in “progressing the Digital Health agenda”.
A Queensland Health spokesman said hospitals with the ieMR installed often continued operating the "legacy systems", which are assessed by Queensland Health's clinical governance for patient safety risks.
"Where a decision is made to continue using such a system (or systems), they will continue to be fully supported," the spokesman said.
"Hospital and Health Services are independent statutory bodies, have their own budgets and have always paid, and continue to pay, support costs for their own legacy systems.
"This would have been the case whether ieMR was being implemented or not."
Lots more here including detailed costs:
Then came this just to ramp up the pressure:

'We cannot remain silent': Queensland clinicians' fears on electronic medical record

By Lucy Stone
February 13, 2019 — 9.48pm
Clinicians at Queensland's public hospitals say they “cannot remain silent” in the face of patient safety risks related to Queensland Health’s integrated electronic medical record project.
Their fears have been detailed in letters written by hospital staff, and by peak health bodies writing on their behalf, to Queensland Health’s director-general Michael Walsh, to the Health Minister, and to eHealth Queensland’s former chief executive Richard Ashby.
Patient safety risk examples given by some clinicians in their correspondence included difficulties administering medications and medications going missing in the software.
Health Minister Steven Miles said Queensland Health consulted "in depth" with all hospital clinicians before, during and after the rollout of the integrated electronic medical record at hospitals.
"There have been no reports of patient harm linked to the implementation of the ieMR, indeed the [Queensland Auditor-General] has found the system is improving patient outcomes," Mr Miles said.
"However, all systems, including paper-based systems, have risks and Queensland Health works with clinicians to identify and address these risks."
In one incident, eight clinicians spent half an hour trying to decipher a medication dose prescribed through the integrated electronic medical record (ieMR) system to determine whether a patient had received the correct dosage.
Clinicians also highlighted the “inordinate amount of time to complete simple prescribing tasks” and ward rounds taking many hours longer each day because of the software.
Dr Ashby resigned late last month for “personal reasons” after Mr Walsh referred allegations of an undeclared personal relationship with a Queensland Health staffer to the Crime and Corruption Commission.
The CCC has been investigating eHealth Queensland, the department responsible for the ieMR, for months.
The ieMR is designed to connect all the state’s public hospitals, allowing all clinicians to access any patient’s medical record from any hospital.
Clinicians have expressed strong support for installing an electronic medical record at hospitals, believing it will improve patient care and lower the burden on the health system, but have raised concerns the ieMR is not being rolled out safely.
One letter from clinicians said while they were supportive of electronic health systems, they protested the rollout of “inferior” systems that risked patient health.
Mr Miles said issues or suggestions on the ieMR rollout were dealt with as they occurred.
"No hospital or health service would even attempt a transformative project of the scale and importance of digital hospital without the backing of the majority of clinicians and other stakeholders," he said.
Brisbane Times investigation has revealed serious safety concerns with the ieMR, including an independent 2014 report that warned of potentially “catastrophic” consequences on a par with the 2011 payroll debacle if the software was rolled out.
Queensland Health requested that report be modified to remove the warnings. The independent consultant who wrote the report refused.
Mr Miles had earlier questioned why the LNP did not heed the report commissioned during the Campbell Newman LNP government and said Labor had made changes to address some of the report's concerns.
In one letter, a clinician wrote that the ieMR’s prescribing system “was prone to mistakes especially in a rapidly evolving situation of a critically sick patient”.
The ieMR software was purchased “off-the-shelf” from US medical technology giant Cerner in 2011 and is modified to suit each hospital as it is rolled out.
"The Director-General himself personally meets with clinicians twice ahead of any digital hospital rollout to understand they are happy with the training they have received, and asks them whether they believe the system can go live safely and effectively," Mr Miles said.
"If the clinicians don't believe this is the case, the rollout does not proceed."
Cerner has been contacted for comment by Brisbane Times and has not provided a response to questions.
More here:
and lastly this:

Premier called upon to halt electronic medical record project

By Lucy Stone
February 14, 2019 — 5.28pm
The Queensland premier has been questioned in State Parliament on whether she will halt the rollout of Queensland Health’s integrated electronic medical record.
It follows relevations about the state’s public health clinicians detailing serious concerns with the project’s fast-tracked rollout and the consequences for hospitals including patient safety risks.
Dr Richard Ashby, the chief executive officer of eHealth Queensland and responsible for the rollout until late December, resigned two weeks ago for “personal reasons” after Queensland Health director-general Michael Walsh referred allegations of an undeclared personal relationship to the Crime and Corruption Commission.
Health Minister Steven Miles immediately ordered the halt of a second major eHealth Queensland digital project, the $200 million patient administration system replacement.
In Question Time on Thursday, opposition health spokeswoman Ros Bates asked the premier Annastasia Palaszczuk about the status of the integrated electronic medical record (ieMR).
“The Auditor-General has exposed that Queensland Health's ieMR project is $256 million over budget,” Ms Bates said.
“The CEO of eHealth Queensland has resigned under corruption allegations and medical staff say that the project puts patient safety at risk.
“Will the Premier finally order a halt to the rollout of this project until all of these issues are resolved?”
A Brisbane Times investigation has shown a series of errors caused by the ieMR, including blood tests labelled with the wrong patient data, personal information going into the wrong patient record, data going missing and clinicians struggling to use the unintuitive and poorly-designed software.
More here:
I suspect, strongly, this is becoming a political beat up by a few powerful doctors who are determined to get their way and will stop at nothing to get it.
I would love some feedback from the ground as to why systems that seem to work fine in NSW are so risky and dangerous in Qld?
Comments please
David.