This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
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."
The National Press Club election health debate today provided a rare if welcome opportunity for the rival health policies to come under the sort of scrutiny we need to see more of, the CEO of the Consumers Health Forum, Leanne Wells, said.
“We congratulate the Health Minister, Greg Hunt, and Shadow Health Minister, Catherine King, for exposing themselves and their policies to questions on their health policies.
“This was a reasoned debate with only the odd heated exchange. However, the debate demonstrates that what we have is a patchwork of piecemeal proposals to fix various problems in the health system.
“What the Australian health system needs is a more holistic vision and coordinated health strategy that focuses on consumer needs.
“Both speakers put hospitals and medicine first. Neither spoke of the social determinants of health, such as housing, education and employment, which have such an impact on health.
“What we want to see is prevention and transformative primary care being central to the vision for better health in Australia.
“Each side is offering different initiatives, whether it be Labor’s bumper $7.5 billion boost to public hospitals, cancer care and pensioner dental treatment, or the Government’s plans to reform primary health care for the elderly by enabling easier communications with the doctor.
“Mr Hunt emphasised the individual benefits for patients able to access life-saving and highly expensive drugs through the Pharmaceutical Benefits Scheme, while Ms King said that on overall policy there was a stark choice between the two sides.
“Even before the debate yesterday, both sides of politics launched fresh initiatives. The Coalition announced earlier in the day a $308 million expansion in subsidies for medicines prescribed to patients with multiple conditions --- a pledge Labor said it would also meet.
“Labor also announced a $115 million preventive health plan, including a national obesity strategy which we welcome.
“The two parties’ views on a variety of issues ranging from mental health, to health insurance rebates to codeine regulation, highlight the diversity of costly and complex issues that bedevil health care.
“What Australian health consumers need now is a more joined up approach that gives much more emphasis to integrated care in the community,” Ms Wells said.
Australia's healthcare system could be taken in two very different directions after the nation votes in this month's federal election, according to the two people vying to be its stewards.
Health Minister Greg Hunt and Labor health spokeswoman Catherine King have tried to distinguish their plans for keeping Australians well and looking after them when they are sick in a televised debate.
Ms King talked up Labor's proposal to spend $2.3 billion over four years to improve Medicare coverage of cancer services and an extra $2.8 billion on public hospitals.
"This election offers a stark choice, and nowhere is that choice more stark than when it comes to health policy," Ms King told the National Press Club in Canberra on Thursday.
"It's a choice between a Labor Party with an ambitious health agenda, and a Liberal Party with no agenda at all."
Mr Hunt challenged the sentiment that his party doesn't have a vision for improving health care, saying it is focused on four areas: primary health, hospitals, mental health and medical research.
The coalition's efforts to improve primary health have involved increasing funding for Medicare, diagnostic imaging, and subsidies for making medicines more affordable, he argued.
It has also been making doctors more accessible to older patients over the phone and computer.
Hospitals, mental health centres and medical research have also been getting more cash under the current government, he argued.
Mr Hunt noted that Labor stopped subsidising all new medicines through the Pharmaceutical Benefits Scheme when last in government in 2011, a claim the party denies.
"That's why you need a comprehensive, long-term national health plan and you need a strong economy to back it," Mr Hunt said.
The minister also accused Labor of offering far too little detail on its new cancer investment and not estimating its costings correctly.
"They haven't done the work," he said.
But Ms King said the coalition simply had no plan to match its efforts to grapple with out-of-pocket costs for cancer treatment.
Labor also pledged on Wednesday to spend $115.6 million on initiatives to prevent people from becoming unwell, including $39 million over three years to implement a national anti-obesity strategy.
The opposition said it would "consider" forcing food companies to change the recipes of their products to make them healthier.
But Ms King stressed Labor wouldn't necessarily make the change "straight away".
The election campaign has been underway for a bit over three weeks and we have about two to go.
As best I can tell the ADHA and their CEO are in ‘witness protection’ and it seems just no one wants to talk about Digital Health from either side.
Labor Policy from their manifesto (The National Platform) is as follows (p137):
Investing in digital health
49. Information and communications technology play a crucial role in health care by improving coordination and reducing duplication to deliver better health outcomes.
50. To drive better use of information and communications technology in health, Labor will:
·Continue to build the digital health record system while ensuring appropriate privacy and security protocols protect consumers’ rights and their sensitive medical information;
·Educate all Australians on the benefits of an electronic health record that will improve the coordination of care, eliminate duplication, and reduce the likelihood of errors;
·Work with health care professionals to disseminate health and related education via technology and increase utilisation of digital health, including uploading of required data;
·Integrate digital health records with hospital, pathology, diagnostic imaging, aged care, medicine compliance and other clinical systems, and where appropriate, seek to deliver more health care solutions into people’s own homes;
·Work with States and Territories to introduce electronic health records and integrate them with national systems including the My Health Record;
·Prioritise interoperability so information can be shared across our health care system;
·Expand the rollout of TeleHealth services for specialist care where the efficacy is already proven; and
·Encourage processes to facilitate better information sharing between patients, health providers, hospitals, pharmacies and insurers.
Given Ms King’s comments in the period around opt-out with condemnation and a call for various changes and investigations it is hard to know how much actually is current. I think the approach may just be a bit more sceptical.
No mention of Digital Health I can find – send a link if you can locate any useful policy material.
I listened to the whole debate and Digital Health was totally AWOL!
We can only conclude that both sides are so embarrassed with what has / is going on they prefer it not to be even mentioned! Pity no-one wants for face up to the issues and fix them!
Note:
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It’s
a question which has plagued the NHS for many a year: how can we make
interoperability happen? For Peter Anderson, the answer is through a
mixture of top-down focus and regional action.
DHI Admin, 25 April, 2019
As
a participant in bodies like the Professional Record Standards Body
(PRSB) and INTEROPen, I’m trying to play my part in making
interoperability a reality in the NHS. Matt Hancock’s energetic drive
for nationally specified open standards – and the secretary of state’s
promise that vendors who don’t play ball won’t work with the NHS – is
definitely taking us in the right direction, and I say more power to
him.
But
even if we had all the necessary standards today, it could take years
to build on them. New software components must be written, and existing
systems upgraded.
That’s
why I think that, as well as top-down focus, we need renewed regional
effort to get record sharing moving. That means CCIOs and CIOs in NHS
trusts accepting and working with current standards and today’s systems.
Applying commonsense, proven – yet often neglected – IT project
delivery capability and being open minded about what is added to
integration toolkits will help give clinical users the information they
need.
London ambulance staff to be given real-time access to patient data
London Ambulance Service staff will be able to access patient data while on the move without the need for a smartcard or N3.
Andrea Downey, 23 April 2019
The
NHS Identity Service pilot will give medics access to information about
a patient in their care, without the patient having to answer difficult
questions when they are in pain.
Developed
by NHS Digital, it will use Camden Ambulance Station as its initial
base, with around 60 medics having access to patients summary care
records (SCRs) on secure iPads.
SCRs
include information about a patient’s medical history including
long-term conditions; prescriptions and medication; allergies; and other
specific needs.
‘Biggest obstacle’ in digitising healthcare is privacy, Wachter warns
One
of the “biggest obstacles” we face in the move to digitise healthcare
is public concern about privacy, Dr Robert Wachter has warned.
Andrea Downey, 26 April, 2019
The
NHS “failed epically” to digitise 15 years ago, he said, but the
cash-strapped health service is now making better progress, though there
are still remaining challenges.
Writing for Wired UK
Dr Wachter added the move to digitise healthcare was “essential” but it
will be “incredibly hard” to take advantage of the digital revolution
if data can’t be shared.
“Privacy
campaigners have expressed concern over partnerships such as the recent
UK tie-in between the NHS and DeepMind, that gave the latter access to
the (partially anonymised) records of 1.6 million patients,” he wrote.
A new study published in Science Translational Medicine
describes the work of researchers at San Diego's Rady Children's
Institute for Genomic Medicine to rapidly diagnose genetic diseases
using whole-genome sequencing.
The
new method is powered by automated machine learning and clinical
natural language processing and is able to deliver genetic test results
to physicians in neonatal and pediatric intensive care units
significantly faster than manual and other genome sequencing methods.
by Judy George , Senior Staff Writer, MedPage Today April 24, 2019
A
novel brain-computer interface, with sensors implanted temporarily into
individuals whose skulls had been opened for other purposes, translated
neural activity into intelligible speech sounds, researchers reported.
The
system, which decoded neural signals for the jaw, larynx, lip, and
tongue movements involved in speaking, showed it's possible to create a
synthesized version of a person's voice that is controlled by brain
activity, reported Edward Chang, MD, of the University of California San
Francisco (UCSF), and co-authors in Nature.
The
advancement could have a profound effect one day for people who cannot
speak. "It's been a long-standing goal of our lab to create technologies
to restore communication for patients with severe speech disability
either from neurological conditions, such as stroke or other forms of
paralysis, or conditions that result in the inability to speak," Chang
said in a press conference.
(Reuters
Health) - While nine out of 10 phone apps for depression and smoking
cessation assessed in a recent study were found to be sharing user data
with third parties, only two out of three disclosed they were doing so.
Much
of that data, including linkable identifiers, was shared with Google
and Facebook, among others, but barely half of apps sharing data with
those two giant companies told users about it, researchers report in
JAMA Network Open.
“If
you download a mental health or smoking cessation app, there’s a high
chance it will share marketing, advertising or usage tracking data with
either Facebook or Google,” said the study’s lead author Kit Huckvale, a
postdoctoral research fellow at the Black Dog Institute in Randwick,
Australia. “Unfortunately, in many cases, there’s no way to tell that
this is happening and you can’t rely on the privacy policy to tell you.”
Report: Clinical decision support tools may help improve antimicrobial stewardship programs
Jackie Drees – 24 April, 2019
Adding clinical decision support tools to the EHR can help improve
interventions efficiency and metrics tracking required by antimicrobial
stewardship standards, according to a report published in Infection Control & Hospital Epidemiology.
In
the paper, the Society for Healthcare Epidemiology of America
recommends using CDS tools and the EHR to enhance antimicrobial use,
which includes antibiotics and other medications that prevent and treat
diseases and infections caused by microorganisms.
"While
existing systems may present challenges, when used optimally,
informatics can create readily available tools for local and national
reporting, help guide appropriate antimicrobial prescribing that
improves selection, dosing and duration of therapy, and serve as an
educational reference for trainees and providers," Kristi Kuper, PharmD,
senior clinical manager for infectious diseases in the Center for
Pharmacy Practice Excellence at Vizient and lead author of the paper,
said in a news release.
Editor's note:
This story was reported in Helsinki, Finland on a trip paid for by
Microsoft, which covered airfare and lodging for reporters. Healthcare
IT News made no promises to Microsoft about the content or quantity of
coverage. Healthcare IT News is a HIMSS Media publication.
There
is no doubt that healthcare systems around the world are undergoing a
period of transformation, according to HIMSS chief clinical officer Dr
Charles Alessi. Rising expectations of patients, as consumers, shifts in
health trends, ageing, and workforce shortages are only a few of the
key factors behind the urgent need for change.
“But
the question is not if healthcare is changing, it’s at what pace
healthcare is changing,” Dr Alessi said at a recent event organised by
Microsoft, taking place ahead of the June HIMSS & Health 2.0 European conference in Helsinki, Finland.
eHealth Barometer 2019 results: What the Swiss think
From
spring 2020, the electronic health record will be available in
Switzerland. In the eHealth Barometer 2019, the country has already
asked its citizens their views on the new digital health services.
With
the latest population survey in the context of the eHealth Barometer
2019, new insights into the acceptance and dissemination of digital
health services in the Swiss society were gathered.
Since
2009, the eHealth Barometer has regularly polled Swiss residents, as
well as representative health professionals from seven areas, on the
state of digitalisation in healthcare, and provides insight into
personal attitudes, current usage and needs in the electronic health
record, eHealth and digital healthcare services in general.
More
than 1,800 health professionals, including doctors, pharmacists,
caregivers and others, as well as 1200 Swiss citizens were questioned by
telephone.
Croatia
has become the fifth country ready for the cross-border exchange of
ePrescriptions with other EU member states. From this summer, Croatian
patients will be able to collect medication prescribed in their home
country while travelling in Finland, Estonia, Luxembourg and Czechia.
In
January, Finland and Estonia became the first live participants in the
eHealth Network policy, which aims to have 22 member states
participating by 2021. Luxembourg and Czechia have since been declared
‘ready’ by the eHealth Network, and they were joined by Croatia
following a positive vote of the eHealth Member State Expert Group
(eHMSEG) on 11 March. Portugal, Malta, Cyprus and Greece are expected to
follow by the end of the year.
Participating countries will also be able to exchange patient summaries as the scheme develops during the coming months.
Standardizing
address information and last names could help to link patient health
records by as much as 8 percent in the United States.
Such
relatively simple standardization efforts could result in more than 2
billion additional records matched to patients, research suggests.
That’s the finding of a study, published in the Journal of the American Medical Informatics Association,
from researchers at the Regenstrief Institute, Indiana University
Richard M. Fairbanks School of Public Health at IU–Purdue University
Indianapolis, IU School of Medicine and The Pew Charitable Trusts.
Change Healthcare has released its ninth annual Industry Pulse Survey assessing the state of the industry.
Research
for the report came from 185 healthcare leaders at high levels in their
organizations, including providers, insurers, vendors and Change
Healthcare customers, all of whom collaborate via the HealthCare
Executive Group. The report is important, says Ferris Taylor, who
oversees the executive group. “If traditional stakeholders aren’t able
to transform healthcare, outside parties will.”
The
report offers snapshots of issues such as market trends, population
health, value-based care, consumer engagement, data analytics, risk
sharing, social determinants and cybersecurity.
Although data breaches are rare, almost half – 44 percent – are caused by third-party vendors, according to an esentire survey.
Of
the data breaches that happened from a vendor, only 15 percent of firms
affected reported that the vendor informed them when a breach happened.
The
survey was sent out to 600 information technology and security
decision-makers, asking about their top concerns around supply chain and
policies or procedures used to mitigate identified vendor risks.
An
alert and “hard stop” programmed into an electronic health records
system at an academic medical center resulted in a significant reduction
in inappropriate gastrointestinal panel testing and cost savings.
Researchers
at the University of Nebraska Medical Center hard-wired criteria into
the hospital’s EHR to provide clinicians with a best-practice alert and a
hard stop that prevented them from ordering a gastrointestinal pathogen
panel (GIPP)—a costly test that detects common disease-causing
organisms—more than once per admission or in patients hospitalized for
more than 72 hours.
As
a result of the EHR’s best-practice alert and hard stop, the hospital
was able to reduce inappropriate testing by 46 percent and saved as much
$168,000 over 15 months, according to a study published on Tuesday in the journal Infection Control & Hospital Epidemiology.
Healthcare,
compared with many other industries, is slow to adopt organizational
change around new tools and technologies. This rings particularly true
in the creation of new professional roles to revised adaptive
organization frameworks.
Medical
device security enforcement is a great example of this. Until recently,
healthcare leaders prioritized digitizing their collateral, including
patient data and health records, without a leading focus on security and
data privacy. This classic case of running before walking is affirmed
by the Ponemon Institute’s benchmark study
on healthcare data security, which revealed 89 percent of healthcare
organizations had patient data lost or stolen in the past two years.
Recently
though, healthcare has started taking a page out of financial services’
book—another industry where data protection and regulatory scrutiny are
paramount—by appointing chief information security officers (CISOs) who
can measure a healthcare organization’s security posture and inform all
relevant stakeholders.
How FHIR 4 will drive interoperability progress in healthcare
Experts
from across health IT, including members of the HL7 board and advisory
council, say the new standard can do big things for data exchange, but
it's not a cure-all.
On
January 2, Health Level Seven debuted the new version of its
interoperability specification. Many CIOs and technologists in
healthcare have been awaiting the fourth iteration of the Fast
Healthcare Interoperability Resources standard – FHIR 4, for short –
because future changes now will be backward compatible.
“Applications
that implement the normative parts of R4 no longer risk being
non-conformant to the standard,” said FHIR Product Director Grahame
Grieve on the FHIR blog.
Grieve
also said that, in addition to the base platform, several key pieces of
FHIR also now are normative, including the RESTful API, the XML and
JSON formats, the terminology layer, the conformance framework and its
Patient and Observation resources.
Are Workplace Wellness Programs a Privacy Problem?
What you must know about these perks and your personal information
By Sally Wadyka
April 22, 2019
Workplace wellness programs—promoted as a way to foster healthy behavior and encourage preventive care—are having a moment.
Last
year, 82 percent of larger companies (those with 200 employees or more)
and 53 percent of smaller ones offered some type of wellness program,
according to the Kaiser Foundation’s annual survey of workplace
benefits. By some estimates, workplace wellness is an $8 billion
industry.
And having access to a wellness program at work—one that may help you lose weight, get in shape, quit smoking,
or otherwise improve your health—sounds like a welcome benefit.
Especially if it comes with financial enticements, such as gift cards,
merchandise like fitness trackers, cash, contributions to health-related
savings accounts, or a discount on your health insurance. The 2016
Kaiser workplace benefits survey found that 42 percent of large firms
with wellness programs offered employees a financial enticement to
participate in or complete the program.
One
of the biggest corporations on the planet is taking a serious interest
in the intersection of artificial intelligence and health.
Google and its sister companies, parts of the holding company Alphabet,
are making a huge investment in the field, with potentially big
implications for everyone who interacts with Google — which is more than
a billion of us.
The
push into AI and health is a natural evolution for a company that has
developed algorithms that reach deep into our lives through the Web.
"The
fundamental underlying technologies of machine learning and artificial
intelligence are applicable to all manner of tasks," says Greg Corrado,
a neuroscientist at Google. That's true, he says, "whether those are
tasks in your daily life, like getting directions or sorting through
email, or the kinds of tasks that doctors, nurses, clinicians and
patients face every day."
A
wearable device that uses artificial intelligence to remotely track and
analyze multiple vital signs while worn by patients at home has been
cleared by the Food and Drug Administration.
The AI-powered
wearable remote patient monitoring device from Edinburgh,
Scotland-based Current Health received Class II clearance from the FDA
for post-acute care, marking the first time that an end-to-end,
real-time, passive RPM wearable and platform has received clearance from
the agency, officials from the company said.
The
device, an upper-arm wearable, is already used in hospitals and
measures a patient’s respiration, pulse, oxygen saturation, temperature
and movement. According to the company, the device delivers continuous
“ICU-level accuracy” with analytics to derive actionable insights to
enable clinicians to monitor patients’ health and intervene earlier if
the data signal an emerging problem.
Phil Muncaster UK / EMEA News Reporter , Infosecurity Magazine
The
number of organizations in Europe and the US that have been hit by a
cyber-attack over the past year has soared to over three-fifths (61%),
according to a new report from Hiscox.
The global insurer today released the results of its Hiscox Cyber Readiness Report 2019, which
is compiled from interviews with over 5300 cybersecurity professionals
in the US, UK, Belgium, France, Germany, Spain and the Netherlands.
It
revealed a sharp increase in the number of firms suffering an attack,
up from 45% in the 2018 report. In the UK, the figure rose from 40% to
55%.
A
statistical machine learning technique has been shown to be 89 percent
accurate in distinguishing between the voices of veterans with
post-traumatic stress disorder and those without PTSD.
Researchers
at the NYU School of Medicine—in collaboration with SRI
International—have developed an artificial intelligence tool that is
able to link patterns of specific voice features with PTSD, a medical
diagnosis defining symptoms that last at least a month after
experiencing a traumatic event.
“The
classifier assigns higher probabilities of PTSD to those with features
indicating speech that is slower, more monotonous, and less change in
tonality and activation,” finds a study published this week in the journal Depression and Anxiety.
Hackers
are increasingly focusing attention on the people working at healthcare
organizations, not worrying about the technical defenses that
providers, payers and others have erected.
“Attackers
are adept at exploiting our natural curiosity, desire to be helpful,
love of a good bargain and our time constraints,” according to new
report from Proofpoint, a security awareness training firm that based
results on the five questions it asked 7,000 working adult technology
users.
Overall,
users were not familiar with common information security terms such as
phishing, smishing and vishing, and neither are end users very worried
about cyberattacks—many rely on IT personnel to automatically discover
and fix accidental downloads of malicious software.
It’s
no secret that every network, be it healthcare or not, is almost
guaranteed to have insecure and often unknown devices attached to it.
We
have all been conditioned to want the latest technology, and we want it
to work immediately with little to no effort. In an effort to keep up
with this exceedingly popular consumer demand, device makers do
everything they can to make their “things” instantaneously work when you
turn them on or plug them in. This is shockingly true and consistent,
whether it’s a $15 smart light bulb or a multi-million dollar MRI
machine.
The
major issue with this approach is that it makes security an
afterthought at best, leaving security gaps that attackers can exploit
at will. To compound the problem, there are constantly more “things”
being added and connected to the Internet. As of mid-2018, there were
more than 17 billion devices, 7 billion of those IoT devices, connected to the Internet. This is expected to be 10 billion in 2020 and 22 billion just five years after that.
The
U.S. Federal Trade Commission on Wednesday announced that it is
charging Surescripts with illegal monopolization of the market for
e-prescriptions.
WHY IT MATTERS
“The
FTC alleges that Surescripts intentionally set out to keep
e-prescription routing and eligibility customers on both sides of each
market from using additional platforms (a practice known as multihoming)
using anticompetitive exclusivity agreements, threats, and other
exclusionary tactics,” the FTC explained in a statement.
“Among other things, the FTC alleges that Surescripts took steps to
increase the costs of routing and eligibility multihoming through
loyalty and exclusivity contracts.”
FTC
said it aims to achieve three things with the lawsuit: to undo
Surescripts competitive methods and prevent them from happening again in
the future, to restore competition in the marketplace and to provide
“monetary redress to consumers.”
ON THE RECORD
“For
the past decade, Surescripts has used a series of anticompetitive
contracts throughout the e-prescribing industry to eliminate competition
and keep out competitors,” said Bureau of Competition Director Bruce
Hoffman. “Surescripts’s illegal contracts denied customers and,
ultimately, patients, the benefits of competition – including lower
prices, increased output, thriving innovation, higher quality, and more
customer choice. Through this litigation, we hope to eliminate the
anticompetitive conduct, open the relevant markets to competition, and
redress the harm that Surescripts’s conduct has caused.”
Tim Cook is not one of Time’s 100 most influential people of 2019. Nonetheless, as a three-time honoree of that list, he was invited to be interviewed by Nancy Gibbs at the Time 100 Summit.
As expected, Cook didn’t reveal any details about new products,
software, or services. Instead, the questions posed and answers given
were broad, touching on Cook’s and Apple’s values and how technology
fits into the world we live in.
Here’s some of what he said about a variety of issues. Quotes have been lightly edited for clarity.
On Apple’s values
“I’ve
always deeply felt that people should have values, a corporation is
nothing more than a collection of people, and therefore by extension a
corporation should have values.
“We’ve always had a set of things
that were really important to us and that we felt said something about
us. Part of that is how we treat the environment, part of that is
evangelizing and advocating for high-quality public education, and
privacy—before anybody was talking about privacy. This has been at the
depths of who we are as a company.
-----
Telehealth, EHR optimization & more: See the breakdown of most-important trends in healthcare
Mackenzie Garrity – 22 April, 2019
Definitive Healthcare released
its 2019 Annual Healthcare Trends Survey, which asked healthcare
leaders across biotech, financial services, staffing, life sciences,
information technology and consulting sectors to determine the
most-important trends in the industry.
Most
leaders (25.2 percent) indicated industry consolidation is the most
important trend. In 2018, there were 803 mergers and acquisitions and
585 affiliation and partnership announcements. This is only expected to
increase in 2019, Definitive Healthcare reports.
Attackers are changing both their tactics and targets in an attempt to remain criminally successful, Proofpoint's study found.
A low-level, non-executive title is no defense against spear-phishing campaigns, a new report has found.
Attackers
are finding success with old tactics used against new targets:
R&D and engineering staff tend to be more frequently targeted
than employees in other departments, and individual engineers and
developers are targeted at a higher rate than executives, according to
Proofpoint's quarterly analysis of highly targeted cyberattacks.
Big
data has been making waves across the entire business sector and almost
entirely transforming the way things operate. Construction and
development, information security, retail, entertainment and e-commerce
have all been changed irrevocably by big data, management and cloud
computing technologies. However, healthcare has been slow to adopt these
innovative solutions.
That's
been changing slowly but surely during the last couple of years. Big
data is definitely picking up speed in the medical field, and it's a
maturation that’s happening as a result of today’s landscape.
Healthcare
leaders and executives understand the need to make smarter, more
informed decisions about the way they treat patients and customers. Big
data and data management solutions will provide the necessary tools to
make that happen and can also improve the efficiency, output and
accuracy of nearly all medical operations.
Vanderbilt
University Medical Center in Nashville, Tennessee, is one of the
largest academic medical centers in the Southeast, serving the primary
and specialty healthcare needs for patients throughout Tennessee and the
mid-south.
THE PROBLEM
Like
many other healthcare organizations, Vanderbilt's caregivers have felt
the administrative burden of clinical documentation and labor-intensive
healthcare technologies. Caregivers found that the day-to-day practice
of medicine was challenged by IT workflows that got in the way of,
rather than improving, patient care.
Querying
and entering patient information via keyboard and mouse, for example,
proved to be an inefficient use of the caregivers' expertise and was
taking them away from engaging with their patients at the bedside.
PROPOSAL
In
2011, when Apple debuted Siri, and in 2016, when the Amazon Echo became
prolific, it also became clear that advances in artificial intelligence
and natural language processing had matured to the point where
communicating naturally with technology was no longer science-fiction,
said Dr. Yaa Kumah-Crystal, core design advisor at Vanderbilt University
and assistant professor of biomedical informatics and pediatric
endocrinology at Vanderbilt University Medical Center.
Names,
soccer players, musicians and fictional characters make up some of the
worst passwords of the year, according to the U.K. government’s National
Cyber Security Center.
But nothing beats “123456” as the worst password of all.
It’s
no shock to any seasoned security pro. For years, the six-digit
password has been donned the worst password of all, given its wide
usage. Trailing behind the worst password is — surprise, surprise —
“123456789”.
The
NCSC said more than 30 million victims use those two passwords alone,
according to its latest breach analysis based off data pulled from Pwned
Passwords, a website run by security researcher Troy Hunt, who also
runs breach notification Have I Been Pwned.
The
second draft of the Trusted Exchange Framework and Common Agreement is
intended to enable widespread data exchange, working as a set of
principles between health industry participants.
On
Friday, HHS through the Office of the National Coordinator for Health
IT issued a second draft of the Trusted Exchange Framework and Common
Agreement (TEFCA), among other steps to promote easier exchange of
health information. It’s now seeking comments on the draft.
“The
seamless, interoperable exchange of health information is a key piece
of building a health system that empowers patients and providers and
delivers better care at a lower cost,” says HHS Secretary Alex Azar.
“The 21st Century Cures Act took an important step toward this goal by
promoting a national framework and common agreement for the trusted
exchange of health information. We appreciate the comments and input
from stakeholders so far, and we look forward to continued engagement.”
Researchers
have devised an approach for coping with the lack of reliable standards
for the preparation and digitization of tissue slides used to diagnose
patients.
Poor
quality slides can result because of air bubbles and smears or during
the digitization process, when blurriness and brightness issues can
arise. However, manual review of these slides can be time-consuming and
labor-intensive, as well as subject to intra- and inter-reader
variability.
To
ensure the quality of digital images for diagnostic and research
purposes, researchers have developed an open-source tool that leverages
different measurements and classifiers, which automatically flag
corrupted images—while keeping those that are valuable for making
diagnoses.
Analytics are helping providers better understand and provide care for their patient populations.
How
often in past 12 months have you gone without a meal? How often do you
need a ride to a medical appointment? These are the sorts of questions
that might not seem relevant to a patient's check-up, and they are never
easy for physicians ask. But more and more providers understand their
importance.
Factors
such as food security, access to transportation and even the
availability of sidewalks, all are considered critical social
determinants of health. These insights can help identify people whose
environment or life circumstances may have an upstream effect on their
health – and point the way toward improvements in their care. A patient
who doesn’t have a car or access to public transportation misses follow
up appointments could be offered a rideshare ride, for example.
But
when a health system takes on new patients, how can they identify those
who may need additional assistance or are most at risk? And how best
use limited resources to serve those who need it most?
If
it seems like health data interoperability is a mess now, consider what
it was like two decades ago. Dr. Mark Roche, who was there to witness
it, explains in this video what was happening then and contrasts that to
our current state of interoperability.
"It was a huge fight," Roche, who is a partner at Avanti iHealth, told HIMSS TV.
That’s
mostly because of so many competing standards. There were
specifications for data exchange, and different specs for clinical
coding systems and, to make it even harder, they were at various levels
of maturity.
Today,
"it is tremendously different because we have made certain standards
freely available to the public. That makes it easy to use, easy to
adopt."
A fraction of internal medicine interns' time is spent in face-to-face
interactions with patients, and even then they're multitasking.
KEY TAKEAWAYS
·Interns
spent the most time performing indirect patient care, taking up an
average of 15.9 hours of a 24-hour period—almost five times more hours
than the next most common activity, direct patient care, which accounted
for three hours of the day.
·Education was the third-highest category of intern time, attributed to 1.8 hours.
First-year
physicians spend 87% of their work day away from patients, half of
which is spent futzing with electronic health records.
Most of the remaining 13% of face time with patients is spent multitasking, according to a new study from Penn Medicine and Johns Hopkins University.
Black Dog Institute report finds privacy shortfall.
While nine out of ten phone apps for depression and smoking cessation assessed in a recent study were found to be sharing user data with third parties, only two out of three disclosed they were doing so.
Much of that data, including linkable identifiers, was shared with Google and Facebook, among others, but barely half of apps sharing data with those two giant companies told users about it, researchers report in JAMA Network Open.
“If you download a mental health or smoking cessation app, there’s a high chance it will share marketing, advertising or usage tracking data with either Facebook or Google,” said the study’s lead author Kit Huckvale, a postdoctoral research fellow at the Black Dog Institute in Randwick, Australia.
“Unfortunately, in many cases, there’s no way to tell that this is happening and you can’t rely on the privacy policy to tell you.”
While the apps studied by Huckvale and his colleagues didn’t appear to be directly sharing mental health information, “what we did see was information indicating the kinds of apps people are using,” Huckvale said in an email. “That can be enough to reveal what conditions people might have.”
Huckvale and his colleagues assessed 36 top-ranked depression and smoking cessation apps designed for Android and iOS. The researchers downloaded the apps onto an Android phone or an iPhone and then put the apps through their paces. All network traffic generated during those simulated uses was intercepted with specialised software.
The destination and content of each transmission was tagged automatically to identify whether the app’s developer or a third party was being contacted. The researchers also noted instances when personal and other user-generated data was contained in the transmissions.
There is little to be said about this other than it simply ought to stop and use of this type of information to support an advertising based business model has not place I believe.
Even if the apps need to charge a dollar or two for the app this is far preferable to secret client betrayal. A further example appeared a week of two ago!
