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.
-----
https://patientengagementhit.com/news/assessing-the-market-for-patient-experience-surveying
Assessing the Market for Patient Experience Surveying
Industry
mainstay Press Ganey is still a leader for CAHPS surveying, but as more
organizations begin to do real-time patient experience surveys other market
leaders emerge.
By Sara Heath
December 03,
2021 - Press Ganey is still a leading vendor for CAHPS and patient
experience surveying, according
to a new KLAS Segment Insights Report.
But as the
healthcare industry begins to embrace
real-time patient experience surveying, other vendors like Qualtrics are
starting to emerge, as well.
Patient
experience surveying has long been a key part of clinical quality measurement.
CAHPS surveys, or Consumer Assessment of Healthcare Providers and Systems
surveys, have traditionally been the formal method for measuring patient
experience and satisfaction, with many value-based care programs using the tool
as part of their quality assessments.
According to
the KLAS report, Press Ganey continues to be the market leader for CAHPS
surveys, with 16 of its customers telling KLAS they use Press Ganey for CAHPS
benchmarking. NRC Health likewise shows strength in CAHPS benchmarking, with 12
of its customers telling KLAS they use it for such.
-----
https://healthitsecurity.com/news/fda-mitre-mdic-create-medical-device-threat-modeling-playbook
FDA, MITRE, MDIC Create Medical Device Threat Modeling Playbook
MITRE and
the Medical Device Innovation Consortium (MDIC) partnered with the FDA to
release a playbook for medical device threat modeling.
By Jill McKeon
December 03,
2021 - MITRE and the Medical Device Innovation Consortium (MDIC) teamed up
to release a playbook
for medical device threat monitoring to help organizations strengthen the
cybersecurity of medical devices.
The playbook
incorporated insights from a series of threat modeling bootcamps for medical
device manufacturers hosted by MITRE, MDIC and the Food and Drug Administration
(FDA) in 2020 and 2021.
“Medical
devices are increasingly complex and connected systems existing in complex
connected ecosystems of healthcare delivery,” the playbook stated.
“Although
standard lists of controls such as the National Institute of Standards and
Technology (NIST) Special Publication (SP) 800-53 and ANSI/AAMI/IEC 80001 can
ensure some baseline security capabilities, they fail to address the myriad of
ways that medical devices are used, interface with the healthcare ecosystem,
and most important, how security risks could result in unacceptable safety
issues.”
-----
https://www.digitalhealth.net/2021/12/government-white-paper-digital-care-records/
Government white paper commits to more digital care records
A
government white paper has committed to ensuring that at least 80% of social
care providers have a digitised care record in place by March 2024.
Hanna Crouch –
01 December, 2021
The Adult Social Care Reform White Paper, which is part of the
government’s wider social care plans, is backed by £5.4billion which will go
towards helping to improve the physical, digital and technological
infrastructure of care homes.
This includes
at least £150million going towards improving care quality and safety, support
independent living through new technology and digitisation such as digital care
records, over the next ten years.
According to
the paper, ‘only 40% of social care providers are fully digitised with the
remainder using paper records’.
The paper
adds: “By March 2024, we will ensure that at least 80% of social care providers
have a digitised care record in place that can connect to a shared care record
– a commitment that was set out in the draft Data saves lives: reshaping
health and social care with data strategy.
-----
https://www.medpagetoday.com/meetingcoverage/rsna/95984
Artificial Intelligence Tool Gets High Marks in Reading Mammograms
— Breast
cancer screening results show AI's mettle in real-world dataset
by Ed Susman,
Contributing Writer, MedPage Today December 2, 2021
CHICAGO -- An
artificial intelligence program designed to assist radiologists in reading
breast cancer screening scans proved to be almost as good as trained doctors in
a 3-year test, a researcher reported.
Of the 100
positives detected by humans reading the 12,120 cases in the 2016-2017 period
at a single center, the artificial intelligence program achieved a sensitivity
of 91%, a specificity rate of 91.11%, and a recall rate of 9.56% for the same
cases, reported Gerald Lip, MD, of the University of Aberdeen in Scotland, at
the annual meeting of the Radiological
Society of North America.
The findings
were similar when looking at the results for the 2017-19 period, which included
229 positives among 27,824 screens: The artificial intelligence algorithm
achieved a sensitivity of 88.21%, a specificity rate of 90.92%, and a recall
rate of 9.73%.
"The
performance of this artificial intelligence tool shows a high degree of
sensitivity, specificity, and an acceptable recall rate," Lip concluded.
"The findings demonstrate how an artificial intelligence tool would
perform as a stand-alone reader and its potential to contribute to the double
reading workflow."
-----
https://www.statnews.com/2021/12/02/just-stupid-stuff-logistics-and-lack-of-testing-stymied-finding-omicron/
‘Just stupid stuff’: Logistics and lack of testing stymied finding the
Omicron variant in the U.S.
By Megan Molteni Dec. 2,
2021
After South African scientists
alerted the world last week to the new, concerning Omicron variant of
SARS-CoV-2, researchers here in the U.S. warned that the highly mutated strain
was likely already circulating on American soil. It was just a matter of time
before someone found it.
On
Thursday, health officials reported the country’s second Omicron infection, in
a Minnesota man who attended an anime conference in New York days before his
symptoms began. Notably, he had not traveled internationally, unlike the
first case — a California resident recently returned from South Africa
—
indicating the occurrence of domestic transmission. But the timing of
discovery has many wondering, “why did it take so long?”
According
to details shared by the Minnesota Department of Health, the man, who is a
resident of Hennepin County, home to the state’s most populous city,
Minneapolis, first developed symptoms on Nov. 22. He took a PCR test on Nov.
24. News of Omicron broke on Nov. 25. Minnesota health officials didn’t confirm
from sequencing data that his infection was caused by the Omicron variant until
a week later, on the evening of Dec. 1.
By
contrast, public health agencies in the U.K. found that country’s first cases
of the new strain less than 48 hours after South Africa sounded the alarm.
-----
https://www.healthcareitnews.com/news/pandemic-stress-cyberattacks-are-compounding-degradation-care-delivery
Pandemic stress, cyberattacks are compounding degradation of care delivery
An researcher
from CISA describes the findings of a report, which finds the U.S. healthcare
infrastructure in "critical condition" thanks to COVID-19 and the
disruption of ransomware and other security threats.
By Mike Miliard
December 03,
2021 09:00 AM
This
past September, the U.S. Department of Homeland Security's Cybersecurity &
Infrastructure Security Agency published a report designed to assess the health
of the nation's hospitals and health systems.
Perhaps
unsurprisingly, the report, "Provide Medical Care is in Critical Condition: Analysis
and Stakeholder Decision Support to Minimize Further Harm,"
doesn't offer encouraging news.
It
finds the nationwide infrastructure enabling provision of medical care – one of
CISA's 55 National Critical Functions – to be severely strained by
the COVID-19 pandemic and all the clinical, financial, workforce and supply
chain challenges it has brought,
The
concurrent cyber-pandemic of rampant ransomware and nation-state skullduggery
has only compounded the difficulties faced by providers.
As
the report notes: "Beyond the obvious consequences of disruptions to
diagnostic, testing, and treatment equipment, even minor reductions in
efficiency caused by cyber incidents compound to increase staff workload and
degrade the system's ability to provide medical care."
-----
https://www.stltoday.com/business/investment/personal-finance/medicare-s-telehealth-experiment-could-be-here-to-stay/article_f7e34ab2-c7e7-5e2a-a053-306690fd610f.html
Medicare’s Telehealth Experiment Could Be Here to Stay
Alex
Rosenberg 4 November, 2021
Medicare
beneficiaries used 63 times more telehealth services in 2020 than in 2019 after
the federal government loosened Medicare’s strict telehealth rules due to the
COVID-19 pandemic, according to a report released Friday by the Department of Health and
Human Services.
The policy
changes were intended to be temporary, but data on telehealth use is being
analyzed to help policymakers decide the future of those services under
Medicare.
The HHS
report "provides valuable insights into telehealth usage during the
pandemic," said Chiquita Brooks-LaSure, who leads the Centers for Medicare
& Medicaid Services, in a press release. "CMS will use these insights — along
with input from people with Medicare and providers across the country — to
inform further Medicare telehealth policies."
How did
Medicare’s telehealth rules change in 2020?
Prior to
2020, Original Medicare covered telehealth only under fairly
narrow circumstances (private insurers offering Medicare Advantage plans have much greater discretion to set
their own telehealth policies).
-----
https://mhealthintelligence.com/news/higher-costs-prompt-patients-to-switch-from-telehealth-to-in-person-care
Higher Costs Prompt Patients to Switch From Telehealth to In-Person Care
A new
study revealed the impact of out-of-pocket costs on visit modality, showing
that patients who preferred telehealth were likely to switch to in-person care
if it was cheaper.
By Anuja Vaidya
December 02,
2021 - Patients who preferred telehealth visits were more sensitive to
out-of-pocket cost than those who preferred in-person visits, according to a new study by
the RAND Corporation, a nonprofit research organization.
Published in
JAMA Network Open, the
study aims to assess patient preferences for video visits once the COVID-19
pandemic has ended and to identify the role of out-of-pocket cost in changing
the patient preference for virtual versus in-person care.
Researchers
gathered data from the American Life Panel Omnibus Survey, conducted between
March 8 and March 19. A total of 2,080 RAND American Life Panel members
completed the survey.
About 45
percent of participants reported having had one or more video visits with
healthcare providers since March 2020. Only 2.3 percent among them reported
that they were unwilling to use it again in the future.
-----
https://imia-medinfo.org/wp/history-book/
IMIA History Book
IMIA
acknowledges with great appreciation Dr. Casimir Kulikowski, Chair of IMIA’s
History Working Group, for his unprecedented commitment and dedication in
providing IMIA’s first published History Book. Dr. Kulikowski was
supported by the long standing and dedicated Vice Chairs of the working
group Dr. George Mihalas, Dr. Yalerio Yacubsohn, Dr. Robert Greenes and Dr.
Hyeoun-Ae Park.
We
are very glad that IMIA has published the long-awaited volume of personal
narrative contributions as part of the IMIA History Working Group’s efforts
over the past decade. We greatly appreciate all the work of the
individual contributors and thank those who in this way have shared their
unique personal insights into the development of research and practices in our
key biomedical and healthcare disciplines and their informatics technologies at
an international level. We are planning future activities which could
lead to further volumes in this series covering the organizational histories of
IMIA’s affiliated societies and associations, as well as narratives that can
help broaden the scope of perspectives that inform the many worldwide efforts
in our field. Please do not hesitate to share your comments on the book, and
suggestions for future activities.
Casimir
A. Kulikowski, George I. Mihalas, Hyeoun-Ae Park, Robert A. Greenes, Valerio
Yacubsohn
Editors of the eBook International Medical Informatics and the Transformation of
Healthcare, 2021 and Editorial Board of the IMIA History WG.
-----
https://histalk2.com/2021/12/02/news-12-3-21/
Announcements and Implementations
An
ISMP Medication Safety Alert further explains the previously described problem
in which three pharmacy data sources sent Surescripts incorrectly formatted
medication history instructions, which caused problems such as “take 1 1/2 tablets
daily” being sent to the network as “take 112 tablets daily.” Surescripts
helped the three data sources fix their problem, removed their medication
history response messages until they implement a permanent fix, and offers
health systems and technology vendors a report of their impacted patients.
-----
https://www.healthcarefinancenews.com/news/cvs-health-partners-microsoft-advance-digital-first-strategy
Dec 02 2021
CVS Health partners with Microsoft to advance digital-first strategy
The organization hopes the collaboration will speed along development of a
more data-driven, personalized customer experience.
Jeff Lagasse,
Associate Editor
As
part of efforts to accelerate a digital-centric strategy, CVS Health is teaming
with Microsoft and will be tapping into its cloud computing and artificial
intelligence technologies, the company announced this week.
CVS
Health hopes the collaboration will speed along development of a more
data-driven, personalized customer experience, while complying with patient
privacy and confidentiality policies.
The
idea is to combine information from different areas across the company, so CVS
can enhance its omnichannel pharmacy capabilities and deliver customized health
recommendations. The company said it will also scale up retail loyalty and
personalization programs that use advanced machine learning models running on
the cloud computing service Azure.
-----
https://www.healthcareitnews.com/news/zoom-announces-new-integration-cerner-ehr
Zoom announces new integration with Cerner EHR
The
functionality is currently available for beta testing with some customers,
allowing them to join scheduled sessions by clicking a link within a patient's
chart.
By Kat Jercich
December 02,
2021 12:04 PM
[Ed.
note: This piece has been updated to include comment from Cerner about the
initiative.]
Zoom
announced this week that it had launched an integration option with Cerner's
electronic health record platform.
The
initiative, which is currently available
to beta customers, is aimed at facilitating easier access to telehealth
from within Cerner's EHR.
"With
virtual care here to stay, providers must focus on delivering a seamless
experience for telehealth visits – one that’s easy, intuitive, and frictionless
for patients, and secure, trusted and simple from a clinical standpoint,"
wrote Zoom Global Healthcare Lead Ron Emerson in a post about the announcement.
WHY IT
MATTERS
Cerner
users at hospitals, health systems, physician offices and clinics will be able
to launch secure Zoom visits directly within EHR workflows, the companies say.
-----
https://www.healthcareittoday.com/2021/12/02/could-2022-be-the-year-telehealth-breaks-out-of-its-silo/
Could 2022 Be The Year Telehealth Breaks Out of Its Silo?
December 2, 2021
Anne Zieger
While
telehealth use has
made tremendous gains since the emergence of COVID, the technology still
sits largely on the sidelines. Telehealth visits are now widely available, but
the providers offering these visits aren’t adding new capabilities or even
integrating the technology into their overall workflow.
In
theory, telehealth consults could be enriched with health data gathered from
countless other sources and used to give providers a more nuanced picture of
the patient’s status, but in my experience as a patient, this never happens.
As
a patient, I’d definitely love to see telehealth visits incorporate information
gathered from other digital sources – notably remote patient monitoring devices
– but the platforms my providers use seem far too limited to support this.
Don’t
get me wrong, I’m delighted that telehealth is widely available in any form. As
someone with multiple chronic illnesses, having remote access to my clinicians
is a big deal in and of itself. Given that I see several specialists, I’m
grateful that I don’t have to haul myself into their offices anytime I need
something. I find it much easier to manage my health when I can be seen even if
I don’t feel well enough to go out.
------
https://mhealthintelligence.com/news/52-of-providers-say-patients-declined-telehealth-due-to-security-concerns
52% of Providers Say Patients Declined Telehealth Due to Security Concerns
A majority
of the global providers surveyed also expressed concerns about data use and
sharing, as well as about the personal penalties that may arise if data is
leaked.
By Anuja Vaidya
December 01,
2021 - Though the popularity of telehealth has grown over the course of
the COVID-19 pandemic, more than half of global telehealth providers have
experienced cases where patients refused to participate in a virtual visit
either because they do not trust the technology or due to privacy or data
concerns, according to
a new survey.
Commissioned
by Kaspersky and conducted by Arlington Research, the survey includes results
from 389 interviews, of which 170 were completed with enterprises that have
more than 1,000 employees. The survey was conducted across 34 countries.
Survey
results confirmed the widespread use of telehealth worldwide, with 91 percent
of medical providers saying they have already started using telehealth. About
44 percent of respondents said they started using telehealth after the pandemic
began, while 21 percent said they started using it less than a year before the
onset of the public health emergency.
In fact,
about 13 percent of providers have switched completely to online consultations
on a regular basis and almost a half (46 percent) are likely to do so in the
future.
-----
https://www.medpagetoday.com/opinion/happy-healer/95931
Three Antidotes to Patient Depersonalization
— Better patient-provider communication improves quality of care
by Neil Baum
MD November 30, 2021
Imagine going
to the doctor for your annual checkup, and the physician pulls out a chart or
looks at the EMR of a different patient. Or picture the doctor discussing
medications you're not taking and the results of tests you never had. These
egregious mistakes would certainly not endear a patient to his or her doctor.
A study
published in the Annals of Emergency Medicine found that patient identification
mix-ups can
happen easily, especially in emergencies, although they can happen in a variety of
clinical settings. While most are caught early, nearly 10% cause harm to patients, according to ECRI
(originally the Emergency Care Research Institute).
For example,
among the most serious mistakes uncovered in the ECRI study was that of a
healthcare team not attempting to resuscitate a patient in cardiac arrest
because team members had pulled up the record
of a different patient with a do-not-resuscitate order.
Clinical
mistakes quickly diminish a patient's confidence in his or her physician and
fuel a motivation to find a new provider. From my decades-long experience
practicing urology, I can attest that building patient trust typically takes
years, yet it takes just one problem or unpleasant experience to undo that
hard-earned trust. Unfortunately, frustrated patients often place the blame on
the physician -- even when it's not the doctor's fault.
-----
https://www.healthleadersmedia.com/technology/indiana-hie-innovates-er-while-teaming-five-other-hies-extend-reach
Indiana HIE Innovates in the ER While Teaming Up With Five Other HIEs to
Extend Reach
Analysis
| By Scott Mace |
December 01, 2021
Indiana's
largest health system is now using a FHIR app developed by the Indiana Health
Information Exchange, providing emergency physicians with one-button data
gathering for common symptoms.
KEY
TAKEAWAYS
·
Pandemic gave birth to Consortium for State and
Regional Interoperability, which stood up a six-state COVID dashboard in three
weeks, with the IHIE as a founding member.
·
The IHIE's Network for Patient Care is the
nation's largest clinical data repository, with data on more than 17 million
patients.
·
The goal is to make health data interoperability
more economical or attractive than unstructured data via fax machine image
exchanges, which live on within the EHRs themselves.
As the oldest
health information exchange in the United States, founded in 2004, the Indiana Health Information
Exchange (IHIE) has provided a road map for other HIEs to follow. And as
pandemics rage and physician burnout threatens to spiral out of control, the
IHIE is more than just a pipeline in which for medical records to flow.
It operates
the Indiana Network for Patient Care (INPC), the nation's largest
interorganizational clinical data repository, with participation from more than
120 hospitals, 18,000 practices, and 50,000 providers. All told, it includes
data on more than 17 million patients, at a time when interoperability remains
a challenge nationwide.
The IHIE is
also a member of the Strategic Health Information Exchange Collaborative, a
national collaborative of more than 80 HIEs, which collectively serve 95% of
the U.S. population.
-----
https://mhealthintelligence.com/news/best-buy-doled-out-400m-for-rpm-provider-current-health
Best Buy Doled Out $400M for RPM Provider Current Health
In its
latest earnings call, Best Buy leaders not only disclosed the amount the
company paid to buy Current Health, but also outlined its three-pronged
healthcare strategy, which includes virtual care.
By Anuja Vaidya
November 30,
2021 - Best Buy's acquisition of remote care services provider Current
Health made headlines back in October, and now the company's leaders have
revealed the large price-tag behind the deal: $400 million.
In its third
quarter 2022 earnings call last week, Matt Bilunas, Best Buy's chief financial
officer, disclosed the amount the company paid to purchase Current Health and
said the acquisition is expected to have "a slightly negative impact on
our Q4 non-GAAP operating income," according to a transcript released
by Seeking Alpha.
The retailer announced
plans to buy Current Health last month. Current Health's platform
integrates patient-reported data with information from biosensors, including
the company's own continuous monitoring wearable device, to provide real-time
insights into a patient's condition. This allows healthcare organizations to
monitor patients remotely and coordinate in-home care through its service
partners.
"The
future of consumer technology is directly connected to the future of
healthcare," said Deborah Di Sanzo, president of Best Buy Health, in an Oct.
12 news release. "We have the distinct expertise in helping customers
make technology work for them directly in their homes and by combining Current
Health's remote care management platform with our existing health products and
services, we can create a holistic care ecosystem that shows up for someone
across all of their healthcare needs."
-----
https://patientengagementhit.com/news/patient-provider-communication-misses-the-mark-on-medication-adherence
Patient-Provider Communication Misses the Mark on Medication Adherence
Cost is a
key medication adherence barrier, but most patient-provider communication on
the matter focuses on medication management, survey data shows.
By Sara Heath
November 30,
2021 - Cost, health insurance coverage, and the hunt for financial
assistance programs prove the biggest hurdles to medication adherence, but new data
shows that these barriers aren’t always part of patient-provider communication.
The Health
Union survey of about 2,000 patients with chronic illness confirmed what many
in the healthcare industry know to be true: the high price tag for drugs is
keeping patients from achieving optimal medication adherence.
And not
achieving that optimal medication adherence comes with negative consequences.
Patients who are not able to take their medications as prescribed run the risk
of seeing acute adverse health events that could land them in high-cost and
high-acuity settings, like the emergency department.
This survey
confirms the conventional wisdom that patients don’t skip doses because they
are obstinate, but rather because they
cannot afford their medications or face other cost-related barriers.
Twenty-seven percent of surveyed patients said their biggest barrier to
medication adherence was the cost of their drugs.
-----
https://www.healthdatamanagement.com/articles/fhir-offers-potential-to-automate-expedite-prior-authorization
FHIR offers potential to automate, expedite prior authorization
The emerging
standard holds promise in helping payers and providers move patient information
seamlessly to make care reimbursement decisions.
Nov 30 2021
Diana
Manos
Proponents of
Fast Health Interoperability Resources (FHIR) say the information exchange
standard is a leading candidate to facilitate information exchange,
particularly when it comes to efforts to remove the barriers that make prior
authorization difficult.
In the midst
of that effort is Tony Sheng, vice president of interoperability solutions for
ZeOmega and member of HL7’s Da Vinci Project. At a recent Da Vinci Project
community web-based meeting, Sheng and fellow Da Vinci member, Change
Healthcare’s Craig Knier, demonstrated the use of FHIR and application
programming interfaces (APIs) to enable real-time prior authorization between
providers and payers.
The effort to
incorporate FHIR to solve vexing prior auth challenges is significant because
relatively few such communications between providers and payers are
accomplished in even a partially automated way. Most of these intricate
transactions are time-consuming, labor-intensive and put many patients at risk
while they are waiting for their care to be approved, trade groups say.
Sheng said
the use of FHIR and APIs to speed the prior authorization process is exciting
and holds promise for things to come. But it’s not a silver bullet. In the long
run, because “FHIR is just a set of standards,” he says. Providers still have
to get all documentation necessary when it comes to compiling all the needed
clinical evidence to get an authorization passed.
-----
https://www.medpagetoday.com/opinion/patientcenteredmedicalhome/95920
Perfecting the Art of Nudging
— In a world full of reminder fatigue, how can we ensure patients get that
needed test or vaccine?
by Fred N.
Pelzman, MD November 29, 2021
After
taking a couple of days off for the Thanksgiving holiday, I returned to find
the usual stack of mail and faxes that needed going through, as well as a plump
electronic medical record in-basket.
One
of the letters I received in the mail struck me as sort of strange, and made me
think about how we need to rethink so many things in healthcare. The letter
started out with a large-font bolded message: "Action
Requested." Then it had the usual amenity "Dear Test
Provider: your patient has not completed the test you ordered for them. Our
company has made several attempts to encourage your patient to perform this
test. We
encourage you to contact your patient directly to ensure your patient completes
their test." [boldface theirs]
This
was followed with some details about the test and the patient's identifying
information. And then it wrapped up with, "Thank you for your help!"
As if I don't have enough to do.
This
had all started out during an office visit, when a patient and I went through
the risks and benefits and alternatives of an item that had been quite
delinquent on their healthcare maintenance. We decided on this particular test
as a plan, and then I had done my part to set the process into motion. From
that point on, it was up to the company to send them the test to perform at
home, and up to the patient to ultimately do it and return it to the company so
it could be processed. After that, it would once again have been my job to
communicate the results of the test to the patient, and talk with them about
the next steps that we needed to do to continue to keep them as healthy as
possible.
------
https://www.healthcareitnews.com/news/how-ai-bias-happens-and-how-eliminate-it
Global Edition
Artificial
Intelligence
How AI bias happens – and how to eliminate it
A Stanford
cardiologist and expert in artificial intelligence and machine learning
explains where biased algorithms come from. He offers advice for
preventing them and enabling improved decision support for better outcomes.
By Bill Siwicki
November 30,
2021 01:03 PM
Artificial
intelligence holds great promise for healthcare, and it is already being put to
use by many forward-looking hospitals and health systems.
One
challenge for healthcare CIOs and clinical users of AI-powered health
technologies is the biases that may pop up in algorithms. These biases, such as
algorithms that improperly skew results because of race, can compromise the
ultimate work of AI – and clinicians.
We
spoke recently with Dr. Sanjiv M. Narayan, co-director of the Stanford
Arrhythmia Center, director of its Atrial Fibrillation Program and professor of
medicine at Stanford University School of Medicine. He offered his perspective
on how biases arise in AI – and what healthcare organizations can do to prevent
them.
Q. How
do biases make their way into artificial intelligence?
A.
There is an increasing focus on bias in artificial intelligence, and while
there is no cause for panic yet, some concern is reasonable. AI is
embedded in systems from wall to wall these days, and if these systems are
biased, then so are their results. This may benefit us, harm us or benefit someone
else.
-----
https://www.healthleadersmedia.com/payer/cms-repeals-final-rule-digital-therapeutics-year-shifting-guidance
CMS Repeals Final Rule on Digital Therapeutics in a Year of Shifting
Guidance
Analysis
| By Laura Beerman |
November 29, 2021
"[T]he
absence of an established, repeatable, and scalable path to commercialization
and prescription of DTx has bottlenecked broader uptake," says one
physician leader.
KEY
TAKEAWAYS
·
The Centers for Medicare & Medicaid Services
has repealed its Medicare Coverage of Innovative Technology final rule.
·
The action leaves multiple unanswered questions
for digital therapeutic reimbursement, with payers using a patchwork of
existing coverage, benefit, coding, and billing options.
·
It is a scenario not uncommon to healthcare
innovation: building the bicycle while riding it—and many others.
On November
14, 2021, the Centers for Medicare & Medicaid Services (CMS) repealed
its final rule on Medicare Coverage of Innovative Technology (MCIT) and
Definition of Reasonable and Necessary. The repeal marks the fifth MCIT action
in 2021 as Medicare, Medicaid, and commercial payers await guidance on digital
therapeutics (DTx), including those that require a prescription. Until the
regulatory dust settles, DTx commercialization will continue to develop—like so
many healthcare innovations—in a "both/and" world, one in which
stakeholders work within and around existing frameworks while attempting to
forge new ones.
The CMS MCIT 2021 timeline began in January with a final rule
that would have "automatically provide[d] Medicare coverage for devices
receiving FDA breakthrough designation for four years," writes Health
Affairs contributor and physician-investor Nisarg Patel.
MCIT sought to close "the current nine- to twelve-month gap between FDA
approval and Medicare National Coverage Determinations, as well as the
inconsistent coverage by local Medicare administrative contractors."
Additional
legislative and industry changes needed
-----
https://ehrintelligence.com/news/how-an-api-coordinated-data-sharing-for-clinical-research
How an API Coordinated Data Sharing for Clinical Research
A research
concierge API connects public academic institutions with private hospitals to
support data sharing for clinical research projects.
By Hannah Nelson
November 29,
2021 - The implementation of a research concierge application programming
interface (API) has helped improve data sharing for clinical research across
Virginia, according to a study
published in JAMIA.
The
integrated Translational Health Research Institute of Virginia (iTHRIV) is a
collaboration between public academic institutions—the University of Virginia
and Virginia Tech—and private hospitals—Inova Health and Carilion Clinic—that
aims to promote inclusive clinical
research through data sharing.
The iTHRIV
Commons set out to provide participants with a cross-site scalable research
infrastructure for the secure sharing, storage, and analysis of data in
accordance with NIH FAIR (Findable, Accessible, Interoperable, and Reusable)
principles.
The iTHRIV
Research Concierge Portal is an API
that serves as the front end to the iTHRIV Commons. The portal supports
federated login, personalized views, and secure interactions with objects in
the ITHRIV Commons federation.
-----
https://healthitsecurity.com/news/h-isac-releases-ciso-guide-for-identity-centric-data-sharing
H-ISAC Releases CISO Guide for Identity-Centric Data Sharing
H-ISAC
released a guide to help CISOs navigate the 21st Century Cures Act by adopting
an identity-centric data sharing approach.
By Jill McKeon
November 29,
2021 - Health-ISAC released
new guidance to help CISOs navigate interoperability, patient access, and
identity-centric data sharing under the 21st Century Cures Act. New
interoperability mandates under the Cures Act require healthcare organizations
to implement APIs to promote the digitization of electronic health information
(EHI).
“While APIs
are the ‘door’ to enabling interoperability of EHR between healthcare
organizations, strong identity solutions are the ‘key’ that keeps EHI secure,”
the guide explained.
Specifically,
the
Act depends on APIs that operate on the Fast Healthcare Interoperability and
Resources (FHIR) standard. The FHIR standard was developed by nonprofit
standards group Health Level 7 (HL7) and was created to allow patients to
easily access data through a third-party application of their choice.
“These new
interoperability mandates pose significant challenges, not the least of which
is ensuring that new systems deployed to enable information sharing do not
create new security concerns,” the guide stated.
“Digital
identity is front and center in these new interoperability architectures, given
the importance of ensuring that only the right people can access sensitive
EHI.”
-----
https://www.bloombergquint.com/gadfly/patients-now-see-their-records-but-can-they-understand-them
Patients Now See Their Records, But Can They Understand Them?
Eliana Perrin
07:00 PM IST, 24 Nov 2021 12:35 AM IST, 24 Nov 2021
Save
Patients Now See Their Records, But Can They Understand Them? (Bloomberg
Opinion) –
I am a
primary care pediatrician who often hears from friends or relatives when they
get bad or confusing medical news. Recently, a call came late on a Friday from
someone who had just checked a test result in her MyChart account, a widely
used electronic patient portal, and learned she had cancer. The weekend was starting,
she wouldn’t be able to discuss the news with her d\doctor until Monday, and
she spent the weekend reading and rereading her report and anxiously searching
the internet for information.
Experiences
like this have become common since April, when a provision requiring the
release of patient medical information was put into full effect as part of the
21st Century Cures Act. This legislation, originally from 2016, was a
bipartisan effort to assurethat doctors and hospitals would share with patients
(at no cost) several types of medical records and test results. While this may
sound like a small step toward openness, it actually represents a sea change in
the way doctors and patients communicate.
To be sure, doctors and health-care groups should always be willing to share
health information with patients. Research has found transparency can
strengthen doctor-patient relationships, and providing accurate information in
a timely manner helps empower patients to improve their self-care.
But there are two problems — both rooted in the traditional practice of
medicine: First, most providers write their lab and exam findings and other
notes so that other medical professionals can understand them. That’s the point
of most charts: to communicate to communicate complicated information among
trained caregivers and billers. Patients, especially those with lower literacy,
cannot easily interpret this language. Only one part, the after-visit summary,
is written to and for the patient. Also, many patient portals aren’t available
in Spanish or other languages, further limiting their accessibility and
increasing health disparities.
-----
https://healthitsecurity.com/news/patients-file-lawsuits-in-wake-of-healthcare-data-breaches
Patients File Lawsuits in Wake of Healthcare Data Breaches
Some
hospitals are successfully putting a stop to lawsuits filed in the wake of
healthcare data breaches, claiming a lack of real injury to patients.
By Jill McKeon
November 29,
2021 - Healthcare data breaches may result in the exposure of protected
health information (PHI) and personally identifiable information (PII), and
victims are often advised to remain vigilant against suspicious account
activity and consistently monitor their credit reports.
Although data
breaches can be a cause for concern for impacted individuals, it can be
difficult to prove financial harm or justify concern as a reason to seek
damages.
Nonetheless,
many hospitals face class-action lawsuits after suffering a ransomware attack, in
which former patients may claim that the hospital or health system should have
implemented proper safeguards to prevent the breach from happening.
UF Health
Requests Dismissal of Patient Lawsuit
UF Health
Central Florida filed a motion to dismiss a lawsuit
that alleged that the health system was negligent and failed to prevent a May
31 ransomware attack that led to nearly one month of EHR downtime and impacted
over 700,000 individuals, according
to Villages-News.
-----
https://www.healthcareitnews.com/news/boost-interoperability-snomed-ct-power-ips-sub-ontology
In a boost to interoperability, SNOMED CT to power IPS sub-ontology
SNOMED
International says it will create and release an openly available International
Patient Summary sub-ontology in the first half of 2022, aimed at promoting
cross-border information sharing.
By Kat Jercich
November 29,
2021 03:56 PM
SNOMED
International announced this past week that its governance bodies had recently
enacted a decision to support the scope of content within the International
Patient Summary.
The
organization said it will extend the core of SNOMED CT's structured clinical
terminology in order to create and release an open, standalone IPS sub-ontology
in the first half of 2022.
This,
in turn, will support international data-sharing, said SNOMED International.
"2021
has seen increased interest by governments and health and care organizations
globally for implementing the IPS to enhance timely cross-border health
information flow and interoperability," said Alex Elias, chair of SNOMED
International’s General Assembly, in a statement.
-----
https://www.healthcareitnews.com/news/emea/digital-health-apps-germany-update-diga-journey
Digital health apps in Germany - An update on the DiGA journey
Digital
therapeutics have been on the German market for a year. Healthcare IT News
explores the progress made, as well as future developments and their
potential influence on other countries’ eHealth strategies.
By Cornelia
Wels-Maug
November 29,
2021 06:13 AM
Digital
therapeutics, or Digital Health Applications (DiGA), are apps for the
detection, monitoring, treatment, or alleviation of medical conditions. The
DiGA initiative is part of the 2019 Digital Healthcare Act (DVG) that sets the legal
framework for doctors to prescribe DiGAs to the 73 million citizens insured
with a statutory health insurer that reimburses their use, and has
been recognised as a pioneering approach globally. To classify as a DiGA, apps that are CE-marked as Class 1 and 2a low risk
medical devices must have successfully passed the Fast-Track assessment process by the Federal Institute for
Drugs and Medical Devices (BfArM). The assessment appraises an app with
regards to its safety, performance, data protection, information security,
medical effectiveness, interoperability, its ability to bring positive health
effects and advance the healthcare system, among other things.
The
first DiGAs were authorised for use in October 2020, and now a total of 24 are approved (as of 29 Nov 2021). So far, 106 applications
were submitted, of which six were rejected and 52 withdrawn – on the grounds of
inappropriate study design (42%) and inapt systematic data evaluation (42%).
Currently 24 apps are under review. The approved DiGAs cover a range of
medical fields including: cancer (2); cardiovascular system (1); ears (1);
hormones & metabolism (3); muscles & bones & joints (3); nervous
system (3) and psyche (11).
Initially,
DiGA developers stemmed from the startup domain, but interest from medtech
and pharma companies - as well as industry associations is increasing. The
majority (86%) of applications are “made in Germany", with 10% of DiGA
applicants based in other European countries and 4% in the US and New
Zealand.
-----
Enjoy!
David.
