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.
Several motions are expected to be discussed at the British Medical Association’s annual representatives meeting (ARM), calling on NHS England, NHS Digital and individual trusts to collate the advantages and disadvantages of all communication methods currently used in the health service.
East Midlands Regional Council proposed a motion labelling secretary of state for health and social care, Matt Hancock’s, flagship Axe the Fax and Purge the Pager campaigns “premature and ill-conceived”.
The region is calling on the BMA to oppose the blanket policies until “feasible alternatives” are determined.
Anxiety levels are high among some physicians at The Ottawa Hospital as it transitions to a new electronic health record system.
One doctor, who contacted this newspaper, said some physicians feel they were not adequately trained before the June 1 launch and are not receiving the support they need.
In a statement, the hospital’s director of communications and engagement, Kate Eggins, said that 98 per cent of physicians had training. Additional training and support were also provided.
US medical bill and debt collector American Medical Collection Agency (AMCA) has filed for bankruptcy protection in the aftermath of a disastrous data breach.
The companies in question used AMCA's payment portal to bill their medical customers.
The non-profit healthcare industry alliance urged ONC to adopt a lightweight approach to the framework, and suggested the federal agency establish the minimum conditions necessary for efficient health data exchange to occur rather than imposing strict requirements.
“While we applaud the goals of TEFCA Draft 2 to advance nationwide healthcare interoperability between existing networks,” said DirectTrust President and CEO Scott Stuewe, “we advocate for a more agile and iterative approach, which would, appropriately, tie back to the goals of Congress in the 21st Century Cures Act.”
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Placing test orders through the EHR's search engine may reduce overtesting, study finds
Jackie Drees – 20 June, 2019
Limiting orders for gamma glutamyl transferase, an enzyme most commonly found in the liver, tests to only be made from the EHR search engine rather than from lists on the system's main screen can significantly reduce the number test orders made per month, according to a study published in the
American Journal of Managed Care .
For the study, Tel Aviv (Israel) University researchers examined data on GGT test orders from Leumit Health Services in Israel from April 2014 to June 2015. The research team compared the number of GGT tests ordered at times during which the test orders were available on the main screen of the EHR system and when they were only available through the system's search engine function.
Results of the study showed that when the test orders could only be made through the search engine, the number of orders placed decreased from an average of 36,000 per month to 1,000 per month. When the GGT test option was added to just one place on the EHR's main screen, the number of tests ordered increased to 18,000 per month. The rise in number of orders continued to more than 35,000 tests ordered after the GGT test option was restored back to its usual place on all the lists.
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New Recommendations Aim to Protect Electronic Communication of Pediatric Health Records
By Will Boggs MD
June 20, 2019
NEW YORK (Reuters Health) - A new policy statement from the American Academy of Pediatrics (AAP) offers several recommendations intended to safeguard the communication of pediatric electronic health records (EHR) with patients and their guardians.
Many professional medical organizations strongly recommend access to health data via electronic means, but healthcare teams, pediatric patients of all ages and guardians lack guidance to effectively and safely use technology for electronic communication about health record information.
Dr. Emily C. Webber of Indiana University, in Indianapolis, and colleagues from AAP detail various challenges for EHR communication and provide recommendations for physicians and healthcare teams, traditional policymakers and healthcare organizations, and federal policymakers and health-information technology (HIT) developers in their policy statement, released June 17 in Pediatrics.
The main challenges, they suggest, include variable laws and regulations and rapidly changing non-EHR electronic communications; variable definitions of a health record; variable maturity of pediatric patients and guardianship roles as well as age of majority; limited pediatric functionality capabilities of existing EHRs and other HIT; and privacy and confidentiality needs of adolescent patients.
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Telehealth holds appeal for seniors, survey shows
More than half of those polled by American Well say they're willing to use virtual visits – citing quicker healthcare service, time and money savings as big benefits.
June 20, 2019 10:27 AM
Better access to healthcare professionals and faster service are among the top reasons senior citizens are willing to embrace telehealth technologies, according to a survey sponsored by vendor American Well.
WHY IT MATTERS
The survey of 400 American seniors (aged 65 years or older) revealed more than half (52%) are willing to use telehealth. Access to faster healthcare service was identified by nearly three-quarters (73%) of seniors as the main driver behind their willingness to use the technology.
Nearly six in 10 seniors surveyed looked at telehealth as a way to save time and money (54%), as well as a way to better access to providers (53%).
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Voice assistants for health could use improvement, study finds
46 participants spoke common drug names to Google Assistant, Siri and Alexa, and results varied. More R&D is needed, experts say.
June 21, 2019 11:21 AM
A study on voice assistant comprehension reveals platforms like Google Assistant, Apple’s Siri and Amazon’s Alexa need to improve the accuracy of their technology for healthcare applications.
WHY IT MATTERS
The research , conducted by Klick Health and published in Nature Digital Medicine, found Google’s comprehension of the most commonly dispensed medication names in the U.S. was, on average, almost twice as accurate as Alexa’s and Siri’s comprehension.
Voice recordings of 46 participants (12 of whom had a foreign accent in English) were played back to Alexa, Google Assistant and Siri for the brand and generic names of the top 50 most dispensed medications in the United States.
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What if AI in health care is the next asbestos?
June 19, 2019
B OSTON — Artificial intelligence is often hailed as a great catalyst of medical innovation, a way to find cures to diseases that have confounded doctors and make health care more efficient, personalized, and accessible.
But what if it turns out to be poison?
Jonathan Zittrain, a Harvard Law School professor, posed that question during a
conference in Boston Tuesday that examined the use of AI to accelerate the delivery of precision medicine to the masses. He used an alarming metaphor to explain his concerns:
“I think of machine learning kind of as asbestos,” he said. “It turns out that it’s all over the place, even though at no point did you explicitly install it, and it has possibly some latent bad effects that you might regret later, after it’s already too hard to get it all out.”
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Discharge algorithm could save hospitals $860 per care episode
Mackenzie Garrity -
Tuesday, June 18th, 2019 Print | Email
A new clinical decision support algorithm developed by Remedy, a company that connects employers, insurers and health systems, for patients being discharged could save hospital $860 per episode of care.
In the retrospective study, Remedy evaluated 15,887 patients age 65 and older who participated Medicare's bundled payment program. Outcomes were linked to spending over a 90-day episode, 90-day readmission and emergency department utilization.
The algorithm aims at determining the optimal next site of care for patients being discharged from hospitals. The goal was to help hospitals cut readmissions, ED use and overall spending costs.
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Echo, the medication management app, has been acquired by LloydsPharmacy-owner McKesson
Echo , the U.K. startup that offers an app to help you manage your medication and order repeat prescriptions for delivery, has been acquired by healthcare company McKesson, owner of LloydsPharmacy.
Terms of the deal remain undisclosed. However, I understand the buyout sees all of Echo’s existing investors exit, with McKesson becoming the majority shareholder and the remaining shares divided amongst Echo management and other staff. Echo was backed by White Star Capital,
MMC Ventures, Rocket Internet’s GFC, Hambro Perks, Public.io and LocalGlobe.
Echo was founded in 2015 by Sai Lakshmi, who previously worked in biz dev for
Apple, and Stephen Bourke, who (notably) was previously a manager at LloydsPharmacy’s online doctor service. Lakshmi stepped down as CEO of Echo in August last year and was subsequently replaced by ex-HelloFresh International COO Roger Hassan.
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Doctors increasingly use PDMPs, but opioid impact still rising
Published June 20 2019, 12:02am EDT
Despite the fact that physician use of prescription drug monitoring programs has dramatically increased, the use of these state-run databases isn’t curtailing the opioid crisis.
That’s the sobering reality according to Susan Bailey, MD, president-elect of the American Medical Association.
While opioid prescriptions decreased 33 percent between 2013 and 2018, including more than 12 percent between 2017 and 2018, this progress “has not led to an overall reduction in mortality or a measurable increase in positive patient outcomes,” Bailey said in bleak testimony on Wednesday to a House committee.
In fact, Bailey testified that “the nation’s epidemic of opioid-related overdoses and deaths continues to worsen.”
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FCC to vote next month on $100M telehealth pilot program
Published June 20 2019, 12:02am EDT
The Federal Communications Commission will vote at its July 10 meeting to advance a new $100 million pilot program.
The new initiative is intended to boost the use of telehealth for low-income and rural Americans.
FCC Commissioner Brendan Carr made the announcement regarding the proposed Connected Care Pilot Program—targeted at those living in rural areas and veterans—on Wednesday during a visit to a community health clinic in Laurel Fork, Va.
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HIT Think Why physicians are on the hook to not take the bait on phishing attacks
Published June 20 2019, 4:41pm EDT
It’s become widely known that protected health information is a hot commodity on the Dark Web. Research shows that a single medical record is worth at least 10 times that of a credit card number, sometimes even more. A Social Security number may only go for $1; a credit card number fetches between $5 and $100; but medical records are worth as much as $1,000.
Phishing is often the path of least resistance for attackers, so It’s only natural that they are adapting their phishing tactics to target information from not only healthcare organizations and patients but also physicians to gain access to this PHI. They know that this tactic will require the least amount of effort for greater gains, and humans are often the weakest link in the security chain.
Attackers can leverage phished credentials or use password-spraying techniques against physicians to gain access to sensitive information found in email inboxes. We find incident response cases where a hacker had intercepted email in real-time using inbox rules that look for relevant key words or attachments.
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Fear and Confusion Over the Software and Artificial Intelligence Revolution Reaches the FDA
June 20, 2019
Society is being doubly convulsed by the revolutions of software and artificial intelligence. What passes for a moderate observation is the 2011 statement by Marc Andreessen that “Software is eating the world.” At the more extreme end, people dread a future envisioned by the Terminator and Matrix movies. But an alert concern is justified. Health care is starting to grapple with the safe and effective use of these tools, and the FDA joined the discussion this past April with a
proposed regulatory framework . Unfortunately, fear and confusion muddle organizations’ response to change even here.
In this article, I explain the approach to the FDA proposal that we took in a group of computer experts I’m involved with, the
U.S. Technology Policy Committee (USTPC) of the Association for Computing Machinery (ACM). The ACM is one of the earliest organizations in computing, having been formed just three years after ENIAC demonstrated in 1945 that digital computing was applicable to real-life problems. The organization pulls together an enormous variety of deep and well-trained professionals, so the members of the Technology Policy Committee felt we could find something to offer the FDA. We drew in a non-member, programmer and health care expert
Shahid Shah to guide us.
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4 problems industry groups have with the ONC's Trusted Exchange Framework
Jun 18, 2019 12:58pm
With the proposed Trusted Exchange Framework and Common Agreement (TEFCA), the Office of the National Coordinator for Health IT (ONC) is attempting to provide a single "on-ramp" to nationwide data sharing.
While most industry groups support the goals of this initiative, the timeline for implementation is too aggressive, and the framework is still too broad and does not provide enough clarity as to how it will be rolled out, many organizations say.
ONC released the
first draft of the TEFCA back in January 2018 as a framework designed to improve data sharing between health information networks. The
framework (PDF), mandated by the 21st Century Cures Act, provides the policies, procedures and technical standards necessary to exchange patient records and health information between providers, state and regional health information exchanges and federal agencies. ONC released the
second draft of TEFCA in April and public comments were due June 17.
Because
TEFCA was written as a voluntary framework, one of the major issues that ONC will need to wrestle with is how to incentivize participation, many industry leaders say.
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American Heart Association, RapidSOS team up to link emergency responders with patients' medical data
Jun 19, 2019 2:17pm
When first responders arrive on the scene of medical emergencies like cardiac arrest they often have to rely on limited information about patients based on what is communicated verbally to 911 operators. Not having information like patients' medical histories, current medications or emergency contacts can cause critical delays in care.
The American Heart Association (AHA) and emergency technology company RapidSOS are working to close this gap by building a health data registry that first responders and 911 telecommunicators can access to improve medical emergency response.
The registry, which will rely on individuals to opt-in to sharing their medical data, will give emergency responders more context on patients, leading to more informed responses, quicker treatment to those in need and improved outcomes.
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Pew Suggests ONC Use TEFCA to Improve Patient Matching Accuracy
Pew Charitable Trusts recommended ONC include policies in TEFCA that would improve patient matching accuracy and API use.
June 18, 2019 - The Trusted Exchange Framework and Common Agreement (TEFCA) should include policies that promote patient matching accuracy and support modern approaches to data extraction through application programming interfaces (APIs), according to
comments submitted by Pew Charitable Trusts.
Pew submitted feedback to ONC informing the finalized
TEFCA draft , currently in its second iteration. The organization stated its overall support for the draft, but suggested ONC take additional actions to improve EHR data extraction, access, and exchange.
Pew has been a vocal advocate of improving patient matching accuracy for some time, releasing a
report in 2018 outlining nationwide patient matching strategies involving smartphones, biometrics, and other data and technology.
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Game Over for GandCrab: New free decryption tool allows victims to unlock all versions of this ransomware
Shortly after those behind GandCrab announced they are retiring, researchers have released a new tool which nullifies all versions of the ransomware.
A new decryption tool that counters one of the most prolific families of ransomware by allowing victims to retrieve their files for free has been released in a collaborative effort by Europol, the FBI, cybersecurity company Bitdefender, and others.
The latest version of the GandCrab decryptor neutralises the most recent incarnations of the file-locking malware – GandCrab 5.0 through to GandCrab 5.2 – as well as allowing users to retrieve files encrypted by older versions of the ransomware.
It's thought that over 1.5 million Windows users have been infected with GandCrab since it first
emerged in January 2018 , with both home and business networks falling victim to attacks by what Europol describes as "one of the most aggressive forms of ransomware".
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Survey: 62% of patients value access to web-based visit notes when choosing a new provider
Jackie Drees -18 June, 2019
More than half of patients (62 percent) consider web-based portal access to clinician-documented visit notes an important factor when searching for a new healthcare provider, according to a survey published in the
Journal of Medical Internet Research .
The survey includes responses from 23,710 patients or their caregivers from the following organizations that participated in an OpenNotes pilot test in 2010-11: Boston-based Beth Israel Deaconess Medical Center, University of Washington Medicine in Seattle and Danville, Pa.-based Geisinger. The survey was conducted between June and October 2017 via a web-based platform. All participants used a patient portal and had at least one visit note available within the last year at the time of the survey.
Four survey insights:
1. Seventy-two percent of patients said note reading was "very important" in helping them manage their health.
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Survey finds lack of easy exchange of clinical trial data
Published June 19 2019, 4:58pm EDT
A new survey of medical researchers finds many have the desire to streamline clinical trial processes.
All researchers surveyed reported the need to improve information exchange, driven by the necessity to reduce manual processes, improve collaboration as well as increase visibility and oversight during trials, according to the vendor.
On average, survey respondents indicated that they use at least three methods to share clinical trial data and documents among sponsors, clinical research organizations and research sites—with email the primary tool for exchange.
Study start-up is one of the clinical areas with the most potential to improve trial efficiency and speed, the survey finds, as most researchers still rely on spreadsheets.
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Stakeholders say data sharing is critical to lowering healthcare costs
Published June 19 2019, 12:02am EDT
If the United States is going to rein in the high costs of healthcare, the industry must do a better job of sharing data with patients and among other stakeholders.
That’s the contention of Sean Cavanaugh, chief administrative officer for tech start-up Aledade, who previously served as the director of the Center for Medicare and deputy director of the Center for Medicare and Medicaid Innovation.
“Surprise billing in particular occurs because of a market failure—patients don’t have the time or the information necessary to shop to avoid these bills,” Cavanaugh testified on Tuesday before the Senate health committee. “We applaud this committee’s willingness to take on this issue and your willingness to consider multiple solutions and put patients’ interests first.”
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HIT Think How data is crucial to essential improvements in public health
Published June 19 2019, 4:02pm EDT
Americans are used to seeing California as a bellwether. Whether or not that’s a good or bad thing often depends on individual perspective.
But there’s less room for differences of opinion when it comes to housing and homelessness. With a booming economy that is now the fifth largest in the world, California has also experienced a dramatic rise in homelessness in recent years. In Los Angeles County alone, homelessness has risen in three of the last four years, with a 12 percent increase in the last year.
The reasons for California’s uptick in homelessness are treated as obvious. Average rent in the LA area is now north of $2,000 a month, pushing many residents on the financial edge over the brink.
If nationwide data are any indicator, that’s a lot of vulnerable people. According to a widely referenced Bankrate survey, only 40 percent of Americans would be able to pay an unexpected $1,000 expense with dollars in savings.
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COPD patients could benefit from mHealth, study indicates
June 19, 2019 06:33 AM
Around the world, more than 600 million people are estimated to be affected by COPD, with four million in Germany and 16 million in the US.
A Chinese research group has compared six international COPD studies and found that the use of health tips improved the self-management of COPD patients measurably - and has the potential to reduce the number of hospital admissions.
The six studies from China, Germany, Spain, Italy and the Netherlands, all published by 2017, were selected from over 4,000 and examined against four criteria, including the number of hospital admissions and the monitoring of self-management of COPD patients via telemonitoring over a period of at least a month.
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Despite big security risks, healthcare leaders say they're sure of their preparedness
June 19, 2019 10:05 AM
Even as they rely on outmoded data management processes, 70% of execs and IT leaders say they're 'very' or 'extremely' confident of their infosec strategies.
Healthcare executives and IT leaders are overconfident regarding data privacy management, according to a new report from vendor Integris Software.
Its study of 258 business executives and IT decision makers found 70% of healthcare leaders were "very" or "extremely confident" in knowing exactly where sensitive data resides, less than half update their inventory of personal data once a year or even less.
Despite the healthcare industry's history of stringent privacy regulations, as well as an understanding of the importance of securing personal data for compliance purposes, they were not able to effectively track, monitor or know which data they held.
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Telehealth set for big boost with $100M in new funding from FCC
June 19, 2019 11:01 AM
Money from the Connected Care Pilot Program would help rural providers defray the cost of offering remote care to low-income patients, including veterans and others in medically underserved areas.
FCC Commissioner Brendan Carr has announced the agency will vote to advance a $100 million Connected Care Pilot Program, enabling telehealth expansion for low-income Americans nationwide.
WHY IT MATTERS
Speaking in rural Laurel Fork, Virginia, Carr announced that the new funding is meant to increase access to care to patients and veterans in remote areas such as Appalachia.
“With advances in telemedicine, healthcare is no longer limited to the confines of traditional brick and mortar healthcare facilities,” said Carr in a statement. "I think the FCC should support this new trend towards connected care, which is the healthcare equivalent of moving from Blockbuster to Netflix. That’s why the FCC will vote to advance my $100 million pilot program at our July 10 meeting."
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Inside Brunei’s cutting-edge e-health system, built by DXC
Ministry of Health Brunei creates ‘one patient, one record’ system
Nestled on the northern coast of Borneo, Brunei is a small nation housing a cutting-edge healthcare information system.
Designed to deliver universal health benefits to a population housing over 420,000 citizens, the Ministry of Health Brunei (MOHB) has created a ‘one patient, one record’ system through a partnership with DXC Technology.
Billed as a “first-of-its-kind milestone” in healthcare, the implementation of an agile health-information management system now contains health records of every citizen across the country.
With healthcare and medical services provided by the federal government, MOHB - which oversees Brunei’s four government hospitals and 60 health centres and clinics - sought to implement a "comprehensive" healthcare information system.
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Health Insurer Plans To Optimize Drug Treatment Using Data Analytics
June 17, 2019
New Jersey’s largest health insurer has partnered with a biopharma vendor to optimize drug treatment using medical and pharmacy claims data. Horizon Healthcare Services will
work with vendor
Aetion to support case management strategies and develop value-based agreements with pharmas targeting specific patient populations.
Aetion is in the business of providing payers and biopharma companies the information they need to participate in value-based care efforts. It delivers evidence based on health data collected from health insurance claims, EMRs, patient-reported outcomes, patient registries and other sources.
The partners will analyze medical and pharmacy claims using data analytics tools to identify high-risk health insurance beneficiaries. Horizon will then develop formulary and drug adherence programs to improve outcomes.
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Healthcare Cyberattack Volumes, Sophistication Keep Increasing
June 17, 2019
A new survey of healthcare CISOs concluded that the bulk of their organizations saw an increase in cyberattacks over the past year, many of which have grown more cunning over time. For those who were derailed by the WannaCry and NotPetya ransomware attacks of 2017, the news won’t come as a surprise.
According to a
report by data security company
Carbon Black , 83% of survey respondents reported that such attacks have increased, and moreover, 66% said they had become more sophisticated over the past year.
The security firm said that in 2018, its healthcare customers had an average of 8.2 attempted cyberattacks per endpoint each month. This includes attacks hitting often overlooked points such as printers, biomedical devices and imaging suites.
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Refining Clinical Decision Support Tools to Ease Physician Burnout
At Banner Health, improving clinical decision support tools and workflows have helped address burnout among providers.
June 13, 2019 - As healthcare has become increasingly digital and patient outcomes have become more intertwined with provider rewards, physicians have turned to clinical decision support (CDS) tools to help them deliver quality care and streamline their workflows.
From suggesting viable treatments to catching potential adverse events, these tools are
designed to help providers sort through vast amounts of data and extract the actionable insights needed to improve patient care.
However, these tools can often cause
more harm than good . Physicians can get frustrated with unintuitive technology, or overwhelmed by unnecessary alerts and alarms, leading to patient safety issues and physician burnout.
“Physician burnout is a multifactorial issue,” Marjorie Bessel, MD, chief clinical officer at Banner Health, told HealthITAnalytics.com .
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HIT Think From security at the perimeter to security at every interaction
Published June 18 2019, 5:33pm EDT
If you pay attention to tech headlines, you’ve probably noticed that new security threats and breaches—
particularly those involving APIs —are on the rise.
This isn’t because APIs are inherently vulnerable—if they are managed and configured properly, they are actually part of a robust enterprise security layer. And the uptick in security incidents is only partly because bad actors’ skills and tactics have continued to progress.
Rather, one of the biggest factors in all the breaches and vulnerabilities is that application development methods have evolved very rapidly, and not all enterprises’ security approaches have kept up.
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Opinion: Can Patient Summaries drive the patient journey of tomorrow across borders?
June 18, 2019
05:34 AM
Alexander Berler, director for consulting services at Gnomon Informatics SA, looks at a new initiative that can help put the patient at the centre of healthcare in Europe.
What is the eHDSI?
I had the pleasure of personally participating from its very first days in the implementation of the so-called eHealth Digital Service Infrastructure (eHDSI). Member states conceived eHDSI as an open interoperability architecture across borders that would allow the safe, stable, and trusted data information exchange. During the early
epSOS project times , European experts analysed and defined several use cases and specifications. In the end, two of them, Patient summary exchange and electronic medicinal prescription are now in their deployment phase. eHDSI deployment under the CEF (Connected Europe Facility) funds started in 2015, bringing all of us now closer than ever to the expected result. The first two countries, Estonia and Finland that launched cross border ePrescription, have announced operational services this January, having already served more than 1,000 patients. Others are expected to follow until the end of 2019 with an end milestone of having all involved member states serving patient summaries and ePrescriptions in routine operation by the end of 2022.
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How Mount Sinai is using AI to unlock social determinant data in the EHR
June 17, 2019 03:41 PM
A natural language processing algorithm has been helping the New York health system gain new insights from its unstructured notes, boosting its value-based care and pop health efforts.
By now everyone knows how critical social determinants are to population health and chronic care management. But what's not so obvious is how to make use of that valuable information, especially given most health systems' reliance on structured electronic health record data for their analytics projects.
Indeed, the challenge of documenting social data in the EHR – and then extracting it for analytics – is one of the main impediments to more progress on that front, said Dr. Jacob Reider, former chief medical officer and deputy national coordinator at ONC – and now CEO of Troy, New York-based Alliance for Better Health, where he's devoting himself to removing those and other barriers.
"In the medical universe we had ICD, and SNOMED-CT that we would use to capture information,"
he explained in a recent Q&A with Healthcare IT News . "We had a reasonably good way of representing the fact that a patient had diabetes, using a certain coding system."
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Electronic Communication of the Health Record and Information With Pediatric Patients and Their Guardians
Emily C. Webber , David Brick , James P. Scibilia , Peter Dehnel , COUNCIL ON CLINICAL INFORMATION TECHNOLOGY , COMMITTEE ON MEDICAL LIABILITY AND RISK MANAGEMENT , SECTION ON TELEHEALTH CARE
Abstract
Communication of health data has evolved rapidly with the widespread adoption of electronic health records (EHRs) and communication technology. What used to be sent to patients via paper mail, fax, or e-mail may now be accessed by patients via their EHRs, and patients may also communicate securely with their medical team via certified technology. Although EHR technologies have great potential, their most effective applications and uses for communication between pediatric and adolescent patients, guardians, and medical teams has not been realized. There are wide variations in available technologies, guiding policies, and practices; some physicians and patients are successful in using certified tools but others are forced to limit their patients’ access to e-health data and associated communication altogether. In general, pediatric and adolescent patients are less likely than adult patients to have electronic access and the ability to exchange health data. There are several reasons for these limitations, including inconsistent standards and recommendations regarding the recommended age for independent access, lack of routine EHR support for the ability to filter or proxy such access, and conflicting laws about patients’ and physicians’ rights to access EHRs and ability to communicate electronically. Effective, safe electronic exchange of health data requires active collaboration between physicians, patients, policy makers, and health information technology vendors. This policy statement addresses current best practices for these stakeholders and delineates the continued gaps and how to address them.
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Why Vinod Khosla thinks radiologists still practicing in 10 years will be ‘causing deaths’
Doubling down on comments he’s made throughout the years regarding AI’s potential impact on the medical industry, legendary Silicon Valley investor and
Sun Microsystems founder
Vinod Khosla said on Wednesday that he believes “any radiologist who plans to practice in 10 years will be killing patients every day,” because machine-powered solutions will have advanced to such a point that they’ll be far more effective than professional human practitioners.
Speaking at the closing keynote of
Creative Destruction Lab’s Super Session in Toronto, Khosla also said onstage that “radiologists are toast,” and that they flat out “shouldn’t be a job,” continuing that in a decade when AI-based diagnostic technology has advanced, people in this profession will “be causing deaths, because [they] choose to practice.”
The position was in keeping with his past statements on the subject, dating back to as early as 2017, when he expressed the belief that some
types of doctors would be “obsolete” within five years (the timeline seems to have gotten a bit longer in the interim, but he later qualified that this includes the time it will take for acceptance by the community and general public that the tech is better). Khosla added that he also believes that oncologists will also be surpassed by alternatives based on domain-specific AI solutions, but that that’s probably a bit further out on the 15-year horizon.
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OIG found cybersecurity gaps in NIH's All of Us precision medicine research project
Jun 17, 2019 10:13am
The Office of Inspector General (OIG) found cybersecurity gaps in the National Institutes of Health's (NIH's) All of Us precision medicine project that could expose personally identifiable information, including personal health information of the All of Us participants, and allow access to the data.
These vulnerabilities could have allowed an attacker with limited technical knowledge to exploit and compromise the participant-facing IT systems, because most of the vulnerabilities did not require significant technical knowledge to exploit, according to an OIG
report (PDF).
During the audit, which began in August 2017 and wrapped up this past February, NIH addressed and remediated all of the vulnerabilities identified, OIG said in a
summary of the report .
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Proposed Bill Would Close HIPAA Gaps, Curb Health App Privacy Risks
A proposed bipartiasn bill would direct HHS to create regulations for health tech like apps and direct-to-consumer genetic tests, which HIPAA does not cover, to bolster patient privacy.
June 17, 2019 - Sens. Amy Klobuchar, D-Minnesota, and Lisa Murkowski, R-Arkansas, unveiled
legislation on June 14, focused on closing privacy gaps in HIPAA, which does not currently cover tech like health apps, direct-to-consumer genetic tests, and other consumer-focused health technology.
The Protecting Personal Health Data Act is solely focused on creating regulation and standards for data not currently covered by HIPAA.
The Department of Health and Human Services Office for Civil Rights released an FAQ in April, which explained that providers aren’t liable for the third-party apps, APIs, and other patient data sharing uses that patients opt into without recommendation from their provider.
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Senate privacy bill aims to set new federal standard for consumer health apps
Sens. Amy Klobuchar (D-Minn.) and Lisa Murkowski (R-Alaska) have introduced a bill that would create new privacy regulations protecting consumer health data collected through health tracking apps, fitness wearables and direct-to-consumer DNA testing kits.
The
bill , introduced June 14, would set a new federal standard for biometric consent, the Senators said.
“New technologies have made it easier for people to monitor their own health, but health tracking apps and home DNA testing kits have also given companies access to personal, private data with limited oversight,” Klobuchar said in a statement. “This legislation will protect consumers’ personal health data by requiring that regulations be issued by the federal agencies that have the expertise to keep up with advances in technology.”
The topic of consumer data privacy is heating up, both on and off the Hill. Facebook recently came under fire for its privacy policies after
a complaint filed with the Federal Trade Commission accused the social media company of exposing users’ sensitive health data. Facebook has since made
privacy changes to its platform when it comes to users discussing health conditions or sharing health information in closed groups.
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Jun 14, 2019, 07:30am
Identity Is Not The New Cybersecurity Perimeter -- It's The Very Core
Richard Bird is Chief Customer Information Officer at Ping Identity . He frequently speaks and writes about identity-centric security.
As businesses increasingly move mission-critical operations into the cloud, the need for more -- and better -- cybersecurity is growing, fast . To put it into perspective, cloud adoption has grown by an astounding 130% over the past decade, with $175 billion spent in 2018. Meanwhile, cybersecurity spending has likewise reached unprecedented levels, eclipsing $100 billion
For all the billions being spent, however, cyber attacks and data breaches are still on the rise. In fact, according to the latest research from global cybersecurity advisory firm Herjavec Group, cybercrime is expected to cost the world more than $6 trillion by 2021, up from $3 trillion in 2015.
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AHA concerned about ONC removal of FHIR as TEFCA requirement
Published June 18 2019, 12:01am EDT
The American Hospital Association wants to see HL7’s Fast Healthcare Interoperability Resources standard put back into ONC’s Trusted Exchange Framework and Common Agreement.
TEFCA, drafted by the Office of the National Coordinator for Health IT, is intended to support nationwide interoperability by outlining a common set of principles—as well as minimum terms and conditions—for trusted data exchange.
However, in its second draft of TEFCA, ONC removed the requirement for Qualified Health Information Networks (QHINs) to support FHIR application programming interfaces as an exchange modality, according to AHA.
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Facebook posts support predictions of patient medical conditions
Published June 18 2019, 12:02am EDT
The language that people use in their postings on Facebook is effective in predicting diabetes and mental health conditions, including anxiety, depression and psychoses.
That’s the conclusion of a new study from Penn Medicine and Stony Brook University researchers.
Published on Monday in
PLOS ONE , they evaluated whether consenting patients’ Facebook posts could be used to predict their diagnoses documented in their electronic medical records.
Researchers analyzed Facebook postings from almost 1,000 patients who agreed to have their EMR data linked to their profiles.
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HIT Think Why the movement toward a patient identifier is only a start
Published June 17 2019, 5:25pm EDT
In a landmark decision by the House last week, the ban for a national patient identifier was overturned. While the amendment still needs approval by the Senate to become law, it nevertheless was a victory for industry groups such as AHIMA and CHIME in a fight that’s been two decades in the making.
When Congress dismissed the concept of a universal identifier in the early 1990s, healthcare’s IT infrastructure for data exchange was still relatively immature. Today, however, in the wake of digitization, healthcare organizations are inundated with data, and widespread information sharing across settings remains an elusive goal.
While the transmission and capture of a single patient identifier across thousands of disparate systems could take decades for full adoption, it does represent a turning point in addressing the U.S. healthcare system’s patient-matching crisis. As the foundation for patient safety and interoperability, patient identification issues are financially crippling—costing our nation’s healthcare system $6 billion annually.
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Weekly News Recap
Allscripts announces plans to acquire specialty drug prescription prior authorization platform vendor ZappRx.
GE Ventures looks for a buyer for its stake in 100-plus startups that include 27 healthcare companies.
French company Dassault Systèmes will acquire clinical trials software vendor Medidata for $5.8 billion.
Epic will integrate Humana’s real-time prescription benefits checking tool within its e-prescribing workflow as the first of several steps in their newly announced relationship.
Switzerland-based medical Internet of Things vendor Medisanté enters the US market with the opening of an office in Bridgewater, NJ.
A physician’s New York Times opinion piece says corporatized healthcare is cynically taking advantage of the professionalism of doctors and nurses by assuming they will work extra hours without extra pay, with the biggest overtime culprit being the EHR.
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The impact of health information technology on the management and follow-up of test results – a systematic review
Published: 11 April 2019
Abstract
Objective
To investigate the impact of health information technology (IT) systems on clinicians’ work practices and patient engagement in the management and follow-up of test results.
Materials and Methods
A search for studies reporting health IT systems and clinician test results management was conducted in the following databases: MEDLINE, EMBASE, CINAHL, Web of Science, ScienceDirect, ProQuest, and Scopus from January 1999 to June 2018. Test results follow-up was defined as provider follow-up of results for tests that were sent to the laboratory and radiology services for processing or analysis.
Results
There are some findings from controlled studies showing that health IT can improve the proportion of tests followed-up (15 percentage point change) and increase physician awareness of test results that require action (24–28 percentage point change). Taken as whole, however, the evidence of the impact of health IT on test result management and follow-up is not strong.
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Meals on Wheels Uses Mobile App To Keep Care Coordinators In The Loop
June 14, 2019
I love writing stories about successful care coordination programs, so it was great to see the following item turn up in my inbox. It’s a tale of how Meals on Wheels America, the folks who bring hot meals and social support to homebound elders, is using a mobile app to keep care coordinators informed about their clients’ condition.
Before we get into the nitty-gritty details of the project, the background on Meals on Wheels is probably in order. MoW offers what it calls a “more than just a meal” service model, in which staff and volunteers not only deliver food, they visit with clients in their homes and conduct a routine check-in. This puts them in a good position to recognize when problems are emerging.
Hoping to leverage this insight, the charity recently partnered with the West Health Institute and the Brown University Center for Gerontology and Healthcare Research to develop a mobile app tracking observed changes in clients’ mental or physical health. MoW drivers can use the app, known as “Mobile Meals,” to alert care coordinators to such changes. (Its technology comes from Accessible Solutions’ ServTracler software.)
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Estonia: From AI judges to robot bartenders, is the post-Soviet state the dark horse of digital tech?
July 16, 2019
Walking through the fairy-tale streets of Estonia's capital Tallinn, it may seem hard to believe that this tiny nation is home to one of the most advanced e-governance systems in the world.
Key points:
Estonia was one of the first countries to declare internet access to be a human right
99 per cent of government services are available online 24/7
50 new AI applications are set to go online within the public sector by 2020
Even amid the trendy cafes and refurbished buildings of the city's modest downtown area, there are few signs of a thriving high-tech private sector — aside from the occasional Mars-rover-style delivery robot wandering by.
But in less than 30 years, Estonia has made the transformation from a struggling post-Soviet state to one of the most digitalised nations in the world.
It has digitally streamlined an unprecedented number of public services, with 50 new government Artificial Intelligence (AI) projects set to come online by next year.
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Enjoy!
David.