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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Why the NHS might never procure another electronic patient record
There is a new option for NHS digital leaders that is turning heads, that will re-energise the health tech landscape, and that will orchestrate digital strategies, writes Lynette Ousby, UK general manager for Alcidion.
Hanna Crouch - 9 July, 2020
Imagine you are the chief digital officer for one of England’s integrated care systems. Your mission is to create a cohesive flow of digital information across the providers in your geographical footprint. And then – rather than having that information just sitting in records – you want to turn it into something proactively useful for every healthcare professional and patient.
Extremely disjointed existing IT across your ICS footprint makes this challenge even harder. One NHS trust might have an ageing patient administration system and a best of breed digital strategy. Surrounding trusts might have implemented an array of electronic patient record systems, each with different levels of capability.
So, as the CDO, are you tempted to just start over with a new system across the region? Many might be.
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https://healthitanalytics.com/news/forecasting-covid-19-with-predictive-analytics-big-data-tools
Forecasting COVID-19 with Predictive Analytics, Big Data Tools
Using big data resources, CommonSpirit Health developed predictive analytics models to prepare for COVID-19 surges.
By Jessica Kent
July 07, 2020 - In the midst of a situation as uncertain as the COVID-19 pandemic, the healthcare industry has sought to use big data and predictive analytics tools to better understand the virus and its spread.
Hospitals and health systems have leveraged predictive models to gain insight into COVID-19 risk, disease outcomes, and the virus’ potential impact on resources.
However, even with the most comprehensive data and predictive algorithms, the novelty of the pandemic means that the industry is still largely left in the dark.
“This is new to all of us. COVID-19 is a disease we've never seen – it's only been on the planet that we know of for maybe six to eight months,” said Joseph Colorafi, MD, System VP of Clinical Data Science for CommonSpirit Health.
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Jul 09, 2020
Insurers need flexibility in benefit design to continue telehealth past the public health emergency
CMS Administrator Seema Verma: The Centers for Medicare and Medicaid Services needs help from Congress to make temporary flexibilities permanent.
Susan Morse, Managing Editor
Policymakers must allow for flexibility in benefit design for insurers to continue covering telehealth after the public health emergency ends, according to America's Health Insurance Plans.
Regulatory barriers to telehealth access include restrictions around geography, originating sites and state licensure requirements.
Also, telehealth visits should be clinically compared to in-person care and therefore be counted towards network adequacy requirements, risk adjustment calculations and quality measurement, AHIP said.
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July 8, 2020
Protecting your remote workforce from application-based attacks like consent phishing
The global pandemic has dramatically shifted how people work. As a result, organizations around the world have scaled up cloud services to support collaboration and productivity from home. We’re also seeing more apps leverage Microsoft’s identity platform to ensure seamless access and integrated security as cloud app usage explodes, particularly in collaboration apps such as Zoom, Webex Teams, Box and Microsoft Teams. With increased cloud app usage and the shift to working from home, security and how employees access company resources are even more top of mind for companies.
While application use has accelerated and enabled employees to be productive remotely, attackers are looking at leveraging application-based attacks to gain unwarranted access to valuable data in cloud services. While you may be familiar with attacks focused on users, such as email phishing or credential compromise, application-based attacks, such as consent phishing, is another threat vector you must be aware of. Today we wanted to share one of the ways application-based attacks can target the valuable data your organization cares about, and what you can do today to stay safe.
Consent phishing: An application-based threat to keep an eye on
Today developers are building apps by integrating user and organizational data from cloud platforms to enhance and personalize their experiences. These cloud platforms are rich in data but in turn have attracted malicious actors seeking to gain unwarranted access to this data. One such attack is consent phishing, where attackers trick users into granting a malicious app access to sensitive data or other resources. Instead of trying to steal the user’s password, an attacker is seeking permission for an attacker-controlled app to access valuable data.
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https://healthitsecurity.com/news/rwjf-manatt-share-consumer-health-data-privacy-framework
RWJF, Manatt Share Consumer Health Data Privacy Framework
Several privacy groups like eHI and the Center for Democracy & Technology are also working on a consumer health data privacy framework that will pull from RWJF and Manatt insights.
July 09, 2020 - The Robert Wood Johnson Foundation and Manatt Health recently released a consumer Health Data Privacy Framework designed to address some of the gaps in existing health data privacy protections, as well as steps the industry could take to advance these priorities.
As noted by the Department of Health and Human Services, HIPAA regulations do not cover third-party health apps and other consumer health data generated from wearables and other devices chosen by the patient and not tied to or recommended by a healthcare provider.
In May, the American Medical Association released its own insights for non-HIPAA covered entities to address similar gaps. HIPAA was enacted long before these apps and wearables grew in popularity. Thus, industry stakeholders have long warned the privacy regulation needs an update to address these gaps.
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U.S. contact-tracing efforts on Covid-19 falter on privacy worries, technology gap
Published: July 9, 2020 at 5:17 p.m. ET
By Amy Sokolow
Fears of ‘big gov’ and ‘big tech’ hamper contact-tracing apps
Countries such as South Korea have curbed the coronavirus by using contact-tracing phone apps, but the U.S. has stalled in its own efforts because of privacy concerns and other hurdles.
One of the biggest challenges, experts told a congressional panel this week, is dispelling the unease people feel about the government or private companies gaining access to their personal data.
Efforts to use GPS-based contact tracing apps in states such as Utah and North Dakota, for instance, faltered after residents raised a number of concerns.
“The biggest one was fear that either ‘big gov’ or ‘big tech’ was tracking anyone who installed it.”
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Imperial College London to launch COVID-19 information platform
The new project will build a global information knowledge platform to help the healthcare industry deliver more efficient care to COVID-19 patients.
By Sara Mageit
July 10, 2020 10:04 AM
A new platform led by Imperial College London and enabled by Amazon Web Services (AWS) will pool global data on COVID-19 from over half a million sources in response to the ‘infodemic’.
The platform is called REDASA (REaltime Data Analysis and Synthesis) and is being developed by PanSurg, a COVID-19 surgical network made up of Imperial College London’s healthcare professionals and academics.
An excessive amount of information has been seen amidst the COVID-19 outbreak, making it hard for people to find trustworthy sources.
The World Health Organisation has described it as an ‘infodemic’, stating that it has created “an overabundance of information – some accurate and some not – that makes it hard for people to find trustworthy sources and reliable guidance when they need it”.
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UK's Great Ormond Street becomes the first hospital in Europe to attain Stage 6 of both EMRAM and O-EMRAM
The UK children’s hospital has now set its sights on achieving Stage 7 O-EMRAM.
By Tammy Lovell
July 10, 2020 11:58 AM
London’s Great Ormond Street Hospital (GOSH) was awarded Stage 6 on the EMRAM and O-EMRAM by HIMSS this week, making it the first hospital in Europe to achieve both validations.
EMRAM, or the Electronic Medical Record Adoption Model, measures the adoption and maturity of a health facility’s inpatient EMR capabilities from 0 to 7, while O-EMRAM measures its outpatient capabilities.
John Rayner, regional director for EMEA at HIMSS, praised GOSH for its good use of structured data in the outpatient department and said that its clinicians used the flexibility of the EPIC system to the maximum.
The hospital is now looking to achieve O-EMRAM Stage 7 as soon as possible, he added.
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https://www.dawn.com/news/1568273/digital-health
Digital health
Jul 11 2020
ON World Population Day as the Covid-19 pandemic rages on, upending lives and lifestyles, there should be a realisation that healthcare providers have had to come up with creative solutions to provide uninterrupted services to the most vulnerable populations, including pregnant women and new mothers.
A disruption in family planning services and supplies can lead to untold tragedies. This may result in a spike in unexpected pregnancies, unsafe abortions, pregnancy-related complications and even maternal deaths. Launched just ahead of World Population Day, a report by the UNFPA warns that if services and programmes for women remain closed for six months, an additional 13 million girls may be forced into marriage between now and 2030.
While the state grappled with whatever semblance of an on-the-ground healthcare system it had to battle the virus, the digital revolution quickly jumped into the fast lane. With social distancing an important measure to contain the coronavirus, e-health became all the more necessary to ensure safety of both healthcare providers and patients seeking medical advice.
Many physicians and private hospitals began offering consultations electronically using videoconferencing services. Digital health applications that help find nearby doctors, offer home consultations, order medicines, and even help find blood donors, were rolled out rapidly.
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https://www.healthcareittoday.com/2020/07/10/whats-being-missed-in-healthcare-it/
What’s Being Missed in Healthcare IT?
July 10, 2020
Understatement of the Day: COVID-19 has overwhelmed healthcare.
Turns out that this is a reality regardless of whether your healthcare organization has been hit by an influx of COVID-19 patients or not. The overwhelming feeling applies regardless of where you work in healthcare as well. I don’t know of any healthcare department that hasn’t had everything turned upside down due to COVID-19. Not to mention the wear and tear we’ve all felt in all personal lives.
In most cases, it’s amazing what healthcare organizations have done to deal with the pandemic. Temporary hospitals literally thrown up over night. The shift to remote work wherever possible over night. New protocols created, revised, and then created again. Bureaucracies that disappeared over night (ok, so there were some good things, but also take a toll). It’s exhausting just thinking about how much COVID-19 has consumed our mindshare.
As a glass half full kind of person, we’ve no doubt seen some massive benefits to healthcare including:
- Massive Telehealth Adoption
- The Opportunity to Create New Digital Front Doors
- The Benefits of Remote Work Proven Out
- A Chance to Rethink Important Aspects of Healthcare? (I hope this plays out)
While we can see a number of great things happening and it’s totally understandable that people are overwhelmed, I wondered what’s also being missed since our focus and attention has shifted so much to dealing with COVID-19?
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https://patientengagementhit.com/news/top-remote-technologies-for-chronic-disease-management
Top Remote Technologies for Chronic Disease Management
Healthcare is becoming increasingly remote, at least where possible. What are the best technologies to support chronic disease management?
By Sara Heath
July 08, 2020 - As the healthcare industry quickly tips toward a largely remote business, providers are confronted with a key challenge: how can they engage their chronic disease management populations?
Individuals with a chronic illness have long required a high-touch patient engagement strategy, with providers bringing these patients in regularly for health check-ins, health coaching, and overall disease monitoring. This approach has sought to prevent patients from experiencing an acute care episode by addressing smaller problems at short intervals.
But as the industry continues to become more remote, both in an attempt to drive convenience for patients and cut down on clinic foot traffic, providers need to pivot that high-touch engagement strategy.
That does not mean switching high-touch in exchange for low-touch engagement. Instead, it means having high-touch go virtual. Providers will need to lean on a suite of patient engagement technologies for remote chronic disease management.
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https://healthitsecurity.com/news/microsoft-sues-now-controls-covid-19-phishing-campaign-domains
Microsoft Sues, Now Controls COVID-19 Phishing Campaign Domains
Recently unsealed court documents shed light on Microsoft’s efforts to block a massive phishing campaign tied to COVID-19 themes directed at business leaders from 62 countries.
July 08, 2020 - The US District Court for the Eastern District of Virginia recently unsealed court documents that reveal efforts of Microsoft to put an end to a massive COVID-19-themed phishing campaign targeting business leaders from 62 countries.
The judge issued a civil court order that allowed the tech giant to take control of the key internet domains used in the criminal infrastructure, as well as a temporary restraining order. The hackers behind this campaign are referred to as “John Doe.”
“In cases where criminals suddenly and massively scale their activity and move quickly to adapt their techniques to evade Microsoft’s built-in defensive mechanisms, additional measures such as the legal action filed in this case are necessary,” Microsoft researchers wrote.
“This unique civil case against COVID-19-themed BEC attacks has allowed us to proactively disable key domains that are part of the criminals’ malicious infrastructure, which is a critical step in protecting our customers,” they added.
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https://ehrintelligence.com/news/how-ai-scribes-streamline-ehr-documentation-clinician-workload
How AI Assistants Streamline EHR Documentation, Clinician Workload
After trying everything from human scribes, to automated scribes, OrthoIndy Hospital cut off all after-hours EHR documentation with a mobile AI assistant.
July 07, 2020 - Clinicians at OrthoIndy Hospital, Indiana’s first orthopedics specialty hospital and one of the largest of its kind in the country, were spending up to three hours after work and even over the weekend to complete EHR-related tasks. However, after the practice implemented a mobile artificial intelligence (AI) assistant into its EHR, after-hours charting and documentation was a thing of the past.
“When I first started in practice 30 years ago, the medical record was to remind the doctor of when the patient came in for last time, what the direction was, and what the plan is going forward,” Timothy Dicke, MD, president and CEO of OrthoIndy, said in an interview with EHRIntelligence.
“It’s turned into something completely different. It turned into a report card for the government. It turned into a billing measure for the insurance record. If you didn't dot all the Is, and cross all the Ts, and have all the different templated blocks filled in, you did not have a note.”
Dicke explained the EHR did nothing to improve the patient encounter, but in reality, it just added more time to the clinician workday.
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Telemedicine is booming during the pandemic. But it’s leaving people behind.
We’re making things harder than we should for too many patients
By Daniel Horn
Daniel Horn, MD is a primary care physician and director of population health for the Division of General Internal Medicine at Massachusetts General Hospital.
July 9, 2020 at 8:00 p.m. GMT+10
Recent headlines have touted the expansion of telehealth as an unexpected “benefit” of the coronavirus pandemic, and policymakers are examining ways to keep it in play after the virus retreats. However, the widely hailed telehealth revolution is leaving our most vulnerable patients behind. Unless health-care systems commit to deploying video technology that is explicitly designed to provide care for our most vulnerable patients, telehealth will further entrench health disparities.
During the pandemic, I was tasked by our physician in chief with implementing telehealth tools at more than two dozen primary care practices serving over 200,000 patients in eastern Massachusetts. I worked with practices in our downtown Boston campus, in the greater Boston suburbs and, most meaningfully, our community health centers. These health centers are located in communities that have borne the brunt of covid-19 cases and that care for disproportionate numbers of patients with limited English proficiency, immigrants and refugees, essential workers and patients for whom social determinants such as lack of stable income, housing and food are key drivers of poor health outcomes. Most patients are insured by Medicaid.
Early data show that adoption of telehealth in our community health centers has paled in comparison to practices caring for more affluent patients. From April 1 to June 1, the volume of primary care telehealth visits at the three large community health centers owned by Massachusetts General Hospital went from 600 visits to 880 visits weekly. Over that same period, our downtown Boston and suburban primary care clinics nearly doubled their weekly telehealth visit volumes, from 1,100 to 2,080.
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https://ehrintelligence.com/news/cpoe-systems-cds-tools-negatively-impacting-ehr-alerts
CPOE Systems, CDS Tools Negatively Impacting EHR Alerts
EHR flags from CPOE systems and CDS tools are “over-alerting” clinicians, resulting in clinician burden and alert fatigue.
July 08, 2020 - Hospitals are increasing clinician burnout due to a high number of EHR alerts from computerized physician order entry (CPOE) systems and clinical decision support (CDS) tools, according to a study published in The Journal of Informatics in Health and Biomedicine (JAMIA).
Researchers found providers can improve clinician safety and care quality by reducing the number of EHR alerts for nuisance orders and fatal orders.
CPOE adoption has become more common since the HITECH Act in 2009.
Ninety-six percent of hospitals that use CPOE systems also have clinical decision support (CDS) tools. The CDS tool enables prescribers to access real-time patient data, ideally resulting in enhanced patient safety and medication accuracy. CDS can also alert the prescriber about potential patient warnings to prevent errors and additional adverse drug events from happening.
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Groups urge Congress to take action on patient identifier as COVID-19 raises the stakes
Jul 8, 2020 9:52am
Patient identity and matching problems are not new to healthcare. But the COVID-19 pandemic has raised the stakes, healthcare leaders say.
The failure to accurately identify patients to their data raises patient safety and quality of care concerns, such as the wrong lab results being attached to a patient's record or patients receiving the wrong medication.
In the current health crisis, mismatched patient records can also hamper public health efforts to respond to the coronavirus and address health inequities.
"COVID-19 highlights the importance of health IT and data and it's more important than ever to solve our country’s patient misidentification problem," said Wylecia Wiggs Harris, M.D., CEO of the American Health Information Management Association (AHIMA), speaking Tuesday during a virtual Capitol Hill briefing.
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https://www.healthaffairs.org/do/10.1377/hblog20200701.58142/full/#.XwXfZOuMH6A.twitter
Measure The Impact Of The ONC’s New Interoperability Rules Now
July 7, 2020 10.1377/hblog20200701.58142
On May 1, the Office of the National Coordinator for Health Information Technology (ONC) published landmark regulations to improve health data access and interoperability for patients, providers, and app developers, using a standardized application programming interface (API) infrastructure. This new rule implements provisions of the 21st Century Cures Act of 2016. In concept, the regulations take a giant leap forward. In practice, they might fall short of the nation’s goals. How will we know? How can we spot gaps and make timely corrections?
Regulations drive behavior change when markets and actors are not meeting policy objectives. In this case, those objectives include exchange and use of electronic health information without special effort and patient access to electronic health information in a single, longitudinal format. The structural issues here include health data interoperability, access, and information blocking; the actors include electronic health record (EHR) vendors, providers, health app developers, and patients. Concerns motivating the new regulations have centered on behaviors by EHR vendors and hospitals that impede nationwide interoperability—some intentional (information blocking) and some unintentional or systemic (no consensus on the API standard to implement). In addition, vigorous debate and opposition to the new regulations from some (but not all) stakeholders raise concerns that some may seek opportunities to delay or undermine the final regulations’ intent. Moreover, the new regulations only set a minimum standard. They create a foundation upon which the private and public sectors can continue building toward an interoperable learning health ecosystem that supports remote patient monitoring, shared care planning, and social determinants of health data. Thus, we must be able to gauge whether focal actors—in particular, EHR vendors and providers—are engaging in the desired behaviors, and at what levels, to meet national imperatives Congress set out in the Cures Act.
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https://www.healthcareitnews.com/news/scotus-ruling-will-make-it-harder-patients-get-birth-control
SCOTUS ruling will make it harder for patients to get birth control
Providers who e-prescribe birth control through apps and online pharmacies doubt the decision will significantly affect their practices, but they say the mandate is harmful for those who need contraception.
By Kat Jercich
July 09, 2020 09:15 AM
On Wednesday, the U.S. Supreme Court ruled in a 7-2 decision that businesses and universities with religious or moral objections to providing employees with insurance coverage for contraception can deny that coverage.
In their dissent, Justices Sonia Sotomayor and Ruth Bader Ginsburg wrote that the judgment means between 70,500 and 126,400 women will lose access to no-cost birth control.
Providers who prescribe birth control through apps and online pharmacies say the ruling is unlikely to significantly affect their practices. But they stress the importance of patients being able to make their own reproductive decisions – and fear that the judgment will make it harder for patients, especially those who rely on insurance, to get birth control.
"We’re deeply disappointed by the court’s ruling on the ACA contraceptive mandate. Cost is one of the biggest barriers when it comes to birth control," said Dr. Amy Roskin, head of clinical operations and medical director at the birth control prescription and delivery service Pill Club.
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https://www.healthcareitnews.com/blog/why-patient-experience-matters-and-how-improve-it
Why patient experience matters – and how to improve it
Move over patient engagement: A positive patient experience is the new imperative for health systems that recognize the value of customer satisfaction.
July 09, 2020 09:22 AM
Hospitals and healthcare organizations have been developing patient engagement strategies for decades, if not longer. Traditionally, the patient experience has been important, but clinical outcomes have been the main measure for the effectiveness of an organization’s capabilities.
The sands are now starting to shift. The patient experience is showing up as a top priority for most healthcare CEOs. So what has changed that is pushing the envelope on creating new transformational activities around exceptional patient experience?
Consumer demand Is the driving force
Patient expectations regarding their "experience" has changed dramatically in the last several years. This is not to say that clinical outcomes will be less important, but now patients are looking for exceptional engagement and experiences to tie in with the strong clinical outcomes.
In my opinion, there are a few drivers for this shift. First, most patients have become more digital-centric and self-reliant with technology. Most patients now carry smart phones and have WIFI networks set up at their homes. The use of the internet has become commonplace.
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NHS clinicians given free access to online health and care video library
An online video library which covers a wide selection of topics, conditions and procedures has been made available to NHS clinicians and patients.
Hanna Crouch – July 9, 2020
The Health and Care Video Library has been produced by digital health agency Health and Care Innovations (HCI), in partnership with Torbay and South Devon NHS Foundation Trust.
The library of more than 600 health and care videos have all been written by NHS clinicians and developed to work within care pathways.
A six-month licence for the video library for has been secured by NHSX. The library will form part of NHSX’s Covid-19 response and will be made available to NHS staff.
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https://ehrintelligence.com/news/disease-severity-is-a-main-cause-of-duplicated-ehr-problem-lists
Disease Severity is a Main Cause of Duplicated EHR Problem Lists
EHR problem lists saw a positive correlation with disease severity and incompleteness, resulting in clinician burden.
July 06, 2020 - Demographics and disease severity are linked to both the incompleteness and duplication of EHR problem lists, according to a study published in the Journal of Informatics in Health and Biomedicine (JAMIA).
Poor EHR usability, lack of interoperability, and data entry burden have all negatively impacted its users. In return, those issues have led to clinician burnout and a decrease in patient care quality.
Because of those shortcomings, EHR documentation has also been negatively impacted. In particular, problem lists are scattered and sometimes either incomplete or duplicated. Problem lists are crucial to clinicians because they summarize each patient’s medical issues in one location.
According to a separate study noted by the authors, problem list completeness for patients with diabetes ranged from 60 percent to 99 percent, depending on financial incentives and “positive deviance” factors.
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https://ehrintelligence.com/news/3-factors-leading-to-an-increase-of-ehr-inbox-message-volumes
3 Factors Leading to an Increase of EHR Inbox Message Volumes
The number of patients, the average income of patients, and hours worked by primary care physicians result in an increase of EHR inbox messages.
July 03, 2020 - Primary care physicians who manage a larger patient panel, work more days per week in primary care, and care for wealthier patients, experience greater EHR inbox message volumes, according to a study published in the Journal of the American Board of Family Medicine (JABFM).
Beginning with the spread of EHR adoption, managing an EHR inbox has become a regular part of clinician workflow, oftentimes resulting in clinician burden.
According to the study, primary care physicians experience an alarming number of EHR inbox messages that oftentimes result in more than an hour of added work per day.
While numerous studies have been completed on the volume of inbox messages and burnout, researchers wanted to know the correlation between the volume of inbox messages and whether it is impacted on patient panel size, hours worked by the primary care physician, and socioeconomic status of the physician’s patients.
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VA inks 10-year, $100M deal with Philips for remote critical care services
Jul 8, 2020 4:30pm
The Department of Veterans Affairs has inked a $100 million contract with Philips to extend its remote intensive care capabilities.
As part of the 10-year contract, the VA will work with Philips to enhance telehealth technology and services, including tele-ICU, diagnostic imaging, sleep solutions, and patient monitoring, to improve care for veterans.
The contract enables VA to invest up to $100 million with Philips, according to a release.
Together, the organizations will build the world’s largest telehealth critical care system to provide veterans remote access to intensive care expertise, the VA said. The VA manages 1,800 ICU beds nationwide across its more than 1,700 care sites.
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Pence, Azar reassure governors Trump won't end virus emergency declaration
Governors and public health officials have warned the country's virus response would be damaged if Trump lets the public health emergency expire later this month.
Vice President Mike Pence and HHS Secretary Alex Azar strongly indicated to governors that the Trump administration will extend the coronavirus public health emergency before it expires later this month, providing the firmest assurances yet the administration won’t pull back the declaration as infections continue to surge.
In a private call between White House coronavirus task force officials and state leaders, Maryland Republican Gov. Larry Hogan, who chairs the National Governors Association, raised the issue of the expiring public health emergency. Azar said it was likely the emergency would be renewed but stopped short of a firm commitment, according to three sources familiar with the call.
Pence added that the state leaders should be "at ease" that an extension of the emergency declaration is in the works, two of those sources said — though one cautioned that the White House has yet to finalize the decision.
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https://ehrintelligence.com/news/regenstrief-implements-new-set-of-covid-19-dataset-codes
Regenstrief Implements New Set of COVID-19 Dataset Codes
There will now be over 150 new LOINC dataset codes that are linked to COVID-19.
July 08, 2020 - Health IT professionals at Regenstrief Institute have added new COVID-19 standardized codes for laboratory testing and clinical observations to the Logical Observation Identifiers Names and Codes (LOINC) dataset.
LOINC aims to streamline health data standardization for more efficient EHR use and health data exchange, which is key when a pandemic such as COVID-19 occurs.
As one of the most widely-used code systems, LOINC seeks to provide standardization in medical test result identification, observations, and a variety of other clinical measures. LOINC promotes interoperability with new terms for tests and clinical observations available through requests from end users.
LOINC, which has users in 179 countries, added over 1,200 new standardized terms, with roughly 150 codes affiliated to COVID-19.
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July 8, 2020 / 3:07 AM /
U.S. tops 3 million known infections as coronavirus surges
Callaghan O'Hare, Lisa Shumaker
HOUSTON (Reuters) - The U.S. coronavirus outbreak crossed a grim milestone of over 3 million confirmed cases on Tuesday as more states reported record numbers of new infections, and Florida faced an impending shortage of intensive care unit hospital beds.
Authorities have reported alarming upswings of daily caseloads in roughly two dozen states over the past two weeks, a sign that efforts to control transmission of the novel coronavirus have failed in large swaths of the country.
California, Hawaii, Idaho, Missouri, Montana, Oklahoma and Texas on Tuesday shattered their previous daily record highs for new cases. The biggest jumps occurred in Texas and California, the two largest U.S. states, with more than 10,000 each. About 24 states have reported disturbingly high infection rates as a percentage of diagnostic tests conducted over the past week.
In Texas alone, the number of hospitalized patients more than doubled in just two weeks.
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https://www.healthcareitnews.com/news/europe/asda-launches-virtual-store-gp-service-medicspot
Asda launches virtual in-store GP service with Medicspot
Medicspot has announced a partnership with Asda to offer in-store GP video-consultations in the latest expansion of digital primary care services.
By Sara Mageit
July 07, 2020 08:35 AM
Digital healthcare company Medicspot has partnered with British supermarket retailer, Asda to offer in-store GP video-consultations with diagnostics.
The diagnostic devices are designed to be used by the patient with instruction from the doctor on screen.
Medicspot will initially offer the service free of charge to Asda customers to help support those who are having difficulties getting a GP appointment amid the COVID-19 crisis.
WHY IT MATTERS
The partnership will see Asda become the first UK supermarket to offer in-store GP service, allowing customers to see a GP and collect their prescription when visiting the supermarket.
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https://www.healthcareitnews.com/news/how-wearable-tech-can-enable-seamless-rpm-during-covid-19
How wearable tech can enable seamless RPM during COVID-19
Patients have generally gone to their doctor's offices to obtain remote monitoring devices – but the pandemic is proving they don't have to.
By Kat Jercich
July 08, 2020 09:22 AM
At least 2.7 million people in the United States have atrial fibrillation, or an irregular heartbeat sometimes known as AFib. According to the American Heart Association, the risk for strokes among people with untreated AFib is five times as high as for those without. They are also twice as likely to die of a heart-related condition.
Even so, says Judy Lenane, chief clinical officer for iRhythm Technologies, many AFib patients don't even know they have it.
"If we could identify who's at risk – who would benefit from being identified before they have their first stroke – that's what we get excited about," said Lenane.
iRhythm, a San Francisco-based med tech company, combined remote-monitoring and analytics technologies with its Zio wearable patches. As a viable way to detect AFib among patients with increased risk but no known heart rhythm issues, the Zio patches offer an alternative to traditional – often unwieldy – cardiac-monitoring hardware.
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https://patientengagementhit.com/news/experiences-of-racism-can-lead-to-chronic-illness-hypertension
Experiences of Racism Can Lead to Chronic Illness, Hypertension
Researchers found individuals reporting experiences with racism were more likely to develop hypertension as a chronic illness.
By Sara Heath
July 02, 2020 - New data out of the American Heart Association is showing a link between experiencing discrimination and racism and developing high blood pressure, underscoring race as a key social determinant of health.
The study, published in AHA’s journal Hypertension, revealed that black patients in Mississippi who experienced moderate discrimination throughout their lifetimes were more likely to develop hypertension than black patients who reported low levels of discrimination.
“Previous studies have shown that discrimination affects African Americans’ health; however, this research is one of the first large, community-based studies to suggest an association between discrimination over a lifetime and the development of hypertension among a large sample of African American men and women,” said Allana T. Forde, PhD, MPH, the study’s first author and a postdoctoral research fellow at the Urban Health Collaborative at Drexel University in Philadelphia, Pennsylvania.
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https://ehrintelligence.com/news/paper-health-records-still-prevalent-at-substance-abuse-facilities
Paper Health Records Still Prevalent at Substance Abuse Facilities
While substance abuse facilities are still using paper health records, 72 percent of federal government substance abuse facilities are strictly using EHRs to store and exchange patient health data.
July 07, 2020 - Three-in-ten substance abuse treatment facilities strictly use EHRs to store and exchange patient health data, while 57 percent of facilities utilize both paper records and EHRs to demonstrate the same capabilities, according to a recent ONC data brief.
ONC used this data from the Substance Abuse and Mental Health Services Administration (SAMHSA) 2017 National Survey of Substance Abuse Treatment Services (N-SSATS). The survey was completed by 13,385 active SUD treatment facilities across the country about how they utilize health IT to exchange or store health information.
Thirty-seven percent of hospital-affiliated SUD treatment facilities respondents strictly use EHRs to store and exchange data, while only 28 percent of unaffiliated SUD treatment facilities use EHRs. The findings also showed 10 percent of hospital-affiliated SUD treatment facilities use paper health records, while 14 percent of unaffiliated SUD treatment facilities use paper records.
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Major Medical Groups Urge Americans to Wear Face Masks
MONDAY, July 6, 2020 (HealthDay News) -- Three major medical groups are urging Americans to wear face masks, wash their hands and practice social distancing as coronavirus cases continue to surge in the United States.
In an open letter to the public released Monday, the groups noted that stay-at-home orders and other social distancing policies curbed the spread of COVID-19 in the spring.
"But in the weeks since states began reopening, some of the steps that were critical to the progress we made were too quickly abandoned. And we are now watching in real-time as a dramatic uptick in COVID-19 cases is erasing our hard-won gains," stated the letter from the American Medical Association, the American Hospital Association, and American Nurses Association.
"Hospitals in some states are at or nearing their ICU capacity. Shortages of personal protective equipment and testing supplies continue to pose a dire threat to health care workers and patients alike," the letter said. "And last week, Dr. Anthony Fauci told Congress that the U.S. could see 100,000 new coronavirus cases each day if we do not take more precautions.
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https://www.healthcareitnews.com/blog/dirty-data-ehrs-could-cause-unnecessary-expenses
'Dirty' data in EHRs could cause unnecessary expenses
When working with big data, small inconsistencies in data entry matter. Leaving the task of cleaning up registration or demographic data to data scientists or IT staff will be expensive.
July 07, 2020 04:30 PM
The health IT landscape is changing at a rapid pace, and with this change there is critical work to be done to enhance data integrity and prevent unnecessary expense.
With the urgent need for telemedicine some vendors have had to change their course abruptly; some stayed the course but are working faster and harder to get their product to market.
Prior to the COVID-19 outbreak, there were physician practices in the middle of implementing new EHR systems. These projects slowed down during the stay at home mandates, and hopefully project managers took that time to rethink implementation strategies and reengineer system configuration for the physicians’ upcoming workflow changes.
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https://www.healthcareittoday.com/2020/07/07/docdoc-helps-patients-discover-providers/
DocDoc Helps Patients Discover Providers
July 7, 2020
You would think matching patients with the best available provider would be easy with the data and intelligent algorithms we have at our collective disposal. It isn’t. For one, the data required from both patients and providers is siloed and not readily accessible. In addition, there is a lack of momentum by insurance companies to innovate in this area.
One company is seeking to change this in southeast Asia – DocDoc.
Co-founded by the husband and wife duo, Grace Park and Col Sirucek, DocDoc is doing for patients in Asia what Armada Health is doing in the US – use science to better match patients to providers with superior outcomes at lower cost.
For Park and Sirucek, their journey started when their daughter (Rand) was just 3 months old. They brought her to the local hospital in Singapore when they noticed she was jaundiced. That led to a battery of tests which revealed she had a rare liver condition. Park and Sirucek were told that Rand’s liver was failing and that she needed a liver transplant immediately in order to buy her time.
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Telecritical Care Expands Telehealth From the ICU to Where It’s Needed
During a panel session at the American Telemedicine Association's recent virtual conference, experts from two large health systems explained how telehealth improves care for complex patients no matter where they are.
July 01, 2020 - As healthcare providers launch telehealth programs to improve critical care management and coordination, they’re seeing value far beyond the ICU.
Indeed, as the coronavirus pandemic taxes hospital resources and a growing shortage of critical care doctors becomes more apparent, hospitals and health systems are deploying telemedicine technology to treat patients wherever they’re located.
“This is telehealth at a different level,” said Jeff Guy, MD, MSc, MMHC, FACS, vice president of Emergency and Critical Care Services with HCA Healthcare, a Nashville-based network of some 186 hospitals and more than 2,000 care locations in both the US and UK.
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mHealth Sensors Help Hospitals Monitor Vitals in In-Patient Units
Michigan-based Covenant HealthCare is using a telehealth platform to monitor patients in the hospital. The smart bed technology alerts staff to patients in distress, enabling them to take action more quickly.
July 02, 2020 - A Michigan hospital is using mHealth sensors attached to a patient’s bed to remotely monitor vital signs, and executives see a future for the telehealth platform that goes beyond the success they’re seeing in taking care of COVID-19 patients.
“It means a lot to our staff and our patients,” says Nancy Riffel, MSA, BN, RN, the patient services manager at Covenant HealthCare. “I definitely see a lot of potential going forward. It adds another element to our toolbox for us to assess our patients.
Long before the pandemic, health systems were experimenting with smart bed technology to improve in-patient care and reduce the stress on staff. Some saw this platform as an in-hospital remote patient monitoring platform, capable of allowing nurses to manage several beds or entire units from a central nurse’s station.
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https://healthitanalytics.com/news/cellular-network-data-detects-potential-covid-19-hotspots
Cellular Network Data Detects Potential COVID-19 Hotspots
Researchers are using existing cellular network data to identify areas at greatest risk for spreading COVID-19.
By Jessica Kent
July 02, 2020 - A team from Colorado State University are pinpointing potential hotspots for COVID-19 transmission with cellular wireless network data, which could help regions manage risk.
Because the virus is spread by individuals in close proximity, researchers developed a method that helps them identify the most crowded areas, such as city centers. In these places, asymptomatic carriers have a higher probability of coming into close contact with large numbers of healthy people.
The group aims to understand how mobile device users move and gather over time in an area by using what are known as handover and cell (re)selection protocols. These are the cellular network technologies that allow us to move about freely with our mobile devices without losing service.
Using the data collected through these networks, the researchers measure handover and cell (re)selection activity, called HO/CS rates. The higher the density and mobility, the higher the risk of spreading infectious diseases.
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https://healthitanalytics.com/news/enhancing-cervical-cancer-screenings-with-artificial-intelligence
Enhancing Cervical Cancer Screenings with Artificial Intelligence
Integrating artificial intelligence with medical imaging improved the accuracy and efficiency of cervical cancer screenings.
By Jessica Kent
July 01, 2020 - The potential for artificial intelligence to advance medical imaging and radiology has been well-documented in healthcare research.
From earlier detection and more accurate assessments, to less expensive testing and improved workflows, AI and machine learning tools have demonstrated their ability to transform the medical imaging field.
In the realm of cancer care, these potential advances are even more pronounced.
The complexity of cancer, as well as the enormous volumes of data providers need to consider when treating cancer, makes this area well-suited to the abilities of AI.
In particular, researchers have increasingly sought to use AI and machine learning tools to improve cervical cancer screening – a process that, despite advancements, is still susceptible to error.
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Radiologists to FDA: Autonomous AI not ready for prime time
Posted 02 July 2020 | By Kari Oakes
Artificial
intelligence is not ready for autonomy in radiology, according to two
radiological professional associations who asked the US Food and Drug
Administration (FDA) to wait for more rigorous testing and surveillance of the
modality before authorizing its autonomous implementation in medical imaging.
In follow-up to a February 2020 workshop
focused on artificial intelligence (AI) in medical imaging, the chairs of the
American College of Radiology (ACR) and the Radiological Society of North
America (RSNA) said in a joint
letter that they have “some concerns with the approaches suggested at the workshop
by a number of researcher/developer presentations with respect to FDA
authorization pathways for autonomously functioning AI algorithms in medical
imaging.”
The two organizations “believe it is unlikely FDA could provide reasonable assurance
of the safety and effectiveness of autonomous AI in radiology patient care
without more rigorous testing, surveillance, and other oversight mechanisms
throughout the total product life cycle,” according to Howard B. Fleishon, MD,
of ACR and Bruce G. Haffty, MD, of RSNA, who added that having AI perform
autonomous image interpretation at a safe level “is a long way off.”
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Colorado Expands Telehealth Coverage, Includes Home Health Care Services
A law signed today in Colorado expands Medicaid coverage for telehealth services to include RHCs, FQHCs, The Indian Health Service and home health care providers and boosts private payer coverage.
July 06, 2020 - Colorado lawmakers have quickly approved a bill that will permanently expand telehealth coverage and access in the state.
Governor Jared Polis is scheduled today to sign into law SB 212, which was introduced roughly one month ago.
The bill requires the state Medicaid program to reimburse for telehealth services at rural health clinics, federally qualified health centers and the federal Indian Health Service at the same rate as for in-person treatment; expands coverage to include speech therapy, physical therapy, occupational therapy, hospice care, home health care, and pediatric behavioral health care; and allows home health care providers to supervise their own telehealth services.
The home health care provision, added after the bill was introduced, is significant. The Centers for Medicare & Medicaid Services severely restricts Medicare coverage for home health care programs using telehealth, including requiring that telehealth services be prescribed by the patient’s primary doctor. Colorado’s bill gives home health care agencies in the state some leeway to manage telehealth services for Medicaid patients.
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Digital behavioral health startups scored $588M in funding amid COVID-19 pandemic
Jul 6, 2020 12:13pm
Digital health is on pace to have its largest funding year ever thanks to the rising demand for virtual care and disease monitoring.
U.S. digital health companies raised $5.4 billion in venture funding across the first six months of 2020. The first half of 2020 saw more funding than any previous first half of the year from 2011 to 2019 and beat the prior record of $4.2 billion set in H1 2019, according to venture capital firm Rock Health's mid-year report.
It has been a roller coaster ride for digital health funding in 2020 so far. After coming out of the gates quickly with a record $3 billion in funding in Q1, digital health investment—and overall venture funding—hit the brakes in April as COVID-19 spread rapidly around the globe, Rock Health reports.
But investors came roaring back into digital health in May as several regulatory and reimbursement barriers to digital health adoption fell away.
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Developing a Common Operating Picture in Military Health: Being Ready for the Next Fight
To treat U.S. warfighters effectively, the military health system must integrate medical data that’s been siloed in out-of-date systems — and do it in situations where bandwidth is scarce.
By: Northrop Grumman
July 06, 2020 11:23 AM
The success of any military mission — be it conducted by the Army, Navy, Air Force, or Marines – relies upon “readiness.” The United States Department of Defense (DoD) defines readiness as “the ability of military forces to fight and meet the demands of assigned missions.”1 The Armed Forces maintain such readiness with the combination of training, maintenance, and vital communication streams between the different branches and supporting entities. In doing so, they can better ensure the right personnel and equipment are available when required.
But one area where it can be difficult to assess readiness is in the military health system. Michael Wittman, Military Health Program Manager at Northrop Grumman Corporation, said that outdated systems operating in data siloes inhibit military treatment facilities (MTFs) from adequately communicating readiness to treat the service members. In addition, it can also interfere with the MTF’s ability to effectively communicate to military commanders the most up-to-date status of their fighting forces.
“I’ve seen a statistic in a few briefings that, of the 30,000 casualties and injuries in Iraq and Afghanistan, fewer than 10% of those warfighters had any documentation on their medical status,” he said. “Any care conducted at the point of injury is often written on paper — or even just written with a Sharpie directly onto bandages or the body itself. It may not get into the electronic health record, meaning breaks could occur in the continuity of care, and it may not be communicated to the higher-ups that a service member is receiving care and no longer able to fight.”
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https://www.healthcareitnews.com/news/technology-can-make-end-life-care-more-compassionate
Technology can make end of life care more compassionate
It's more important than ever for providers to communicate with patients and their families, speaking honestly about what to expect from end-of-life care, say experts.
By Kat Jercich
July 06, 2020 09:27 AM
End-of-life care can be challenging even in the most ideal circumstances, given our frequent societal reluctance to discuss medical plans around dying and death.
But the coronavirus pandemic means it's more important than ever to communicate with patients and families honestly about what to expect – particularly given that social-distancing protocols may mean these conversations are not happening in person.
At the American Telemedicine Association virtual conference earlier this month, experts urged attendees to use technology to help facilitate end-of-life discussions and care.
"The right time to have the conversation about what you want, and how you want to live your very last days, is not during your very last days," said panel moderator Alexandra Drane, CEO and cofounder of the caregiver resource ARCHANGELS.
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https://www.healthcareittoday.com/2020/07/06/leading-the-ama-through-three-historic-challenges/
Leading the AMA Through Three Historic Challenges
July 6, 2020
In her tenure as American Medical Association President, Dr Patrice Harris has faced a unique confluence of challenges – physician burnout, the COVID-19 pandemic, and racial inequality. Dr. Harris was the 274th President of the AMA, but was the organization’s first African-American woman to hold that position. Her specialty? Psychiatry. Her experience? County public health director.
I think it would be an understatement to say that Dr. Harris has the right experience, skills and perspective that has been needed this past year. I recently had the opportunity to sit down with Dr. Harris via conference call and I asked her about these three challenges she has faced. Below is a summarized version of our conversation.
This pandemic has really put a financial squeeze on primary care physicians. Many are predicting that physicians will be closing their practices and become hospitalists. What are you hearing?
The AMA has really made sure that we had our ears and eyes to the ground during the pandemic. Of course, we do that all the time, but we really put additional focus on it during the pandemic. We wanted to make sure that we were hearing from physicians and doing what we could to act and advocate for physicians and their practices.
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https://histalk2.com/2020/07/03/weekender-7-3-20/
Weekly News Recap
- WellSky’s private equity owner considers selling the company at a valuation of up to $3 billion.
- Epic will delay the return of employees to campus by month following a local uptick in COVID-19 cases, but says it is impossible to maintain its culture when employees are working from home.
- UCSF pays ransomware hackers $1.14 million to regain access to its medical school servers.
- A cybersecurity firm reviews Internet traffic of six Fortune 500 healthcare companies and finds significant security exposure and hacks in progress.
- Telehealth visit counts have steadily declined since their mid-April peak, dropping from 14% of all visits to less than 8% as the availability of in-person visits returned.
- Smartphone urinalysis company Healthy.io acquires competitor Inui Health, formerly known as Scanadu, for $9 million.
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Enjoy!
David.
