Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Saturday, January 11, 2020

Weekly Overseas Health IT Links – 11th January, 2020.

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.
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Digital Health’s 2019 Review: Top 10 most read news stories

With the decade drawing to a close and 2020 mere hours away (scary, isn’t it?) it’s that time of year when we take a look back at Digital Health’s most popular stories of the year.
Owen Hughes – 31 December, 2019
Suffice to say it’s been a big year for the health IT industry. From the establishment of NHSX and fresh investment in NHS England’s flagship LHRE programme, to new starters and fond farewells, 2019 has brought plenty of big headlines to Digital Health News. Join us now as we look at the 10 most-read stories by you, our readers.
A review by US cardiologist, geneticist and digital health expert Dr Eric Topol caught the attention of Digital Health readers in February, which stressed the need for the NHS to focus on building a digital-ready workforce.
Dr Topol was commissioned by health secretary, Matthew Hancock, and Health Education England in May 2018 to carry out an independent review into the digital training needs of NHS staff.
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Digital Health’s Review of 2019 Part Two: July to December

As Digital Health continues its round up of 2019, we hit the second half of the year, when NHSX welcomed new appointments, Google amped-up its healthcare ambitions, and the cost the NHS Digital’s restructure was laid bare.
Owen Hughes – 30 December, 2019
July, 2019
July saw the return of the ever-popular Digital Health Summer Schools, with some 1,500 NHS IT leaders flocking to the University of Leeds to take part in the two-day event.
Summer Schools 2019 included international keynotes from Nick Adkins, John Halamka and Margunn Aenestad; it also saw the launch of the Shuri Network and the return of the coveted Digital Health Awards.
Things weren’t so upbeat over at NHS Digital, however, as Digital Health reported that the organisation had spent some £11m on staff terminations as part of its ongoing restructure.
Twenty-two members off staff received termination payouts of between £100,000 and £150,000, while two received packages worth between £150,000 and £200,000.
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Pop health intervention, technology lower care costs among Medicaid children

January 02, 2020, 11:05 p.m. EST
A new study suggests that population health strategies combined with the use of technology can make a huge difference in outcomes and savings in treating Medicaid-enrolled children.
The authors of the study, published last week in the Journal of the American Medical Association, say it is the largest ever to measure the impact of population health strategies and tools on hospital outcomes among Medicaid-enrolled children.
The research looked at the outcomes of children in the Medicaid program at Children’s Hospital of Philadelphia (CHOP). Results of the study found that among 93,000 children, targeted interventions that combined technology solutions with interdisciplinary integrated care teams led to 50 fewer hospital admissions per month and 3,600 fewer bed days in a year.
CHOP collected data on the study from January 2014 to June 2017, using a set of reporting tools in the patients' electronic medical records, which notified clinicians and staff if their patients visited the emergency department or were admitted to the hospital.
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How to interpret and rate the impact of 2019’s high-tech news

January 03, 2020, 3:45 p.m. EST
Bloomberg—Technology continues to change everything in both hopeful and harmful ways. As in prior years, Bloomberg Opinion assesses the eight top themes in technology for 2019 and what they tell us about the industry and beyond. Here’s the list, in reverse order of importance:.
8) Fractures inside tech companies: It’s hard to know how widespread it is, but there are more signs of tech worker discontent with their bosses and with each other. Some technology employees are speaking up about what they believe are workplace inequities or destructive company decisions in areas such as harmful online activity, environmental damage and tech products’ use by government entities. In a potent symbol of the fissures of ideals meeting the reality of large organizations, Google management ended its weekly question-and-answer session with employees.
7) Unchecked data collection and control: The internet economy has become an arms race for ever-more inventive and aggressive human surveillance by companies, workplaces, educational institutions and an unseen web of middlemen. There is little accountability or true consent from those involved, and too little attention on balancing benefits and risks. At the same time, citizens are reckoning with governments and law enforcement that have honed technology techniques to influence opinion, surveil critics, quash dissent or harness potentially problematic tools.
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Digital therapeutic approaches seen advancing in 2020, analyst says

January 03, 2020, 3:49 p.m. EST
The momentum behind digital therapeutics appears to be advancing, despite some chilling of relationships between vendors of the products and pharmaceutical companies.
The lack of uniform growth is understandable, contends Richard Close, an analyst with Canaccord Genuity, an investment bank that focuses on growth companies.
Close contends that the cooling in activity between digital therapeutic developers and big pharmaceutical companies is understandable because of the lack of understanding for how to commercialize the emerging products.
“These ‘cooling’ events do not imply a sea change for DTx (digital therapeutics); rather, they are indicative of a nascent and emerging industry still trying to figure out the best way to commercialize products,” Close wrote in a research summary released this week.
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Canada Releases Final Guidance on Software as a Medical Device

January 2, 2020
Health Canada has finalized guidance on software as a medical device (SaMD) that clarifies how it fits into the agency’s regulatory framework and how devicemakers can comply.
The classification of SaMD is based on the intended use and on the existing classifications  in Canada’s medical device regulations, ranging from low-risk Class I to high-risk Class IV.
Devicemakers must first determine the software’s risk class, which will be confirmed by the agency’s Medical Devices Bureau when it reviews the application. Software does not meet the SaMD definition if it is just used to drive a hardware medical device.
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VA’s Telehealth Clinic for Cancer Care Is the First in the Nation

Located in Pittsburgh, the telehealth program has been delivering cancer care management and chemotherapy treatment for about a year to a clinic 100 miles away for veterans living in central Pennsylvania.
January 03, 2020 - The Department of Veterans Affairs has made significant strides in telehealth and mHealth adoption over the past few years, in everything from mHealth apps to virtual visits and telehealth stations in remote and retail locations.
Now the VA is gaining praise for a new telehealth service: the country’s first remote chemotherapy clinic.
The program is based in Pennsylvania, and links the James E. Van Zandt VA Medical Center in Altoona with the VA Pittsburgh Medical Center, some 100 miles away. Using telemedicine technology, oncologists at the Pittsburgh hospital have been delivering cancer care and chemotherapy treatment to veterans at the clinic for about a year.
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Machine Learning System Accurately Identifies Medication Errors

A machine learning tool was able to identify medication errors better than traditional clinical decision support systems.
January 02, 2020 - An alert system driven by machine learning could identify medication errors that traditional clinical decision support systems might otherwise miss, according to a study published in the Joint Commission Journal.
Prescription drug errors can lead to significant patient harm, resulting in high rates of mortality, morbidity, and increased healthcare costs, researchers noted. While clinical decision support (CDS) alerting tools are widely used to identify and reduce medication errors, the team pointed out that these tools have several limitations.
“Current CDS systems are rule-based and can thus identify only the medication errors that have been previously identified and programmed into their alerting logic. Further, most have high alerting rates with many false positives, resulting in alert fatigue,” researchers said.
Alert fatigue is one of the root causes of physician burnout, a phenomenon that can negatively affect patient satisfaction and lead to more errors in care.
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Investment in AI growing as health systems look to the future

Forward-looking provider organizations are looking to tap into the benefits of deep neural networks and other forms of data-driven analysis.
January 03, 2020 12:01 PM
Investment in machine learning and artificial intelligence is ramping up across the healthcare industry as multiple players all look to tap into the benefits of deep neural networks and other forms of data-driven analysis.
A number of forward-looking provider organizations made strides with AI in 2019, including Summa Health, a nonprofit health system in Northeast Ohio, and Sutter Health, a health system based in Sacramento, California, to name just two.

Administrative process improvements

Looking forward into 2020, administrative process improvements are expected to be an investment priority, including technologies to help automate business processes like administrative tasks or customer service.
Many in the healthcare ecosystem already are on their way. An October Optum survey of 500 U.S. health industry leaders from hospitals, health plans, life sciences and employers, found 22% of respondents are in the late stages of AI strategy implementation.
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University tests AI-powered ‘radiology assistant’

The NYU School of Medicine’s technology enables radiologists to see images the way they currently see them, then, if they deem necessary, ask the AI for its opinion. Results to date are impressive.
January 03, 2020 12:12 PM
There are various known issues with screening mammography.
Probably the most important one is the fact that even though relatively few women actually develop breast cancer, many women are asked for additional imaging following screening mammography (such as diagnostic mammography, ultrasounds and MRI), which is a big cost both in terms of money spent and the stress it causes patients.

Putting AI to work in radiology

Dr. Krzysztof J. Geras, assistant professor, department of radiology, at the NYU School of Medicine, led an AI-powered effort to tackle this challenge.
“Our intention is to decrease this number of additional imaging, and AI is the means to achieve that,” he stated. “It also is known that a small fraction of cancers are missed by the radiologists during a screening mammography exam. We were also hoping that our AI tool would help catch these cases, which could potentially save lives.”
The name of the proposed technology is “ResNet-22.” It is a type of deep convolutional neural network. The way it works is by learning from a very large number of image/label pairs.
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Hospitals Under Siege By Tech Vendors Hunting Health Data

January 3, 2020
Patient data has always been in demand, particularly among pharmas and medical research organizations that need it to do their daily business. However, a new and very aggressive wave of healthcare data buyers has emerged: tech organizations are hungrily seeking this data, which they must acquire if they hope to develop powerful specialized analytics tools providers are beginning to demand.
Some of this frenzy is doubtless being driven by moves made by tech industry giants like Google, which not only spent more than $2 billion to acquire Fitbit (and obviously, its stream of consumer wearables data), but also its high-profile data crunching agreement with health system Ascension. But things have been moving in this direction for several years at least. This is no fad, but rather the maturation of a market we all knew would emerge.
Hospital leaders are being swamped with pitches from tech companies hoping to access their patient data, sometimes in the form of a partnership proposal and sometimes offers to buy the data outright, according to a piece by CNBC writer Christina Farr.
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Is Location Data The Big Next Health Privacy Threat?

January 3, 2020
With smartphones in the hands of virtually anyone in the U.S. who wants one, they’re part of the background of our lives, quiet, surprisingly powerful assistants that bring much of the modern world into our hands.
But as a new investigation by The New York Times reminds us, they also generate a staggering amount of data on their users’ habits, some of which theoretically could be used to identify patients, dig up private personal information and track their comings and goings. This is bad news for the healthcare industry given that consumers aren’t so sure we’re doing a good job protecting their privacy as it is.
Smartphones generate a stream of location pings that identify where consumers are as long as the phone is still on and service is active. This data is then pulled together by private location data companies, whose methods for collecting such information include partnering with developers of popular apps to insert their tracking software.
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Doctors, Nurses and the Paperwork Crisis That Could Unite Them

They don’t always get along. But they are both under siege by the bureaucracy of a failing health care system.
By Theresa Brown and Stephen Bergman
Ms. Brown is a clinical faculty member at the University of Pittsburgh School of Nursing. Dr. Bergman is a professor of medicine at New York University.
Broken, wasteful, inhuman, expensive, deadly. The problems with the American health care system, or non-system, are neither subtle nor unrecognized — especially by those of us doctors and nurses who actually provide the care. And yet we all too often feel the most helpless, seeing how much of the problem is driven by drug companies and hospital networks.
Too often, each profession sees the other as fighting separate battles, and sometimes against each other. Doctors blame nurses, and vice versa, for the failings of a system that punishes us all, and our patients.
Instead, the two of us are suggesting that nurses and doctors try something unusual. Let’s put our differences aside and work together to achieve real change, starting with a pernicious problem that drives so much of our mutual discontent: electronic health records.
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VUMC, Epic Systems Develop EHR Software to Address ICU Delirium

The EHR software will help Epic Systems users follow clinical protocol to prevent ICU delirium.

December 30, 2019 - New Epic Systems EHR software, developed in partnership with researchers from Vanderbilt University Medical Center (VUMC), aims to address ICU delirium by guiding ICU clinicians through a streamlined workflow change that targets the symptoms of ICU delirium.
ICU delirium is a significant patient safety issue that impacts nearly two in three patients in an intensive care unit. According to VUMC and Vanderbilt medical school researchers, ICU delirium impacts a patient’s ability to think clearly, pay attention, or understand what is going on around her. ICU delirium may also lead a patient to see or observe things around her that are not happening.
Experts say ICU delirium can be caused by a number of factors associated with intensive care, the Vanderbilt researchers say, including the following:
  • Less oxygen to the brain
  • The brain’s inability to use oxygen
  • Chemical changes in the brain
  • Certain medicines
  • Infections
  • Severe pain
  • Medical illnesses
  • Alcohol, sedatives, or pain killers
  • Withdrawal from alcohol, nicotine
Different clinical workflows that look at the whole patient body can help address ICU delirium. Additionally, different use of pain management medications, keeping a patient mobile when possible, and whole-body and patient-centered care can address delirium in intensive care patients.
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Patient Engagement Technology Looms Large for 2020 Health Trends

Heading into 2020, healthcare leaders will lean on patient engagement technology to drive patient-centered care principles.

December 27, 2019 - Patient engagement technology will be the name of the game in 2020, as more healthcare providers look toward new and innovative tools to learn more about their patients and address the shift toward consumerism in healthcare.
While patient communication, access to care, and satisfaction all defined 2019, healthcare experts are expecting the industry to take a more technological turn in 2020. Between different healthcare systems that make sense of patient data to new tools that ease patient care access and create a consumer-centered experience, medical professionals can expect the patient experience to go digital this year.
This does not mean efforts to drive a person-centered, compassionate care episode will no longer be important, experts warn. However, as healthcare consumers become more accustomed to a digital front door to other services in their lives, they will expect the same from healthcare. And in an effort to keep up, health systems are going to deliver.
PatientEngagementHIT.com spoke with three leaders in the healthcare field to understand how technology is going to shape their efforts looking ahead into the new year.
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Tracking system enables facility to be aware of staff whereabouts

January 02, 2020, 12:06 a.m. EST
Most hospitals struggle to keep track of their hospital equipment and devices, which can be hidden away in various nooks and crannies of a facility.
That problem can be exponentially more difficult when trying to keep track of mobile hospital staff as they walk the halls and care for patients.
Now, software is being used to help solve the vexing problem of coordinating indoor hospital logistics. It draws together an electronic floor print of a hospital, its wireless network and Apple’s indoor positioning system.
When that technology is combined, it provides real-time visualization and location of staff who carry iPhones equipped with an app from Novatrack. The technology enables managers to monitor staff location from a traffic control center; it also enables them to communicate with them through text messaging.
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Blue Button breach to test CMS response to inappropriate data access

January 01, 2020, 11:48 p.m. EST
In the wake of the data breach at the Centers for Medicare and Medicaid Services, the agency has conducted a review of Blue Button 2.0, an application that Medicare beneficiaries use to access their own personal Medicare claims data.
Nearly 10,000 beneficiaries were affected by the breach as were 30 applications. Sloppy coding and a bug contributed to the breach, as the bug caused beneficiary information to be shared with other beneficiaries. Further, assumptions were made and not validated, and the identity management system was not tested, CMS acknowledges.
The agency reports that no beneficiary Social Security, bank account or credit card numbers were exposed because Blue Button 2.0 does not have access to the information.
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HIT Think

What the House's decision to lift the ban on funding NPI means

January 02, 2020, 3:45 p.m. EST
The House of Representatives recently voted to lift a ban prohibiting funding for a national patient identifier system (NPI) designed to improve patient matching.
So, what does that mean moving forward? Let’s dive into the implications of the House’s vote.
What will an NPI system do?
Now that the House has lifted the ban on the Department of Health and Human Service providing funding a national patient identifier, it’s important to become familiar with exactly what an NPI system is.
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Ransomware attacks in 2019 forced some health systems to pay up

Cybersecurity experts warn healthcare organizations not to pay up for fear of more attacks, but some provider organizations had no choice last year.
January 02, 2020 10:52 AM
Phishing attacks continued to plague health systems around the world in 2019, forcing some provider organizations to pay up in order to get their systems back online. In the meantime, these attacks forced hospitals to revert to paper-and-pen record keeping, underlining how debilitating these attacks can be.
Just last month New Jersey’s Hackensack Meridian Health, one of the state’s largest health systems was forced to pay up following a ransomware attack, even though the health system said the technical issues had been limited to rescheduling a “small number” of non-emergency procedures.

17 hospitals and clinics affected

The organization said it was not aware of any impact to the confidentiality of health information, including patient records, but the attack affected all 17 hospitals and clinics and forced the health system to use paper records as it worked to bring systems back online.
The undisclosed sum paid by the New Jersey health system is covered by an insurance plan that helps it cover costs related to cyber attacks, officials said.
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AI maturation, 5G, augmented reality point to accelerated innovation in 2020

These trends in the new year ahead will see healthcare provider organizations innovating solutions and practices to improve healthcare, one expert predicts.
January 02, 2020 11:21 AM
Healthcare information technology will see many changes in 2020 spurred by newer technologies that will enable CIOs and other healthcare leaders to successfully innovate in various areas of healthcare, predicted Tim Costantino, vice president and head of product at AdvancedMD, a vendor of EHR and practice management software.
First and perhaps foremost, artificial intelligence began maturing in healthcare in 2019, and 2020 will see the complex and useful set of technologies really come of age in the industry, Costantino stated.

AI pushing into the mainstream

“Healthcare AI technology is currently in the testing phase and organizations will continue to push into the broad adoption phase,” he said. “The possibilities are endless; the key is that when done successfully, it won’t even feel like AI. AI will simply be another tool in our toolbox to help payers and providers.”
For example, he mentioned AI-powered practice management assistance: patient acquisition, efficient intake and scheduling, and efficient billing. AI will be able to identify patterns between a practice management activity and the end action and predict behavior moving forward.
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New Module from Esri Takes Aim at Foodborne Illnesses

January 2, 2020
The innovative health team over at ESRI, recently revamped their restaurant inspection module to help public health agencies tackle the challenge of foodborne illness in the United States. With the new module, cities and counties can prioritize facilities most in need of inspection as well as optimize the route taken by inspectors – something that was done previously by gut feel.
According to the CDC, roughly 1 in 5 Americans (48 million people) get sick each year from foodborne illnesses leading to 128,000 hospitalizations and 3,000 deaths. Preventing foodborne illness is the responsibility of three government bodies:
  1. US Department of Agriculture’s Food Safety and Inspection Service, responsible for the meat, poultry and processed egg supply
  2. US Food and Drug Administration, responsible for domestic and imported foods
  3. City/County Governments, responsible for restaurant safety inspections
All three of these government entities face a lack of budget and are in chronic need of additional personnel. By necessity, they must be judicious in how they use their precious resources.
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How Pharmacy Automation Transformed Our Hospital’s Workflows & Bottom Line

January 2, 2020
The following is a guest article by Gee Mathen, Assistant Director of Pharmacy Applications and Technical Services, Texas Children’s Hospital.
The largest children’s hospital in the U.S. has implemented a phased rollout of automation solutions from Omnicell to minimize dosing risks unique to pediatric care, realize real-time inventory visibility and control, and save millions annually.
One succinct way of describing Texas Children’s Hospital (TCH) is that we’re very large and very good. We’re the largest children’s hospital in America, and for ten consecutive years, U.S. News & World Report ranked TCH #4 of 200 pediatric hospitals in the country. This year we rose to the number-three spot.
Constantly striving for excellence of care—which of course most hospitals and health systems aspire to, regardless of their size—comes with an array of challenges. Doing that while operating at massive scale comes with even more. Perhaps nowhere are these challenges more evident than in medication management, where substantial amounts of money are tied up and—more importantly—lives can hang in the balance.
TCH has long been committed to harnessing technological innovations to drive better outcomes. Over the past two years, we’ve deployed a phased implementation of the automated medication management platform from Omnicell, and our vision and investment are already paying off handsomely in improved patient safety, workflow efficiencies, and cost savings.
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ONC: 2015 Certification Edition is aiding SDOH adoption

December 30, 2019, 9:38 p.m. EST
Efforts to ensure that social determinants of health data can be electronically captured, used and exchanged are getting a boost from the federal government’s Health IT Certification Program.
According to the Office of the National Coordinator for Health IT, the agency’s 2015 Edition certification criteria has created a first step for the standardized collection and use of interoperable SDOH data.
“Since the release of ONC’s 2015 Certification Edition, 72 health IT developers have voluntarily certified 93 unique products to an SDOH-oriented certification criterion,” reports the agency.
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Apple, Google, Amazon to work on one language for smart devices

December 31, 2019, 2:06 p.m. EST
Bloomberg—Apple, Alphabet’s Google and Amazon—three of the biggest smart-home and voice-assistant providers—are joining forces to make Internet-connected homes easier to set up and safer to use.
The rivals announced this month that they’re working with the Zigbee Alliance, a foundation that promotes standards for the Internet of Things, and its members, which include Samsung Electronics, Somfy and IKEA, on a new standard that will ensure their products work with one another.
While an increasing portion of the home can now be controlled by a voice-activated speaker or remote app, from thermostats to lights and even refrigerators, “the lack of an industry-wide connectivity standard leaves people confused and frustrated when trying to understand what devices work with each smart home ecosystem,” Nik Sathe and Grant Erickson, engineers at Google’s Nest unit, wrote in a statement. “It also places a heavy burden on manufacturers to make sure all devices are compatible with each other.”
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2020 cybersecurity presents an ever-evolving threat landscape

December 31, 2019, 2:33 p.m. EST
The sheer amount of data and its interconnectedness in 2020—along with the determination of cybercriminals to devise with new ways to access it—will add up to trouble, cybersecurity experts warn.
Clayton Calvert, a consultant at netlogx, an IT security and risk assessment firm, says 2020 will provide “an ever-evolving threat landscape.”
“There is no such thing as complete security, so enterprises are adopting cyber resiliency in order to bounce back quickly from continuous security breaches,” Calvert says. He offers a number of ways that enterprises can be resilient.
One way is to combine machine learning and automation with visibility to fight cyberattacks, such as through the use of security orchestration, automation and response (SOAR) products. “This type of machine learning helps reduce operational errors and helps enterprises self-manage, self-defend, and potentially self-heal against risks and breaches,” Calvert says. “Using technology such as SOAR reduces human error and enables IT teams to focus on other tasks necessary in the enterprise.”
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HIT Think

2019 was a tumultuous year for HIPAA enforcement

December 31, 2019, 2:58 p.m. EST
HIPAA experienced yet another year of attention, questioning and enforcement. The issues around in 2019 were not necessarily new, although arguably approaches are beginning to change.
Getting a handle on the issues may provide a means for better adherence to privacy and security principles contained in HIPAA and improving all overall operations.
From the enforcement perspective, 2019 saw the first two settlements involving the individual right to access as well as settlements based on more of the same. As would be expected, the two settlements for failure to grant access to records fulfilled long-stated promises that individual rights would garner more attention from the Office for Civil Rights.
The first right of access settlement centered on not honoring an individual’s request, giving that individual’s attorney a difficult time, and taking almost a year in total to finally provide the complete record. The first settlement generated a significant amount of attention since problems around right of access have long been known, but without any serious action taken to hold organizations accountable for non-compliance.
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More on Policy and Legislation

Ten years of the Affordable Care Act comes to a close: A look back, and what to expect in 2020

Former President Barack Obama's signature health legislation was passed into law on Dec. 24, 2009, marking a fundamental shift in American healthcare

Jeff Lagasse, Associate Editor
When the ball drops and the clock strikes midnight, it will mark the end of not just the year but the decade. And over these past 10 years, arguably no health policy has received more scrutiny, praise, condemnation, controversy and attention than the Affordable Care Act.
Former President Barack Obama's signature health legislation was passed into law on December 24, 2009, marking a fundamental shift in Americans' access to health insurance. Before this past decade began, Americans had few insurance options beyond what was offered through their employers, and if they were unable to find work, that left them out in the cold.
The primary goal of the ACA was to expand access to insurance coverage, and in that measure it largely succeeded. The law established a Health Insurance Exchange, or marketplace, that offers varying degrees of insurance and at least a semblance of a safety net for those in danger of falling through the cracks.
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EHRs are still a mess for physicians, but change is coming

A chief medical officer says 2020 will be a breakthrough year in making EHRs less stressful for providers if the growing avalanche of data is reigned in with health IT that makes EHRs work better.
December 31, 2019 10:54 AM
Even though the vast digitalization efforts underway across the healthcare industry are aimed at improving care, efficiency and interoperability, a critical piece of the puzzle – electronic health records – are in many cases causing additional stress for clinicians.
With physicians already dealing with mountains of data on a daily basis, there is concern EHRs will not be fully useful unless additional technology that turns the data into actionable clinical information at the point of care also is implemented.

Layers of data within EHRs

Dr. Jay Anders, chief medical officer at Medicomp Systems, which markets artificial intelligence-powered, point-of-care systems designed to enhance EHRs, explained there are more layers of data than ever in EHRs, from more sources than ever.
Much of it is a result of emerging “data wars” between the nation’s tech giants, which are getting more involved in healthcare.
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2020 Hot Topic: SDoH (Social Determinants of Health)

December 31, 2019
Yesterday, we shared a number of hot 2020 topics including Privacy and Security, Medical Coding Standards, and Patient Matching. As mentioned in that article, we got so many thoughts on the future of SDoH, that we decided to share those responses in a separate article. Enjoy these perspectives as you consider how SDoH will play into your plans for the new year.
Adriane K. Martin, DO, FACOS, CCDS Vice President at Enjoin
For decades the impact of various social determinants of health have been examined nationwide and worldwide. Yet, social determinants of health are not routinely addressed in the day to day business of caring for patients. Why? In part, it is the lack of incorporation or clear visibility of these elements in the EHR. Placing social determinants of health into a readily visible portion of the EHR allows the first step in addressing these factors to occur, recognition of a problem. Failure to include social determinants of health into the EHR or making the data difficult to access will prevent routine identification of these elements, which must be addressed to achieve a healthy individual and, ultimately, a healthy population.
Dr. Sanjay Seth, Executive Vice President at HealthEC
The challenge to overcome in SDOH is accurately collecting all the data across all points of entry: patients, hospitals and physicians’ practices. However, getting this data into the EHR is only the first step. Where the industry must focus is implementing survey and assessments instruments within the EHR to give actionable events or interventions based on the data. Risk algorithms must be developed and used for this next step to occur. Furthermore, I predict an expansion in the SDOH. We must move beyond housing, nutrition, transportation and food to also capture and incorporate financial health of the patient and their family.
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End of a Decade Gratitude

December 31, 2019
Hard to believe that we’re at the end of a decade. Even harder to believe that I started blogging about healthcare IT 14 years ago. Next year we’ll be 15 years old and have to do something special to celebrate. However, as we end a decade, I’m just full of gratitude for the Healthcare IT Today community. We really do consider it a community and our proud to be contributing members to the community.
The last decade was extraordinary for us as we grew to over 15 different blogs at the height of meaningful use and when we were trying to figure out what worked and what didn’t. Now, at the end of the decade we’re happy to have everything consolidated in one main health IT media site at Healthcare IT Today.
The number of articles we’ve written is a little murky since it’s across multiple sites and with the consolidation, but we can easily say that we’ve passed 13,000 articles on Healthcare IT Today since our start 14 years ago. We really appreciate long time writers like Anne Zieger, Erin Kennedy, and Andy Oram. Not to mention, newer writers like Colin Hung, Troy Foster, Mike Semel, Mitch Parker, and plenty of guest authors. We’re working with a number of new writers that are going to continue to take the quality of content created on Healthcare IT Today even higher.
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A Reality Check On Artificial Intelligence: Are Health Care Claims Overblown?

By Kaiser Health News  |   December 31, 2019

As happens when the tech industry gets involved, hype surrounds the claims that artificial intelligence will help patients and even replace some doctors.

KEY TAKEAWAYS

·         Health industry experts fear AI-based products won't be able to match the hype.
·         Doctors and consumer advocates fear that the tech industry, which lives by the mantra 'fail fast and fix it later,' is putting patients at risk ― and that regulators aren't doing enough to keep consumers safe.
This story was first published on Monday, December 30, 2019 in Kaiser Health News.
Health products powered by artificial intelligence, or AI, are streaming into our lives, from virtual doctor apps to wearable sensors and drugstore chatbots.
IBM boasted that its AI could "outthink cancer." Others say computer systems that read X-rays will make radiologists obsolete.
"There's nothing that I've seen in my 30-plus years studying medicine that could be as impactful and transformative" as AI, said Dr. Eric Topol, a cardiologist and executive vice president of Scripps Research in La Jolla, Calif. AI can help doctors interpret MRIs of the heartCT scans of the head and photographs of the back of the eye, and could potentially take over many mundane medical chores, freeing doctors to spend more time talking to patients, Topol said.
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Alarm at ‘secret’ NHS meeting with tech firms on sharing patient data

Mark Bridge, Philip Aldrick
December 31 2019, 12:01am, The Times
NHS chiefs held a closed meeting with giant technology and pharmaceutical companies to consider how billions of pounds could be made from a central database of patient records.
The scheme better to harness anonymised medical data would address concerns that the health service had given away intellectual property rights too cheaply in existing deals with companies such as Google’s DeepMind.
Local NHS IT officers have criticised the service’s leaders for discussing it “behind closed doors”, saying that a lack of transparency could erode public trust. The NHS denies acting secretively.
At the meeting in London in October, officials including the chairman and the chief executive of NHS England, Lord Prior of Brampton and Sir Simon Stevens, met representatives of companies including Microsoft, Amazon Web Services and Astrazeneca. NHS data is of great interest and monetary value to US and global companies because of the service’s universal coverage.
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AI offers potential as diagnostic tool for acute myeloid leukemia

December 29, 2019, 11:02 p.m. EST
In the largest metastudy to date on acute myeloid leukemia, German researchers contend that they have demonstrated that artificial intelligence can detect this common and deadly form of blood cancer.
Results of their proof-of-concept study, published in the journal iScience, are based on the analysis of the gene activity of cells found in blood using 12,029 samples from 105 different studies.
“Our results support the notion that transcriptomics combined with machine learning could be used as part of an integrated -omics approach where risk prediction, differential diagnosis and subclassification of AML is achieved by genomics while diagnosis could be assisted by transcriptomic-based machine learning,” state the study’s authors.
Researchers from the German Center for Neurodegenerative Diseases (DZNE) and the University of Bonn leveraged the enormous amount of study data on the gene activity of blood cells, while focusing on the transcriptome—the set of all RNA molecules in one cell or a population of cells.
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Bradford partners with TytoCare to provide virtual consultations for children with acute health conditions

NHS Trust will implement telehealth solution to provide patients remote physical examinations in their homes.
December 30, 2019 05:41 AM
Bradford Teaching Hospitals NHS Foundation Trust will be the first provider in the UK to partner with TytoCare, an all-in-one modular device and telehealth platform for remote medical examinations.
The Trust will carry out a three-month pilot of the TytoCare handheld module examination device to enable remote examinations and diagnoses of a cohort of young patients, with acute and worsening chronic conditions.
In early 2020, the pilot will be evaluated to assess its benefits to the cohort, and its potential for expansion to other patient groups.
The TytoCare device enables clinical grade physical exams of the heart, lungs, skin, ears, throat and abdomen, and measures body temperature and heart rate, to enable remote diagnosis of acute care situations.
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Rather than be an asset, health data can quickly become a liability

A cybersecurity expert discusses how digital risks and the needs of patient care turn health data into a liability, and that CIOs and CISOs must treat data as a living, breathing entity.
December 30, 2019 11:23 AM
Healthcare IT News asked Dr. Zulfikar Ramzan, chief technology officer at RSA Security, a vendor that identifies, assesses, monitors and protects digital assets, to dig deep and identify a healthcare cybersecurity issue that is not one of the common ones, a serious threat that perhaps might be somewhat overlooked. He was all over this question.
“One issue related to security in healthcare settings that keeps me up at night and that is off the beaten path is data liability,” he stated. “Data is the greatest asset of the many modern tech companies peppered throughout Silicon Valley. These organizations gather treasure troves of data about their users and subsist by monetizing it effectively. They pay some of the most intellectually gifted people of our generation lavish salaries to optimize ad placements.”

The difference between life and death

In healthcare settings, patient data is crucial for providing effective treatment. More so, with advances in areas like precision medicine and genomic analysis, the value extracted from sensitive patient data can literally mean the difference between life and death.
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10 years on from meaningful use, major progress despite the challenges

There have been many frustrations with how the federal EHR incentive program was implemented this past decade, but those big government subsidies have enabled headway that might not have happened otherwise.
December 30, 2019 09:00 AM
President Barack Obama signs the American Recovery and Reinvestment Act into law, February 17, 2009. Its HITECH Act provisions infused tens of billions into the health IT industry.
Ten years ago today, on December 30, 2009, the Centers for Medicare and Medicaid Services published the proposed rule outlining how hospitals and physician practices could qualify for Medicare and Medicaid payments from the EHR incentive program.
Meaningful use, as the program became known in the months and years ahead, was a transformative event for the health IT sector – for better and for worse.
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2020 Health IT Predictions – Healthcare IT Today Podcast Episode 27

December 30, 2019
For the 27th episode of the Healthcare IT Podcast, we’re making predictions as to what you should expect to see in health IT in 2020.
Last episode, it was fun to look back at the past decade of health IT. In this episode, Colin and John take a look forward and make some 2020 predictions on what we can expect to see in health IT. It’s a fun look forward since we predict both the successes and disasters we expect to see. Plus, we’ll check back next year and figure out where we were right and where we were wrong.
Here’s a quick rundown of the main topics we’ll discuss in this episode:
  • What Will Be the Biggest Successes in 2020?
  • What Will Be the Biggest Disasters in 2020?
  • Ones to Watch in 2020
  • What We’re Looking Forward to Most in 2020
If you’ve enjoyed this episode of Healthcare IT Today, take a minute to rate and review us on your favorite podcast application. We appreciate every rating and review. Plus, we’d love to get any feedback on the show in the comments, on our Contact Us page, or on Twitter with @techguy or @colin_hung.
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Hot 2020 Health Information Management and Health Information Technology Topics

December 30, 2019
As we head into 2020, I reached out to a number of people in Health Information Management (HIM) and Health Information Technology (HIT) to hear their thoughts on these hot topics: Social Determinants of Health (SDoH), Privacy and Security of Health Information, Medical Coding Standards, and Patient Matching.
Turns out that SDoH was a particularly hot topic, so tomorrow we’ll share the responses we received in regards to SDoH. Today, we’ll share what a number of experts saw coming down the pipe on the other 3 topics. I think you’ll enjoy these insights and perspectives heading into 2020.
Rita Bowen, VP, Privacy, Compliance and HIM Policy at MRO
The hottest  topic for 2020 will be the Information Blocking Rule.  There will be some areas of that rule and HIPAA that may appear in conflict – which will further drive the discussion and need for an update to HIPAA.  I have predicted for sometime now that the US needs something more in line with GDPR, such as what California institutes 1/2020 “CCPA”.
As the Information Blocking Rule encourages the flow of information for patient enhanced management of their own healthcare through the use of health information – we will be seeing increased patient directed flow of their health information to APIs and other support management tools.  Flow of information for quality improvement/population health will be seen via QHINs
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Rapid SMS: 10 years of E-health

Christine Uruvugundi is animatedly engaged with her mobile phone under a tree outside Karwasa Health Centre in Musanze District. She is also looking through a handful of documents on her lap.
She is a community health worker (CHW). Her task is to keep tabs on pregnant mothers from the time the pregnancy is announced until delivery. She also makes follow-ups on malaria cases and other community case management. And she follows up the life of a child after birth in the outskirts of Musanze.
This, Uruvugundi says, was difficult to do until she started using the Rapid SMS programme to convey all the messages related to the state of pregnant mothers, and people with community management cases, to the concerned institutions, mainly those under the Ministry of Health.
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Enjoy!
David.

Friday, January 10, 2020

The Push For Using Your Data Without Your Explicit Consent To Help The Government Manage The Health Sector Just Grinds On!

This appeared last week, with the UK seemingly trying again after the Kelsey led care.data debacle:

Alarm at ‘secret’ NHS meeting with tech firms on sharing patient data

Mark Bridge, Philip Aldrick
December 31 2019, 12:01am, The Times
NHS chiefs held a closed meeting with giant technology and pharmaceutical companies to consider how billions of pounds could be made from a central database of patient records.
The scheme better to harness anonymised medical data would address concerns that the health service had given away intellectual property rights too cheaply in existing deals with companies such as Google’s DeepMind.
Local NHS IT officers have criticised the service’s leaders for discussing it “behind closed doors”, saying that a lack of transparency could erode public trust. The NHS denies acting secretively.
At the meeting in London in October, officials including the chairman and the chief executive of NHS England, Lord Prior of Brampton and Sir Simon Stevens, met representatives of companies including Microsoft, Amazon Web Services and Astrazeneca. NHS data is of great interest and monetary value to US and global companies because of the service’s universal coverage.

According to The Register, a technology website, the meeting discussed the creation of a repository that could be available within two years, bringing together data about all patients in England sourced from GPs, NHS trusts and directly from medical devices — capturing the “full journey of care from cradle to grave”.
By replacing fragmented data repositories with one comprehensive, centralised resource, the intention would be to enable more “effective, efficient and safe patient care”. It could also provide companies and researchers with real-time access to anonymised medical and genetic records, in return for cash or other benefits.
Analysis of the data using artificial intelligence from tech giants could enable earlier diagnoses, the development of new drugs and tracking of wider trends in public health.
A study this year by the consultant EY found that NHS data could be “worth £9.6 billion a year through operational savings, improved patient outcomes and economic benefits”. That breaks down as £5 billion of benefits to the NHS and £4.6 billion to patients. NHS England disputes the estimates.
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Analysis
There is enormous value to be had from NHS patient records, both in improved health and by creating a life science industry that uses data to develop new cures.
No country has such a large cradle-to-grave single provider healthcare system as the UK. If data is curated well, artificial intelligence can be used to defeat disease. EY estimates that the annual benefit to the UK could be £10 billion in both better patient outcomes and stronger economic growth. But it will not be easy. First, personal medical records must be handled extremely sensitively. Second, the benefits will only be realised by investing in systems that are useable by algorithms. Healthcare experts estimate that a fully traceable database may cost £5 billion.
The government lacks the funds and expertise to deliver this, which is why it is talking to tech giants. The Amazons and Microsofts have deep pockets and the skills. They are now in the early stages of discussing commercial terms with the NHS. Vitally, this process must be transparent. In 2016, a similar data sharing programme, Care.Data, was ditched over concerns that patient records would be sold to insurers. The government has since published a commercial partnership framework for data sharing. One firm, Sensyne Health, has even given the NHS a tenth of its equity in return for data access. It’s a start, but leaked stories about secret meetings with US tech companies do the government no favours — it must be an honest advocate.
More here:
The one thing that will save us in Australia is that the data held in the #myHealthRecord is of such low quality and so incomplete it will be hard to make any real sense of it.
If you value your health information privacy it would be sensible to distance your self from the system as far as possible.
David.