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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https://ehrintelligence.com/news/cds-alert-fatigue-runs-rampant-in-ambulatory-clinics
CDS Alert Fatigue Runs Rampant in Ambulatory Clinics
Health systems with affiliated ambulatory clinics should allocate resources to mitigate CDS alert fatigue and improve CDS integration and training.
April 30, 2021 - Ambulatory clinics are facing significant clinical decision support (CDS) barriers related to health IT resources and user satisfaction, which is resulting in CDS alert fatigue among clinicians, according to a study published in the Journal of the American Medical Informatics Association (JAMIA).
Research suggested health systems should provide further assistance to improve CDS alerts at affiliated ambulatory clinics. In particular, rural clinics may need additional resources for CDS training.
Researchers analyzed CDS data from 821 healthcare clinics at 117 health systems in Minnesota.
Researchers identified seven common CDS barriers, which related to resources, user acceptance, and technology:
- Lack of resources to build and integrate CDS
- Lack of staff and provider training
- Redesign of EHR workflow processes
- False and disruptive alarms
- System upgrade requirement
- Software not available
- Hardware problems
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https://ehrintelligence.com/news/best-practices-for-integrating-sdoh-data-into-the-ehr
Best Practices for Integrating SDOH Data into the EHR
Health systems and health information exchanges across the country are trying to identify and integrate social determinants of health data, but it is not an easy task.
April 30, 2021 - Identifying and implementing social determinants of health (SDOH) data into the EHR is critical to finding answers to a state’s most significant issues.
Once identified, SDOH data helps healthcare providers make social services referrals, but the process for doing so using technology is challenging.
“It's not that physicians have totally ignored social determinants of health, but impactful information—such as the fact that the patient had to take time off from a low-paying job and ride two buses to get to the doctor's office—isn't typically collected in electronic medical records,” said Brian Dixon, PhD, director of public health at the Regenstrief Institute.
Health systems across the country are attempting to implement SDOH data into EHRs and health information exchanges (HIEs). However, most health systems face significant issues, such as interoperability, when implementing SDOH into the EHR.
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https://mhealthintelligence.com/news/ahima-launches-mhealth-resource-assessment-tool-for-vendors
AHIMA Launches mHealth Resource, Assessment Tool for Vendors
The American Health Information Management Association is giving providers a resource site for evaluating digital health tools, and giving mHealth vendors an opportunity to seek AHIMA certification.
April 30, 2021 - The American Health Information Management Association is jumping on the mHealth bandwagon with a resource site and assessment standards for digital health companies.
Working with Moxe, a clinical data warehouse focusing on interoperability, AHIMA has unveiled AHIMA dHealth. The site offers resources for healthcare providers on digital health products, including privacy and data security practices and policies, and an assessment tool designed to help vendors meet AHIMA standards.
“Through AHIMA dHealth, we’re assessing digital health products so providers can spend more time focused on patient care and discern risk more quickly,” AHIMA CEO Wylecia Wiggs Harris, PhD, CAE, said in a press release. “Providers will have to place fewer requests in their ‘need to review’ funnel, as they can use the AHIMA dHealth directory to easily see which digital health products are AHIMA dHealth Approved. I believe this program will make it easier for providers to comply with the Cures Act Final Rule.”
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NHS Digital’s online Covid-19 dashboard used three million times
An online dashboard that allows people to check Covid-19 reported near their home has been used more than three million times.
Andrea Downey, 26 April, 2021
More than 65,000 searches were carried out on the Coronavirus in Your Area dashboard on 4 January, 2021, with the site continuing to have more than 70,000 views weekly since.
The tool, provided by NHS Digital, allows users to check virus cases within ten miles of their postcode, as well as statistics for positive cases reported in the past 10 weeks.
Alistair Bullward, NHS Digital’s open data and dashboards manager, said: “We believe in improving lives through data and technology, and our coronavirus In Your Area app empowers people to understand the risk from coronavirus where they live.
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Health Beat: Wearable sensors mean no more finger pricks?
· Apr 28, 2021
UNIVERSITY PARK, Pa. — Instead of a finger prick, what if it were possible to track blood sugar with a patch? A team of bioengineers at Penn State University have developed a small, wearable device that can monitor health non-invasively. The waterproof patch has embedded sensors. Bioengineers designed it to adhere and conform to the skin, staying put through daily activities and during exercise.
"Through that, we'll be able to pick up all the vital information in term of the heart rate, respiration, sweat analysis," explained Huanyu "Larry" Cheng, an assistant professor of engineering science and mechanics at Penn State.
The device collects sweat and analyzes it for PH, sodium, and glucose levels. Those readings are especially important for a person with low blood sugar or diabetes.
"So, we don't need to do the blood sampling all the time, and we'll be able to analyze glucose and the other biomarkers," Cheng shared.
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Cerner Agrees To Share Patient Medical Records With Life Insurance Industry Intermediary
April 30, 2021
Cerner has struck a deal in which it will let a life insurance industry data vendor access patient records. Under the terms of the deal, risk management and digital services vendor MIB will be able to offer life insurance industry players access to 54 million patient medical records, as well as 5,400 patient portals.
The deal makes Cerner the third EHR vendor MIB has signed up for its services, which also include data from Epic as well as other EHR and HIE partners. MIB’s clients use the data as part of the process of underwriting life insurance policies. According to MIB, the life insurance industry currently lacks a single solution that offers easy access to medical information across multiple health systems and data providers.
If you wonder how Cerner can get away with sharing this data, it’s important to note that the partners only intend to offer access to data if patients have given consent for such sharing.
However, this raises the question of how MIB and/or Cerner will scale up obtaining such consents, given that they can’t be obtained en masse. This problem dates all the way back to the early days of HIEs, when the industry first began to grapple with the reality that managing consent for patient data sharing was going to be a huge thing.
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Telehealth: HIMSS Survey Provides Clues About Path Forward
Analysis | By Mandy Roth | April 30, 2021
While generational differences guide preferences for post-pandemic in-person or video visits, as well as primary versus specialty care, telehealth has a significant role to play as health systems formulate their organizational strategies.
KEY TAKEAWAYS
· With the exception of Baby Boomers, about half of all generations prefer video visits for primary care.
· Preference for specialist care via video ranges from 15% to 67%, with younger patients preferring this form of care.
· 67% of respondents expect telehealth to cost less than traditional visits because they are virtual, shorter, and have minimal overhead office expenses.
The year 2020 was a breakthrough year for telehealth. Now that the pandemic appears to be abating, health systems are seeking the best strategies to move forward with these initiatives and find a way to balance video visits with in-person care.
A consumer survey from the Healthcare Information Management Systems Society (HIMSS) provides significant clues about the road ahead. While there is still a preference for in-person care in the post-pandemic world, video visits have significant appeal, particularly among younger generations and certainly for primary care. Even in specialty care, where in-person visits have an edge, a significant number of patients desire video encounters, with younger people expressing the strongest interest.
Research and analysis for the survey was conducted by HIMSS Market Intelligence in March 2021. The sample included 509 individual consumers who had completed at least one telehealth video visit in the past 12 months. Demographics were balanced to the U.S. population.
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https://www.healthleadersmedia.com/nursing/telehealth-increases-nurses-workload
Telehealth Increases Nurses' Workload
Analysis | By Carol Davis | April 30, 2021
Study shows telehealth doubles the tasks nurses complete to assist patients with chronic diseases.
KEY TAKEAWAYS
· The study analyzed data transmitted from 74 patients' in-home telehealth devices to six family medicine clinics.
· Use of telehealth resulted in twice as many activities completed by nurses.
· Because of increased communications with nurses, the telehealth patients had better health outcomes.
More hospitals and health systems are pushing forward with telehealth initiatives, but a new study indicates that telehealth doubles the tasks nurses complete to assist patients with chronic diseases, significantly impacting their workload amid a nationwide nursing shortage.
The University of Missouri study found that nurses remotely monitoring patients with Type 2 diabetes and hypertension were doing more work than nurses who provide in-person care programs.
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https://ehrintelligence.com/news/onc-information-blocking-opens-doors-for-interoperability
ONC: Information Blocking Opens Doors for Interoperability
ONC’s Micky Tripathi led a recent information blocking event to give healthcare stakeholders his thoughts on the present and future of the information blocking regulations.
April 29, 2021 - Healthcare organizations and stakeholders must move on from a compliance mindset and begin to focus on the vast information blocking opportunities at hand, according to Micky Tripathi, national coordinator for health IT.
“We recognize information blocking is a law because it has civil monetary penalties associated with it,” Tripathi said during the Workgroup for Electronic Data Interchange (WEDI) information blocking event. “It's got to be thought of as a compliance mindset.”
However, Tripathi wants compliance to be the floor, not the ceiling, of healthcare stakeholder thoughts and ideas.
On Wednesday, Tripathi headlined WEDI’s “Ready, Set, Comply! Meeting the Information Blocking Challenge” to take a deep dive into the 21st Century Cures Act’s information blocking provisions.
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https://patientengagementhit.com/news/hospital-patient-safety-improvement-was-key-during-pandemic
Hospital Patient Safety Improvement Was Key During Pandemic
More than half of hospitals had better than a B patient safety grade, which was essential during the pandemic emergency, The Leapfrog Group said.
By Sara Heath
April 29, 2021 - A whopping 27 hospitals in the United States have received a perfect letter grade in The Leapfrog Group’s patient safety ratings since the biannual reports started in 2012, a feat the group credits to a deep commitment to continuous practice improvement.
The ratings, an advanced copy of which were shared with PatientEngagementHIT via email, also revealed that about a third of US hospitals got an A in patient safety and about a quarter got a B.
But this string of what The Leapfrog Group called “straight A hospitals” underscores the strides the nation has made in reducing avoidable patient harms in the hospital setting.
“We find that straight ‘A’ hospitals have strong structures of safety in place,” Leah Binder, president and CEO of The Leapfrog Group, said in a public statement. “These hospitals are continuously learning, monitoring data, and addressing areas of improvement.”
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Apr 26, 2021,10:45am EDT|26,447 views
Did MIT Study Really Challenge 6-Foot Social Distancing For Covid-19 Coronavirus? Here’s What It Said
Some people on social media are trying to put the six feet social distancing recommendation essentially six feet under. They are claiming that a study from researchers at the Massachusetts Institute of Technology (MIT) is showing that keeping six feet apart won’t really do much to prevent the spread of the Covid-19 coronavirus indoors. For example, Peter Navarro, PhD, an economist who served as an advisor to then U.S. President and current Mar-A-Lago resident Donald Trump, used the study published in the Proceedings of the National Academy of Science (PNAS) to take another shot (the mudslinging type and not the vaccination type) at Anthony Fauci, MD, Director of the National Institute of Allergy and Infectious Diseases (NIAID):
So does this mean that it’s OK to start stuffing indoor locations to their capacities like Hot Pockets and no longer keep people six feet or one Denzel (because Denzel Washington is about six feet tall) apart?
Before you listen to these claims and start walking right up to others in a room and saying, “how you doin,” stop. And hold on, in the words of Wilson Phillips. Take a closer look at what this PNAS study really showed.
For the study, Martin Z. Bazant, PhD, a Professor of Chemical Engineering, and John W. M. Bush, PhD, Professor of Applied Mathematics, who are both at MIT, put together sets of equations that tried to represent the spread of the Covid-19 coronavirus in what they called a “well-mixed” room. In this case, a well-mixed room doesn’t mean a room with a good DJ but rather one where any floating particles would end up spreading fairly evenly in the airspace.
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https://www.healthcareitnews.com/news/cms-proposes-modifications-promoting-interoperability-program
CMS proposes modifications to the Promoting Interoperability Program
The agency is floating new requirements for hospitals to report on syndromic surveillance, immunization registries, electronic case reporting and electronic reportable laboratory results. It also has new plans for quality reporting.
By Mike Miliard
April 29, 2021 09:15 AM
As part of the Centers for Medicare and Medicaid Services' proposed rules this week around Medicare fee-for-service payment rates and policies for hospitals and long-term facilities – changes that could boost FY 2022 hospital payments by $2.8% – there are several provisions focused on technology, information exchange and patient access.
WHY IT
MATTERS
Most notably, there are a series of proposed changes to CMS' Promoting
Interoperability Program – the successor to meaningful use – designed to
bolster the response to public health emergencies such as COVID-19.
The agency plans to amend program stipulations for eligible hospitals and critical access hospitals – broadening requirements focused on public health and clinical data exchange.
The proposed rule would make it mandatory for hospitals to report on four measures, rather than allowing a pick-and-choose approach, as had been the case before:
- Syndromic Surveillance Reporting.
- Immunization Registry Reporting.
- Electronic Case Reporting.
- Electronic Reportable Laboratory Result Reporting.
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https://www.healthcareitnews.com/news/sanford-health-builds-ehr-templates-epic-eliminate-note-bloat
Sanford Health builds EHR templates in Epic to eliminate note bloat
Around half of primary care providers are using the standard note templates, resulting in short, efficient charting – with time in notes and note length below Epic's overall average.
April 29, 2021
Sanford Health is one of the largest health systems in the United States. Headquartered in Sioux Falls, South Dakota, the organization includes 46 hospitals, 1,400 physicians and more than 200 Good Samaritan Society senior care locations in 26 states and 10 countries.
THE PROBLEM
Providers at Sanford Health had for years been sharing feedback that a lot of the information in the note section of the EHR was not necessarily useful for the person reading the notes. For example, no one wants to review blood work in the notes. That would be better viewed in results in the patient's chart.
"But the biggest concern we heard from providers was that they would have to scroll through pages and pages of information to get to the assessment and plan section they were looking for, which were always at the very end," said Dr. Roxana Lupu, chief medical information officer at Sanford Health.
"To illustrate the challenge, one provider scrolled through what ended up to be a 19-page printed document to get to the information she needed in one paragraph on the last page of the note."
There also were complaints about how information is organized differently by each note author, and how note readers have to adjust to so many individual templates. One ask that Lupu heard repeatedly from clinicians was a similar look and feel for all notes.
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Member states agree on technical specifications for EU-wide vaccine passport
The "Digital Green Certificate" is on track to be rolled out by June.
By Tammy Lovell
April 29, 2021 07:52 AM
Plans for EU-wide "Digital Green Certificates” have moved a step forward, with member states agreeing on the main technical specifications for the plans.
The certificates are intended to facilitate free movement during the COVID-19 pandemic by providing proof that a person has either been vaccinated, received a negative test result or recovered from the virus.
Member state representatives in the eHealth Network, a voluntary network connecting national authorities, have agreed on guidelines describing the main technical specifications for the implementation of the system.
The guidelines cover data structure and encoding mechanisms, including the QR code, which will ensure that both digital and paper certificates can be verified across the EU.
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https://ehrintelligence.com/news/advanced-ehr-capabilities-lead-to-improved-clinical-performance
Advanced EHR Capabilities Lead to Improved Clinical Performance
The number of EHR super-user providers increased by 10 percent over a three-year period.
April 28, 2021 - Between 2014 and 2017, healthcare facilities with more significant EHR capabilities had better clinical quality composite measures than other facilities, but healthcare clinics that adopted EHRs during that time period had less significant clinical quality increases, according to a study published in JAMA Network Open.
The latter finding might suggest a longer timeline for seeing clinical quality performance improvements after EHR adoption and implementation.
For over 15 years, healthcare stakeholders have considered the EHR to be vital in achieving quality patient care because of the data storage and analytic capabilities vastly exceeded other alternatives, such as paper records. EHRs also allow for optimization and tool integration to improve quality, such as clinical decision support and registries.
However, a gap remains between high-quality patient care and actual care delivery.
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https://ehrintelligence.com/news/ehr-support-team-pushes-user-satisfaction-to-cut-clinician-burnout
EHR Support Team Pushes User Satisfaction to Cut Clinician Burnout
Rush University Medical Center faced a significant clinician burnout problem, but new health IT management found a way to enhance EHR usability and mitigate frustration.
April 28, 2021 - Just six years ago, Rush University Medical Center clinicians experienced a significant lack of EHR support and training, which resulted in increased frustration and a crippling case of clinician burnout.
“In the past, the clinician would either ask a colleague that had spent some dedicated time and was willing to help them personalize their experience, or they would try to work with an analyst or a health IT specialist to explain to them their specialty or their clinical background to see if they could help them,” Jordan Dale, MD, Rush’s acting CMIO, said in an interview with EHRIntelligence.
Sometimes that method was successful if there was a natural subject matter expert in that specialty, Dale explained. However, if there was a knowledge gap or if Rush did not have a health IT expert or a clinician with experience working beside the clinician, the clinician experienced frustration and burden.
But under new CMIO leadership, the organization sought out its end-users to identify the critical sources of health IT and EHR frustration. Rush conducted its first KLAS Arch Collaborative survey in 2017. This survey identified several critical EHR usability issues that Rush clinicians and end-users consistently encountered.
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Health CIO: IT Must Be Core Business Element to Tackle Security Challenges
At Xtelligent Healthcare Media’s Privacy and Security Summit, health CIO Michael Archuleta stressed the need for IT to be a key business element if the sector hopes to overcome cybersecurity challenges.
April 28, 2021 - If healthcare hopes to overcome cybersecurity challenges and inefficiencies, the overall security posture must evolve by building a strong foundation around cybersecurity that advocates for incorporating employees, executives, and management as part of the cybersecurity structure.
On Tuesday, Michael Archuleta, Chief Information Officer for Mt San Rafael Hospital, kicked off Xtelligent Healthcare Media’s Privacy and Security Digital Summit with a keynote centered on the evolution of cybersecurity threats in the healthcare sector.
While the overall security process and technology has evolved over time in healthcare, it’s moving at a sluggish pace when considering other industries.
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https://www.statnews.com/2021/04/26/artificial-intelligence-afib-mayo-clinic/
AI caught a hidden problem in one patient’s heart. Can it work for others?
By Casey Ross April 26, 2021
Somewhere in Peter Maercklein’s heartbeat was an abnormality no one could find. He survived a stroke 15 years ago, but doctors never saw anything alarming on follow-up electrocardiograms. Then, one day last fall, an artificial intelligence algorithm read his EKGs and spotted something else: a ripple in the calm that indicated an elevated risk of atrial fibrillation.
Specifically, the algorithm, created by physicians at Mayo Clinic, found Maercklein had an 81.49% probability of experiencing A-fib, a quivering or irregular heartbeat that can lead to heart failure and stroke. Just days later, after Maercklein agreed to participate in a research study, a wearable Holter monitor recorded an episode of A-fib while he was walking on a treadmill.
The finding dramatically altered the course of his care. He was put on a blood thinner and eventually received a pacemaker, interventions that happen too late, or not at all, for hundreds of thousands of people who die every year of untreated heart disease.
“I would have never known that I had A-fib,” said Maercklein, a 73-year-old retired hospital finance executive at Mayo who lives in rural Olmsted County, Minn. “For me, it worked out incredibly well. Without this study, who knows when I would have been diagnosed.”
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Teladoc Q1 revenue more than doubles to $454M as telehealth visits continue to climb
Apr 28, 2021 4:34pm
Teladoc's first-quarter revenue reached $454 million, jumping 151% from $181 million a year ago.
Despite a historically weak flu season, the telehealth giant delivered 3.2 million virtual visits in the first quarter of 2021, up 56% compared to the first quarter in 2020.
During a first-quarter earnings call Wednesday, Jason Gorevic, chief executive officer of Teladoc Health, said the company was making considerable progress on the integration of digital chronic condition management company Livongo. Teladoc acquired Livongo in a massive $18.5 billion deal in October.
Earlier this month, the company launched the first wave of members to access and register for Livoingo programs within the Teladoc pap, making "the first step to creating a seamless member experience to engage with members more effectively across programs," Gorevic said.
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American College of Cardiology studies will explore whether AI can improve clinicians' guideline adherence
by Dave Muoio
Apr 28, 2021 8:00am
The American College of Cardiology (ACC) is planning a trio of studies that will measure whether personalized clinical guideline support delivered by an AI tool at the point of care can improve heart patients’ outcomes.
The TRANSFORM studies will each use HealthReveal’s software to generate and deliver care recommendations based on current best practices. These insights are surfaced to clinicians through the electronic health record (EHR) system and include medical literature informing the software’s recommendations.
The first of these tests will be the TRANSFORM HFrEF study. It will be led by Massachusetts General Hospital cardiology researcher Jim Januzzi, M.D., and focus on the treatment of patients with heart failure with reduced ejection fraction (HFrEF).
Effective strategies have already been established for treating the condition, said Januzzi, who is also a professor of medicine at Harvard Medical School and a trustee of the ACC.
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https://www.medpagetoday.com/meetingcoverage/aapm/92284
Will Telehealth Shape the Future of Pain Care?
— Lessons from the pandemic may guide the way pain medicine is delivered
by Judy George, Senior Staff Writer, MedPage Today April 26, 2021
Telehealth has the potential to transform pain care, and changes made during the COVID-19 pandemic may offer a glimpse of the future, researchers said at the American Academy of Pain Medicine virtual meeting.
"There was an immediate need to pivot to telemedicine to continue care and education for our patients, and generally I believe this was quite successfully achieved," said Mary Ann Fitzcharles, MD, of McGill University and Montreal General Hospital in Canada, at the meeting. "We have learned that healthcare professionals can step up and can adapt rather rapidly."
To continue virtual pain care beyond the pandemic, the field needs to harness strategies that were successful, she noted. "We must remember that one size does not fit all, and we have to bear in mind that we must provide secure, efficient, and equitable ongoing care to our patients."
During COVID-19, telemedicine provided time and cost savings for many, Fitzcharles noted. "We were able to triage new patients and at least do an initial evaluation by telehealth in preparation for an in-person visit," she said. "The followup of stable patients was mostly efficient, and patients generally are fairly satisfied." Importantly, telehealth gave patients in outlying regions access to pain specialists, she observed.
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https://ehrintelligence.com/news/national-patient-identifier-coalition-launches-strategic-framework
National Patient Identifier Coalition Launches Strategic Framework
The national patient identifier group wants the federal government to help boost patient matching, patient safety, and security.
April 27, 2021 - Patient ID Now, a national patient identifier coalition of over 40 healthcare organizations, has called on the federal government to collaborate with the private sector and public health organizations to create and implement a national strategy to enhance patient matching, according to a recently published framework.
Patient matching is when there is a link between patient records across various healthcare providers. A patient visiting two different doctors or two separate health facilities should yield the same patient medical history. However, the data proves otherwise.
Robust patient matching lowers costs, increases patient safety, improves clinical decision-making, and fosters care coordination, healthcare experts have said.
“Over the past year, the COVID-19 pandemic has highlighted the need to address patient misidentification throughout the health ecosystem,” AHIMA CEO Wylecia Wiggs Harris, PhD, said in a statement.
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Department of Defense expands Cerner EHR implementation to 10,000 more providers
MHS Genesis has been successfully deployed to 12 new states, said officials in a statement this week.
By Kat Jercich
April 28, 2021 11:44 AM
The Department of Defense's new electronic health record system, MHS Genesis, has been successfully delivered to 10,000 more clinicians and providers.
MHS Genesis was developed by the Leidos Partnership for Defense Health, comprising Cerner Corporation, Accenture, Leidos and Henry Schein One, along with about 30 supporting businesses.
According to a Leidos press statement, the most recent deployment has locations in 12 more states: Arizona, Colorado, Kansas, Missouri, Montana, Nebraska, New Mexico, North Dakota, South Dakota, Texas, Utah and Wyoming.
"Our team continues to be impressed by the hard work and dedication demonstrated by the staff at each of these locations. They are the driving force behind our success to date," said Liz Porter, Leidos Health Group president, in a statement.
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How to help C-suite leaders and clinicians trust artificial intelligence
A healthcare AI expert offers advice to help health system CEOs and CIOs, physicians and nurses appreciate the promise of burgeoning machine learning technologies.
By Bill Siwicki April 28, 2021
11:34 AM
Many health IT decision-makers and clinicians are cynical about the potential for artificial intelligence solutions to improve healthcare, particularly in the wake of high-profile setbacks and continued frustration at care recommendations that seem to come from a black box of technological machinations with little transparency or context.
It seems to boil down to a matter of trust: AI developers need to prove the technology's promise to healthcare end users, many of whom are still (often rightly) skeptical about algorithms' shortcomings.
Industry groups, whether they're focused on clinical informatics or on consumer technology, have been keenly focused on this idea recently.
Healthcare IT News decided to dig into the trust factor of AI by interviewing Punit Soni, CEO of Suki, a vendor of AI-powered voice solutions for clinicians.
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ONC Chief Delves Into Everything You Want to Know About Info Blocking Rule
Analysis | By Scott Mace | April 28, 2021
Micky Tripathi gets into details about sharing patient records, clarifies April 5 and December 2022 compliance rules, and more.
KEY TAKEAWAYS
· In December 2022, connectivity between electronic health records will get simplified from each EHR's API to a FHIR interface in standardized data elements.
· USCDI standardization will also accelerate consumers' ability to download their records into personal health apps they control.
· While the HHS OIG prepares to enforce the penalty phase of rule, ONC is prepared to wield the power of EHR decertification.
· Providers should "think strategically" about changing their EHR culture to one of authorized information sharing.
The information blocking rule that took effect April 5 promises to usher in a new era of free-flowing electronic medical record information, under the direction of patients and their physicians.
In Part 1 of this interview with Micky Tripathi, PhD, MPP, who since January has headed the U.S. Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC), Tripathi discussed the challenges hospitals and health systems face in interoperability and telehealth. Part 2 delves deeper into the April 5 rule. This interview has been lightly edited for space and clarity.
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https://ehrintelligence.com/news/dod-launches-mhs-genesis-ehr-system-across-12-states
DoD Launches MHS GENESIS EHR System Across 12 States
The Department of Defense (DoD) new EHR system is now live at over 600 facilities from the west coast to the Midwest.
April 27, 2021 - The Department of Defense (DoD) has completed another EHR implementation wave after the agency and its partners recently deployed MHS GENESIS in 12 states and 25 military healthcare facilities.
The most recent MHS GENESIS wave included over 10,000 clinicians from Arizona, Colorado, Kansas, Missouri, Montana, Nebraska, New Mexico, North Dakota, South Dakota, Texas, Utah, and Wyoming.
“We are gaining momentum and improved efficiency with each Wave deployment,” said Liz Porter, president of Leidos Health Group, DoD’s health IT partner. “Our team continues to be impressed by the hard work and dedication demonstrated by the staff at each of these locations. They are the driving force behind our success to date.”
The EHR platform is now live across 600 military healthcare facilities in the West and Midwest, with roughly 41,000 active users.
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Predictive Analytics Tool Accurately Detects Patient Deterioration
The predictive analytics algorithm significantly outperformed existing products when identifying patients in need of life-saving interventions.
By Jessica Kent
April 27, 2021 - Researchers from Michigan Medicine have developed a predictive analytics model that can accurately identify patient deterioration for both general ward and COVID-19 patients.
The algorithm was more accurate than the Epic Deterioration Index (EDI), an existing tool used for patient deterioration investigation.
In a study published in JMIR: Medical Informatics, researchers describe the development and performance of the Predicting ICU Transfer and other Unforeseen Events (PICTURE) algorithm.
The team trained and validated the PICTURE model on a cohort of hospitalized COVID-19 patients using EHR data from 2014 to 2018. Researchers then applied the model to two test sets, including non-COVID-19 patients from 2019 and COVID-19-positive patients in 2020.
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https://patientengagementhit.com/news/how-intermountain-forged-its-journey-to-health-equity
How Intermountain Forged Its Journey to Health Equity
The health system is nearly a year into renewed work toward health equity and recognizing institutional racism as a public health issue.
By Sara Heath
April 27, 2021 - Despite the years-long conversation around the social determinants of health, it wasn’t until this past one that healthcare began to seriously talk about institutional racism and health equity.
Racism, of course, is a central pillar to the social determinants of health. Racial discrimination in itself can be a health indicator—studies have emerged suggesting discrimination can deteriorate wellness, a concept known as weathering—while racism can permeate other key determinants, too. Race has a strong link to neighborhood, which like dominoes can impact other factors like income, educational opportunity, or food security.
But that conversation began to shift when the COVID-19 pandemic began to shine a light on the stark racial inequities in medicine. It soon became apparent that the virus impacted communities of color, particularly Black, Hispanic, and Indigenous populations, more than White people. This was largely tied to the inequities patients faced in other aspects of their lives that made it harder for them to avoid infection.
And when George Floyd was killed by police, a wave of protests pushed the country to examine its own biases. That included the healthcare industry, which saw a number of leading institutions to commit to anti-racism in medicine, a move that was admittedly and largely unprecedented.
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https://www.dotmed.com/news/story/54579
FDA says goodbye PACS, hello MIMPS
by John R. Fischer, Senior Reporter | April 23, 2021
Health IT PACS / Enterprise Imaging
The FDA has changed the name of its regulatory classification for PACS software to MIMPS (medical image management and processing systems)
The FDA
has changed its regulatory classification of PACS (Picture Archiving and
Communication Systems), referring to it now as MIMPS (medical image management
and processing systems) as part of amended regulatory classification changes
made for radiology-specific software.
The name change reflects an update to the definition of PACS as a medical
device, which no longer includes certain software functions, in accordance with
the Cures Act. These exclusions exempt these applications from FDA review.
“FDA has determined that software functions in the PACS classification
regulation for storage and display of medical images no longer fall within the
definition of a device under section 520(o)(1)(D) of the FD&C Act. However,
FDA recognizes that some software functions in the PACS regulation, which are
for complex image processing, including those for image manipulation, enhancement,
or quantification, remain device functions," said the agency as part of
the Final Rule.
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https://threatpost.com/5-fundamental-iot-device-security-controls/165577/
5 Fundamental But Effective IoT Device Security Controls
April 23, 2021 1:13 pm
Matt Dunn, the associate managing director for cyber-risk at Kroll, discusses how to keep networks safe from insecure IoT devices.
As the pandemic continues to fuel the shift to remote work, numerous manufacturers have capitalized on this movement to create a multitude of handy internet of things (IoT) devices. While these devices may make our home and work lives more convenient, they greatly expand the attack surface for cybercriminals. Here, we’ll take a look at the best cybersecurity practices that can thwart attacks.
IoT devices introduce a host of vulnerabilities into organizations’ networks and are often difficult to patch. With more than 30 billion active IoT device connections estimated by 2025, it is imperative information-security professionals find an efficient framework to better monitor and protect IoT devices from being leveraged for distributed denial or service (DDoS), ransomware or even data exfiltration.
When the convenience of a doorbell camera, robot vacuum cleaner or cellphone-activated thermostat could potentially wreak financial havoc or threaten physical harm, the security of these devices cannot be taken lightly. We must refocus our cyber-hygiene mindset to view these devices as potential threats to our sensitive data. There are too many examples of threat actors gaining access to a supposedly insignificant IoT device, like the HVAC control system for a global retail chain, only to pivot to other unsecured devices on the same network before reaching valuable sensitive information.
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Cybersecurity roundup: U.S. agencies warn of Russian hacks, Australian hospitals struggle to get back online
And mourners remember Daniel Kaminsky, the white hat hacker and "internet security savior," who died this past week at 42.
By Kat Jercich
April 27, 2021 12:27 PM
A day doesn't go by without news breaking of another healthcare breach, ransomware attack or looming cybersecurity threat. Here's a compilation of some of the recent developments in the cybersecurity world.
In the past few days alone, U.S. federal agencies have warned of continuing dangers from Russian state hackers; hospitals in Queensland, Australia, have been forced to rely on pen and paper following a major ransomware hit; and patients at Yale New Haven Health say they still haven't been able to get cancer care after one of its software vendors was breached.
Meanwhile, infosec experts have come together to mourn Daniel Kaminsky, a renowned researcher and passionate security advocate who died this past Friday.
Russian threats continue
The FBI, the Department of Homeland Security, and the Cybersecurity and Infrastructure Security Agency released a joint advisory on Monday warning of the continued threat from Russian cyber actors.
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https://www.healthleadersmedia.com/revenue-cycle/coalition-calls-national-patient-id-strategy
Coalition Calls for National Patient ID Strategy
Analysis | By Alexandra Wilson Pecci | April 27, 2021
A newly released framework calls on the federal government to create and implement a national strategy around patient identification that protects patient safety and privacy.
A new framework released by the healthcare coalition Patient ID Now calls on public health authorities to create and implement a national strategy for accurate patient identification.
The Framework for a National Strategy on Patient Identity: A Proposed Blueprint to Improve Patient Identification and Matching calls on the federal government to closely collaborate with the private sector and with state, local, tribal and territorial public health authorities to create and implement a national strategy around patient identification that protects patient safety and privacy.
Patient identification and matching is important for a lot of reasons. On the revenue cycle side, patient identification errors are a leading cause of denials.
There are also issues involving patient safety and high costs. Patient ID Now points to the vaccine rollout for recent examples of each.
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ONC Coordinator Outlines New Vistas for Telehealth, Unblocked Health Records, and Patient ID
Analysis | By Scott Mace | April 27, 2021
ONC head Micky Tripathi urges swift adoption of federal regulations.
KEY TAKEAWAYS
· ONC is prepared to create rules to support any possible CMS actions that might support reimbursement for telehealth visits.
· Video visits remain a workflow issue that may require ONC to specify appropriate EHR support.
· The significant existing investment in existing patient matching systems may be weighed against the cost of adopting a possible national standard.
Micky Tripathi, PhD, MPP, who holds a master's degree in public policy from Harvard University, took the reins of the Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC) on the first day of the Biden administration in January.
Tripathi is no stranger to the thorny issues at the heart of healthcare IT, such as medical record interoperability, standards, and certifying electronic health record software. His previous 20 years of work in the field let him hit the ground running. He most recently worked as chief alliance officer for population health management technology company Arcadia, previously served as president and CEO of the Massachusetts eHealth Collaborative, and has been on the board of directors of the HL7 FHIR Foundation, CommonWell Health Alliance, and The Sequoia Project.
Tripathi recently granted an interview to HealthLeaders. Following are excerpts from the discussion, lightly edited for space and clarity. Keep your eyes on HealthLeaders for part two of this discussion tomorrow.
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Considering COVID-19 Vaccine Education, Messaging for Young People
Some data suggests COVID-19 education and messaging for young people should appeal to their sense of altruism.
By Sara Heath
April 26, 2021 - Public health leaders can look to teens’ views on mask-wearing to get a head start on COVID-19 vaccine education and messaging for the newly eligible population, according to researchers from Michigan Medicine.
Particularly, the researchers said public health messaging around the COVID-19 vaccine can call to young adults’ altruism to be effective.
COVID-19 vaccine distribution has relied on two key factors: having enough supply and having enough demand. Now that the US has crossed the threshold allowing the general population ages 16 and older to access the shots, it’s clear the supply issue has largely been resolved.
But the demand issue might now be the issue. Experts from the Kaiser Family Foundation recently revealed that the US could see a shift in the supply and demand paradigm in as little as two weeks, as health departments have more doses than arms into which they can insert them.
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https://patientengagementhit.com/news/what-is-patient-generated-health-data-why-is-it-important
What Is Patient-Generated Health Data, Why Is It Important?
The rise of application programming interfaces, patient data access, and remote monitoring tools could propel patient-generated health data use.
By Sara Heath
April 26, 2021 - The regulatory push for better patient data access, coupled with the insurgence of remote patient monitoring technology, has brought to the forefront a key type of health information: patient-generated health data.
As healthcare organizations across the country issue apps and other services that allow patients to view and download their EHRs and patient portals, any are leveraging tools that will work the other way around. In other words, more patient data access apps are letting patients contribute their own medical information on the record, too.
That information is coming from a myriad of sources, most prominently remote patient monitoring tools. These technologies, which have existed for some time, are becoming more ubiquitous as they both prove their use in chronic disease management and become more affordable for patients and providers.
Amidst all of that has come a renaissance for patient-generated health data, or PGHD, a type of health information that has been championed by the healthcare industry but brought with it many integration challenges.
Below, PatientEngagementHIT outlines PGHD, its uses, and why now may be the time providers can better utilize it.
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https://healthitsecurity.com/news/secure-communication-used-in-50-malware-attacks-to-evade-detection
Secure Communication Used in 50% Malware Attacks to Evade Detection
Sophos data shows an increasing number of malware and ransomware threat actors are using TLS to hide communication and cyberattack activities.
April 26, 2021 - Research from cybersecurity firm Sophos shows an increasing number of malware threat actors are levering Transport Layer Security (TLS) to hide communication between the victim and their command and control server.
The TLS cryptographic protocol was designed to secure the privacy and security of legitimate web, messaging, and application traffic. It’s leveraged by the HTTPS, StartTLS email protocol, Tor, and virtual private networks (VPNs).
The SSL/TLS encryption is the industry-standard method for protecting data in transit. Cyberattacks utilizing the encrypted channels aren’t altogether new. Previous ZScaler ThreatLabZ research found hackers were using the encryption channels to bypass legacy security controls.
In fact, SSL-based attacks have increased by 260 percent since 2019 with the healthcare sector as the leading target.
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https://healthitsecurity.com/news/healthcares-biggest-cybersecurity-blindspots-and-misconceptions
Healthcare’s Biggest Cybersecurity Blind Spots and Misconceptions
While awareness of the threats facing the healthcare sector has improved, providers have inherent blindspots and misconceptions leaving them exposed to a host of cybersecurity risks.
April 26, 2021 - Threat actors are moving at a drastic pace and with stealthy tactics able to hide their activities from system administrators. The truth is that healthcare is struggling with some massive cybersecurity blindspots and misconceptions, making it extremely difficult to keep pace.
Data exfiltration and extortion was once seen as a rare worst-case scenario, but now it’s occurring in the majority of ransomware attacks. Meanwhile, reports show an increasing number of attacks targeting a range of newly disclosed vulnerabilities, along with legacy security gaps that administrators have overlooked and failed to patch.
A brief look at the four zero-day vulnerabilities in Microsoft Exchange and the ease in which advanced persistent threat actors are actively exploiting the flaws highlight the ever-bleak threat landscape and the need for highly advanced cyber posture.
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Top health experts talk telehealth regulation, health inequality
Apr 23, 2021 8:00am
While the telehealth industry is booming, plenty of challenges remain, including the changing regulatory environment and the impact on vulnerable communities.
At Fierce Healthcare's "How COVID Changed Everything" event this week, our reporters caught up with experts across the healthcare industry to dive into these challenges.
We've compiled some of their key thoughts on the state of telehealth, and the future.
Here's more from Office of the National Coordinator for Health Information Technology's Micky Tripathi, Aledade's Farzad Mostashari and other top executives:
Thinking about the latest regulations
Micky Tripathi, the new national coordinator for health IT under the Biden administration, said providers and other industry stakeholders need to view the recently enacted information blocking rule, along with other interoperability rules mandated by the 21st Century Cures Act, as a “philosophy change” by putting patients in control of their health data.
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FTC issues warning that using biased AI could violate consumer protection laws
Apr 22, 2021 11:19am
The FTC Act prohibits unfair or deceptive practices. That would include the sale or use of—for example—racially biased algorithms, an FTC staff attorney wrote in a blog post this week. (Getty/pabradyphoto)
The Federal Trade Commission issued a warning to businesses and health systems this week that the use of discriminatory algorithms could violate consumer protection laws.
It could signal that the agency plans to take a hard look at bias in artificial intelligence technologies.
"Hold yourself accountable—or be ready for the FTC to do it for you," Elisa Jillson, an attorney in FTC’s privacy and identity protection division, wrote in an official blog post.
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https://ehrintelligence.com/news/how-regenstrief-built-an-emergency-ehr-system-during-covid-19
How Regenstrief Built an Emergency EHR System During COVID-19
Regenstrief researchers developed an emergency EHR system within two weeks to help Indianapolis first responders during COVID-19.
April 23, 2021 - To aid Indianapolis Emergency Medical Services (IEMS) with an influx of COVID-19 patients, researchers from Regenstrief Institute utilized a global open-source EHR, OpenMRS, to create an emergency EHR system.
In less than two weeks, the researchers developed the emergency EHR system to register patients, collect patient data, and forward patient data to the Indiana Health Information Exchange (IHIE).
When COVID-19 began to spread throughout Indiana, IEMS leaders realized a significant gap between Indianapolis health system capacity and its health IT system to support the overburdened healthcare system, Regenstrief said.
It is typical for health systems in metropolitan areas to have a specific process for capturing and exchanging patient data during healthcare emergencies, such as COVID-19. Some approaches vary from a full EHR system or a hybrid EHR-paper system, the authors explained.
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Patient ID Now coalition releases national strategic framework for identity, matching
The framework calls on the federal government to partner with other public health authorities and the private sector to ensure patient safety and security.
By Kat Jercich
April 26, 2021 12:07 PM
Patient ID Now, a coalition of more than 40 healthcare organizations, released a framework this week aimed at creating a national strategy around patient identification that protects individual safety and security.
In the framework, the coalition calls on the federal government to closely collaborate with the private sector and with other public health authorities in working toward the goal of accurate patient identification.
"Throughout the past year, the COVID-19 pandemic has highlighted the urgent need to address the issue of patient identification. The inability to accurately match patients with their records has severe patient safety and financial implications, and impedes health information exchange," said Hal Wolf, president and CEO of Healthcare IT News parent company HIMSS, in a statement.
"The framework lays the foundation for a national strategy that saves lives, while protecting a patient's choice and privacy rights," Wolf added.
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https://histalk2.com/2021/04/23/weekender-4-23-21/
Weekly News Recap
- Home monitoring platform vendor Current Health raises $43 million in Series B financing.
- Consumer data aggregation vendor Seqster raises $12 million in a Series A round.
- Hospital operators HCA and Tenet beat Wall Street estimates on quarterly revenue and profit.
- FDA says it will use the term “MIMPS” (medical image management and processing system) instead of PACS in referring to medical imaging systems.
- Cedars-Sinai is using facial recognition software to identify patients with a history of violence or drug fraud.
- FCC will open applications for its $250 million COVID-19 Telehealth Program on April 29.
- FTC warns businesses that using or selling AI algorithms that are racially based or discriminatory – intentionally or not – violates federal law.
- FDA excludes eight software functions that previously invoked its regulation as a medical device.
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Enjoy!
David.
