-----
RSA 2019: Burnout is coming to your cybersecurity team soon
It's time to reevaluate your information security unit's status and stability.
March 07, 2019 02:03 PM
SAN FRANCISCO —Burnout. For healthcare pros, the term conjures frustrated clinicians, nurses and doctors foremost, followed perhaps by administrators, IT and others. Now add security professionals to that mix.
"This talent pool has a lot resting on their shoulders. Society is increasingly relying on us for public safety," said Josh Corman, Chief Security Officer of PTC. "We've got burnout."
Corman spoke here at RSA 2019 during a keynote with
Christina Maslach, a professor of psychology at University of California Berkeley and creator of the Maslach Burnout Inventory.
-----
Implementation best practices: Launching clinical decision support
Three experts offer comprehensive advice and tips for healthcare CIOs starting a clinical decision support journey.
March 07, 2019 01:39 PM
Healthcare CIOs and their IT staff members can be left to their own devices when it comes to installing certain types of systems, but not clinical decision support systems.
Implementation of CDS demands great rigor and teamwork with clinicians and others within the provider organization. And it requires integration with other types of systems, usually including the all-important electronic health record.
Here, three experts in clinical decision support technology offer their implementation best practices for these systems, giving healthcare CIOs some tips to help them achieve success with decision support technology.
Determine the burden
Kody Hansen, a research director at KLAS, often hears from chief medical information officers that they do not adequately address implementation burden with their vendor partners up front.
-----
CMS Seeks to Improve Interoperability With Public Policy Changes
CMS Administrator Seema Verma outlined the federal agency’s plans to push interoperability forward at an FAH public policy conference.
“With interoperability and the seamless flow of data, we can change the way health care in this country operates,” said Verma. “Patients can have access to their health information to understand and engage in their health care to make the best and most informed decisions possible.”
“Providers can provide high-quality, coordinated care for their patients without repeating tests and ensuring safety and quality, resulting in better care and improved outcomes,” Verma added.
Improving interoperability could also lead to significant breakthroughs in research, with researchers gaining access to de-identified EHR patient data.
-----
Pilot shows app improves blood pressure control
Published March 07 2019, 7:32am EST
Using a smartphone app, patients with diabetes and uncontrolled hypertension were able to significantly reduce their blood pressure within six weeks.
That’s the finding of a pilot study funded by vendor Livongo, the maker of the app that remotely monitors blood pressure, provides recommendations on healthy choices and connects users with a health coach.
The study’s results, which will be presented later this month at the American College of Cardiology’s Annual Scientific Session in New Orleans, show that participants’ systolic blood pressure declined by an average of 5.4 mm Hg and diastolic pressure declined by 3.5 mm Hg on average.
-----
HIT Think How to assess the winners and losers with disruptive technology
Published March 07 2019, 5:20pm EST
With wearables, artificial intelligence and machine learning all influencing the healthcare market, how do health plans decide what’s needed to thrive in today’s value-based market?
According to worldwide technology thought leader Enrique Dans, author of Everything Will Change: Technology and Evolution: Adapt or Disappear, and professor of Innovation at IE University’s Business School, in Madrid—the bottom line shouldn’t be the motivating factor.
According to Dans, to take just savings into account, when deciding how to proceed with this new technology, is extremely shortsighted. “Lower costs could be a consequence, but should never be the trigger for adoption,” he says.
-----
Will robots replace doctors?
Vinod Khosla, a legendary Silicon Valley investor, argues that robots will replace doctors by 2035. And there is some evidence that he may be right.
A
2017 study out of the Massachusetts General Hospital and MIT showed that an artificial intelligence (AI) system was equal or better than radiologists at reading mammograms for high risk cancer lesions needing surgery. A year earlier, and
reported by the Journal of the American Medical Association, Google showed that computers are similar to ophthalmologists at examining retinal images of diabetics. And recently, computer-controlled robots performed intestinal surgery successfully on a pig. While the robot took longer than a human, its sutures were much better—more precise and uniform with fewer chances for breakage, leakage, and infection. Tech boosters believe that AI will lead to more evidence-based care, more personalized care, and fewer errors.
Of course, improving diagnostic and therapeutic outcomes are laudable goals. But AI is only as good as the humans programming it and the system in which it operates. If we are not careful, AI could not make health care better, but instead unintentionally exacerbate many of the worst aspects of our current health care system.
-----
EHRA Urges CMS, ONC to Extend Interoperability Rule Comment Period
The EHR association maintained stakeholders need 30 more days to review the substantive interoperability rules from ONC and CMS.
March 05, 2019 - The EHR Association (EHRA) recently issued letters to ONC and CMS requesting a 30-day extension of the comment period for the federal agencies’ proposed rules on interoperability and information blocking.
In
a letter to National Coordinator for Health Information Technology Don Rucker, the association emphasized that ONC’s proposed rule suggests complicated, significant adjustments to regulations governing the health IT industry. As a result, EHRA requested the comment period be extended to June 3, 2019.
“If additional time is allowed, it would enable EHR developers to survey EHR Association members in order to provide ONC with actual development timelines for the measures being proposed,” wrote EHRA.
-----
Enterprises lax about mobile security as more threats loom
Verizon's Mobile Security Index for 2019 has more than a few findings enterprises should be worried about.
Companies of all sizes are scrimping on mobile security, failing to use mobile device management, antivirus and anti-malware and practically inviting attacks, according to Verizon's Mobile Security Index report.
The report, based on 700 respondents from companies of all sizes, has a host of conflicting data points, but the common theme is that mobile security is lax. IBM MaaS360, MobileIron, Wandera and Lookout provided data and research for the report.
"The mobile security risk has grown in the last year or so," said Matt Montgomery, associate director at Verizon Enterprise Solutions. "As we have moved closer to the mobile device the same level of
security you'd see with a laptop hasn't followed."
-----
CMS taps physician-informaticist Mark Roche as first CHIO
Mar 6, 2019 12:18pm
The Centers for Medicare & Medicaid Services (CMS) has appointed Mark Roche, M.D., as its first chief healthcare informatics officer to lead the agency's clinical, technical and interoperability strategy.
Roche, a former Northwestern University adjunct professor and a former physician adviser to the Office of the National Coordinator for Health IT (ONC), will be responsible for helping formulate and implement the clinical and technical aspects of CMS’ interoperability strategy and MyHealthEData initiative, according to CMS Administrator Seema Verma in an email to CMS staff.
Politico first reported Roche's appointment last Thursday, citing his LinkedIn page.
-----
FDA Commissioner Scott Gottlieb to step down
At the Food and Drug Administration, the physician and venture investor promoted policies focused on innovating approaches to population health, opioids, chronic disease, AI and precision medicine.
March 05, 2019 04:19 PM
Food and Drug Commissioner Dr. Scott Gottlieb announced his resignation from the FDA on Tuesday. He said he would step down from the agency in about a month.
Despite the concerns of some that his close ties with the pharmaceutical industry offered the potential for "unprecedented financial entanglements with the industries he would regulate as FDA commissioner," others were hopeful that his energy and enthusiasm would help "accelerate the discovery, development and delivery of new cures and treatments" to address some of the most pressing problems in the U.S. healthcare industry.
In his resignation
letter, Gottlieb cited his work on e-cigarettes and youth vaping, the opioid crisis, access to generic drugs, efforts to "reduce the burden of chronic disease through better information and diets" and other population health imperatives. He also pointed to recent approvals for new gene therapies and other precision medicine tools.
-----
Amazon-Backed Healthcare Venture Gets Much-Needed Name: Haven
A new website launched to coincide with the new name outlines in broad terms some of the areas where Haven could make improvements on the current healthcare system.
KEY TAKEAWAYS
The name Haven was chosen to reflect the venture's goal of partnering with patients and clinicians alike in pursuit of systemic improvements.
The name came with a new website as well, offering some more broad contours of the closely watched initiative.
The joint healthcare venture being launched by Amazon, JPMorgan Chase, and Berkshire Hathaway has been formally known as "Tcorp62108 LLC" since its founding last year, so it should come as no surprise that those watching the entity's potentially disruptive entry into the healthcare industry have been grasping for monikers that are easier to remember and more concise.
-----
FBI Director Christopher Wray: 'Today’s cybersecurity threat is bigger than government itself'
Top Federal Bureau of Investigation official calls for greater public-private partnership to fight back increasingly sophisticated adversaries and attacks.
March 05, 2019 04:21 PM
SAN FRANCISCO — Christopher Wray, the director of the U.S. Federal Bureau of Investigation, struck a cautious tone on Tuesday morning here at RSA 2019 and he called for more cooperation to tackle the cybersecurity problem.
“Today’s cyberthreat is bigger than any one government agency — in fact it’s bigger than the government itself,” Wray said. “The scope, breadth, depth, sophistication and diversity of the threat we face now is unlike anything we’ve had in our lifetimes.”
Wray pointed to multinationals, criminal organizations, hacktavists, insider threats, China and North Korea all as among the most pressing issues as well as the blended threat of foreign intelligence units enlisting the help of hackers.
He said that cyber, perhaps more than any other area, is where public-private cooperation is needed for everyone’s sake.
-----
EHR challenges, information overload often lead to staff workarounds
A new survey of hospital clinicians finds that care teams "pervasively" use electronic health record workarounds at critical points of care.
March 05, 2019 11:22 AM
While the benefits of electronic health records have been widely touted, and EHRs are now ubiquitous across hospitals in the United States, a study of a major teaching hospital in New England indicated care teams commonly use EHR shortcuts and workarounds – potentially impacting quality and safety.
WHY IT MATTERS
The report, published in peer-reviewed science journal
PLOS One, found that EHRs are not used for information sharing and frequently impede intra-care team communication, while also revealing a high degree of variance in the ways care teams use EHRs during morning rounds.
Through a series of interviews, and an electronic survey of hospital clinicians, the researchers found care teams "pervasively" used workarounds at critical points of care.
Some workarounds, such as handwritten notes were used as a cognitive aid for clinicians, while others were used due to lack of system support, the report noted.
-----
This hospital modeled itself after the Apple Store, and lets pregnant mothers use gadgets to monitor their health at home
- Ochsner has enrolled 1,000 pregnant patients in the "Connected MOM" program, which provides wireless blood pressure cuffs and weight scales to monitor them from home.
- They get these devices from the hospital's "O Bar," which is modeled on the Apple Genius Bar.
- Hospitals across the country are starting to embrace digital tools to improve patient care and cut down on unnecessary in-person visits.
Published 10:37 AM ET Mon, 4 March 2019 Updated 1:53 PM ET Mon, 4 March 2019 CNBC.com
Ochsner's "Connected MOM" program is free to pregnant women.
When Lisette Hatamian, a New Orleans resident, learned that she was expecting her first baby last fall, her doctors told her about a new program to monitor her health from home.
Ochsner, her local hospital, had just rolled out a new initiative called Connected Maternity Online Monitoring or "MOM," which was available for free to mothers-to-be.
Hatamian was intrigued and agreed to sign up. After her first visit with an obstetrician, she went over to the Ochsner "O Bar," a part of the hospital modeled on the
Apple Genius Bar. But instead of iPhones, the technologies on display included connected weight scales, blood pressure monitors and activity trackers.
The O Bar gave Hatamian a set of devices selected for expectant mothers, including a wireless weight scale and a blood pressure cuff, as well as dipsticks and cups to measure protein levels in urine.
-----
Electronic Decision Support Tool Can Aid Asthma Care
Use of the tool increased asthma control assessment, creation of asthma action plans
FRIDAY, March 1, 2019 (HealthDay News) -- A new electronic decision support tool can improve the quality of asthma care in primary care settings, according to a study published online Feb. 14 in the European Respiratory Journal.
Samir Gupta, M.D., from St. Michael's Hospital in Toronto, and colleagues compared usual care (year 1) to care with the Electronic Asthma Management System (eAMS; year 2) at three Canadian primary care sites with 23 physicians treating 1,272 asthma patients aged ≥16 years receiving an asthma medication within the previous 12 months. The computerized clinical decision support system tabulated real-time patient questionnaire results (from questionnaires completed in the waiting room) to inform medical record-integrated clinician decision support.
-----
How Banner Health Network is managing interoperability with 30-plus EHRs
A new partnership with Holon Health enables real-time push of key patient information to network providers, regardless of their IT system, cluing them in to data they need to tackle care variation across the ACO.
March 01, 2019 01:32 PM
Banner Health Network, with 5,000 affiliated physicians and 15 hospitals in the Phoenix area, is large and complex. Its accountable care and population health management efforts require lots of high quality data and a keen focus on closing gaps in care. But that's something of a challenge when those physicians are using more than 30 different electronic health records.
"Thirty-two, I think is the number," said David Coe, vice president of data management, analytics and population health technology at Banner Health. "So you could imagine doing point to point interfaces to each one of those individual EHR systems."
So BHN has recently tried a new approach to interoperability, partnering with Atlanta-based Holon for its CollaborNet platform, which Coe said connects physicians across the organization with necessary data to improve care coordination and pop health, enabling the jointly owned Banner|Aetna organization to make good on the the promise of value-based care, officials said.
-----
Cybersecurity Standards Needed as Interoperability Grows, CHIME says
Privacy and security must be included in policy recommendations to combat the rise in threats to data integrity, CHIME’s CIO and CEO recommended to the Senate HELP committee.
March 04, 2019 - The College of Healthcare Information Management Executives recently sent a list of
recommendations to the Senate Committee on Health, Education, Labor, and Pensions (HELP), outlining the need to include cybersecurity in policies designed to address the rise in healthcare costs.
The Senate HELP committee recently
released a request for information to address rising costs to healthcare. CHIME included the need for cybersecurity measures and regulatory changes to support providers in addressing threats to patient data, in its list of recommendations for reducing those costs.
For CHIME, while technology and data sharing are “vital to enhancing” care quality and efficiency, any policies to support those digital changes must include cybersecurity measures to protect patient data.
-----
Microsoft built a bot to match patients to clinical trials
Published March 05 2019, 7:36am EST
A chat bot that began as a hackathon project at Microsoft's lab in Israel makes it easier for sick patients to find clinical trials.
The use of the automation could assist patients with hard-to-treat diseases to identify research that could provide them with otherwise unavailable medicines and therapies.
The Clinical Trials Bot lets patients and doctors search for studies related to a disease and then answer a succession of text questions. The bot then suggests links to trials that best match the patients’ needs. Drugmakers can also use it to find test subjects.
-----
Digital health apps could save NHS billions, says report
A new study shows that effective pre-triage for telehealth could reduce patient pressure on GPs by up to 73 percent.
March 04, 2019 09:32 AM
Digital health could save public health services in England £7.5 billion (nearly $10 billion) across England, according to a report from Now Healthcare Group.
WHY IT MATTERS
The study found the use of telehealth and digital consultations removed the need for a National Health Service general practitioner appointment in more than half (56 percent) of cases, and a hospital appointment in 3 percent of cases if digital health through app-based tech was rolled out across the population.
Around a quarter (27 percent) of consultations via the app did not need to be handled by a GP and 41 percent could have been handed by another healthcare professional such as a pharmacist or nurse.
This indicated that if an effective pre-triage function was set up within a telehealth app, patient pressure on GPs could be reduced by up to 73 percent.
-----
5 ways employees can weaken your cybersecurity defenses
Feb 28, 2019, 3:05am EST
Cybersecurity may begin with putting in place measures like spam filters, fraud detection software, multi-factor authentication and file encryption. But it doesn’t end there.
It’s critical that businesses provide security awareness training to staff because employee negligence is a primary cause of data breaches, according to a recent report by Shred-it, an information security company.
The report found that 47 percent of business leaders said an employee error had caused a data breach at their organization. And with data breaches costing companies an average of $3.6 million globally, the role employees play is too significant to ignore.
-----
Allscripts Enabling EHR-Integrated Multifactor Authentication
Allscripts users will have access to EHR-integrated multifactor authentication when prescribing controlled substances.
The health IT company partnered with identity proofing services provider ID.me to enable providers to verify their identity online in compliance with Drug Enforcement Administration (DEA) regulations.
“With secure digital identity, malicious actors will have a much more difficult time perpetrating opioid abuse,” said ID.me CEO and founder Blake Hall.
“Our solution conforms to rigorous federal requirements for prescribing controlled substances, yet we have taken great care to ensure the process is also accessible for providers so they can spend as much time as possible caring for patients,” Hall continued.
-----
Kaiser, Dignity Health executives: Better strategy needed to get ROI from social determinants initiatives
Mar 4, 2019 2:15pm
NEW YORK CITY—Health systems are increasingly investing in programs to address "social determinants" in healthcare like food and housing insecurity. But too often those efforts are still too fragmented to make the intended impact.
That was the message from executives from Kaiser Permanente, Dignity Health and Centene, who said their own organizations have put money into these traditionally nonclinical areas of patients' lives but see a wider industry struggle to properly scale these efforts.
There needs to be a strategic shift in thinking in order to leverage the full impact of these programs, they said during a recent conference in New York City.
-----
CommonWell-Carequality connection does not guarantee value; shared data must be usable—KLAS
Mar 4, 2019 3:35pm
While most electronic health record (EHR) vendors now have the ability to connect to CommonWell, Carequality or both, progress to make the data easy to use has been slow, according to a new KLAS analysis.
The
report from KLAS, the third in a series on healthcare interoperability, evaluated the progress of the CommonWell-Carequality connection and the usability of the data brought in via those connections.
While most vendors can now reconcile problem, allergy, medication, and immunization data from these network connections, there are big differences in how contextual data, such as notes and labs, is managed, according to KLAS.
-----
Pooling of data reveals five new genes that boost Alzheimer’s risk
Published March 04 2019, 7:14am EST
An international consortium analyzed genetic data from more than 94,000 individuals and in the process discovered five new genes that increase risk for Alzheimer’s disease.
The International Genomic Alzheimer’s Project (IGAP), composed of four consortia in the United States and Europe that have been collaborating since 2011 on genome-wide association studies (GWAS), conducted an analysis of both rare and common gene variants in patients with late onset Alzheimer’s disease.
“Having more and more samples in GWAS datasets is like adding more and more pixels to a photograph—it helps researchers see details that they otherwise wouldn’t and helps them decide where to focus further study,” said Marilyn Miller, director of the Genetics of Alzheimer’s Disease program in the Division of Neuroscience at the National Institute on Aging. “If the genes only appear in one out of 10,000 people, you need to find several samples containing those genes for results to be statistically significant.”
-----
UPMC cuts hospital readmission rates with ML algorithm
Published March 04 2019, 7:06am EST
The University of Pittsburgh Medical Center’s clinical analytics team has leveraged machine learning to develop an algorithm that rates hospital patients for their risks of being readmitted.
Specifically, the ML algorithm identifies patients at highest risk of re-hospitalization within seven and 30 days of discharge. To date, re-hospitalizations have been reduced by about 50 percent.
“Right now, the main area of focus is on seven days,” says Oscar Marroquin, MD, chief clinical analytics officer, UPMC Health Services Division. “The models to predict seven and 30 days are almost identical. The only thing that changes is the statistical weights of each one of the co-variants, which are a little bit different. They are statistically evident but not clinically important.”
Electronic health record data, gleaned from UPMC’s Cerner (inpatient), Epic (ambulatory) and other EHR systems, is analyzed and fed to a dashboard integrated into the clinical workflow that breaks down the findings, helping clinicians to visualize the insights and make it actionable.
-----
Amazon gives AI to Harvard hospital for efficiency gains
Published March 04 2019, 5:37pm EST
Amazon Web Services is working with a Harvard-affiliated teaching hospital in Boston to test how AI can simplify medical care.
It’s the latest sign of powerhouse tech companies like Amazon and Google deepening their reach into America’s $3.5 trillion healthcare market.
While the tech industry has high hopes that powerful computing tools can improve diagnoses and treatment, Beth Israel Deaconess Medical Center’s first projects with Amazon.com are less about sophisticated therapies and more about making day-to-day tasks like patient scheduling more cost-effective.
“They’re identifying the right problems where machine learning truly can help,” says Taha Kass-Hout, senior leader for healthcare and AI at Amazon.
The Seattle-based tech company gave the Harvard Medical School teaching hospital a grant valued at as much as $2 million to experiment with machine learning and AI. It’s a new indication of the desire Amazon and its competitors have to grow in a U.S. health industry bloated with inefficiencies, where high costs strain the budgets of families, employers and governments.
-----
HIT Think Why prospective data analysis has much potential for good
Published March 04 2019, 6:03pm EST
I’ve noticed an emerging trend in social determinants of health conversations. On the payer side, payers are less interested in “what” constitutes social determinants-related activity and how much is invested in said activities. Rather, payers are increasingly interested in measuring and enabling the effectiveness of SDOH initiatives to improve people’s health status.
Providers, on the other hand, are increasingly curious about exploring how SDOH data could be turned into insights. For instance, I recently spoke with the head of data analytics for a provider who was exploring potential health insights from voter registration data. Providers want to better understand their markets’ health needs so that they can be responsive.
And providers have SDOH data today sitting untapped in their EHRs. Note that Google has applied for a
patent on a technology that predicts individualized-at-the-point-of-care clinical outcomes by applying deep learning to records from millions of patients’ EMR data. Using stored, aggregated EHR data from diverse patients, including clinical notes where SDOH data may be lurking, Google’s technology is intended to predict one or more future clinical events and summarize pertinent past medical events related to the predicted event.
-----
Weekly News Recap
- Medsphere acquires Wellsoft
- WellSky acquires HCS
- House VA committee Chairman Mark Takano (D-CA) chastises VA Secretary Robert Wilkie for failing to turn over documents related to the Mar-A-Lago trio’s influence on VA software purchasing decisions
- Crossover Health acquires Sherpaa Health’s technology platform
- More than half of surveyed home care clinicians say they can’t access the hospital EHR records of their patients to reconcile patient medications
- Cedars-Sinai pilots the use of Alexa-powered devices in patient rooms to route their verbal requests and to control their TVs
-----
Enjoy!
David.
