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/dod-affirms-mhs-genesis-ehr-implementation-remains-on-schedule
DoD Affirms MHS GENESIS EHR Implementation Remains on Schedule
The Department of Defense (DoD) addressed concerns regarding its MHS GENESIS EHR Implementation after the VA confirmed it would delay the rollout of its Cerner EHR.
June 24, 2022 - The Department of Defense is confident that its EHR implementation, MHS GENESIS, will be deployed on schedule and completed by the end of 2023, according to reporting from FedScoop.
In light of the Department of Veterans Affairs’ confirmed Cerner Oracle EHR modernization (EHRM) project delays, DOD provided an update on the status of its own EHR rollout.
“We’re continuing our deployments,” Holly Joers, Defense Healthcare Management Systems Program Executive Officer, told reporters during a press briefing Tuesday. “We’ll be complete with our deployments of 2023. We are in the same system as VA. So, as they continue, they always had planned a longer deployment schedule, given the number of sites that they have. So, no, that doesn’t impact our ability going forward from a DOD perspective.”
Both VA and DoD have started multibillion-dollar EHR programs in an effort to replace their legacy EHR systems, FedScoop wrote. The EHR deployed by VA is called Cerner Oracle Millennium, while the DoD and Coast Guard system is MHS Genesis.
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https://mhealthintelligence.com/news/patients-report-better-telehealth-experiences-than-providers
Patients Report Better Telehealth Experiences Than Providers
Patient experience with telehealth appears to be better than provider experience, with only 15 percent of patients saying they had a difficult time obtaining the care they expected, a new report shows.
June 24, 2022 - Overall, patients were more likely to report that they could get the type of care they expected via telehealth as compared with providers, according to the Healthcare Experience Report: 2022 released by Zocdoc.
Based in New York City, Zocdoc assists people in booking in-person and virtual appointments for various types of care.
The authors of the report gathered data from Zocdoc user and provider surveys and analyzed healthcare appointments and booking trends from May 2020 to May 2022.
A key finding of the report was that patients were far less likely to say they experienced issues when using telehealth services. For example, only 15 percent of patients claimed that obtaining expected care was difficult, compared to the 58 percent of providers that reported difficulty when examining patients via telehealth.
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https://www.digitalhealth.net/2022/06/clinical-sat-nav-nhs/
‘Clinical satnav’ for doctors should become a mainstream part of the NHS
A ‘clinical satnav’ for doctors could help improve patient care and should become a mainstream part of the NHS, a new report has suggested.
Hanna Crouch – 22 June 2022
‘Building a ‘clinical satnav’ for practitioners and patients’ explores why providing better computerised advice for routine medical decisions will save lives and help to solve problems like over-prescription of antibiotics.
The report, commissioned by BCS, The Chartered Institute for IT, also argues that a ‘clinical sat-nav’ at the doctor’s fingertips could guide them on which tests to order, evaluation of the results, possible diagnoses, and produce options for care and treatments.
In order to achieve this, the report believes this requires accurate, standardised, computable forms of clinical guidance and systems that must be able to talk to each other across the UK.
BCS also states that computer-driven support for diagnosis and other clinical decisions must become a mainstream part of the NHS.
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Digital Vaccines – Can This AI Tool Save Us from Ourselves?
June 24, 2022
The following is a guest article by Dr. Neecey Hudson, PhD – Founder & Chief Scientist at Hood Medicine Initiative.
Pandemic preparedness has now become a paramount concern across the globe. From vaccine supply chain logistics to hospital capacity management, many nations have failed to provide competent response measures that equitably protect their citizens and reduce the spread of infection, while low and middle-income countries (LMICs) are facing enormous challenges to do so. This global crisis has tested our ability as a civilization to respond to public health emergencies and mitigate the impact of geopolitical interference impeding our collective adherence to sensible policies geared towards disease prevention. Innovative, low-cost interventions are needed to supplement traditional measures in a manner that is irrespective of coordinated government provisions.
One thing upon which all experts can agree is that multilayered approaches to combating communicable diseases optimize herd protection. For airborne viruses like SARS-CoV-2, this includes not only vaccination programs, but also testing and tracing protocols, social distancing, masking, and other physical barriers to infection. However, economic, political, and social pressures have worked in concert to deprioritize the implementation of preventative measures in many countries. In addition, public health communications efforts have been thwarted by targeted disinformation that easily takes hold amidst a concurrent infodemic wherein people are unsure of the trustworthiness of data as well as sources of information.
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CHIME and WEDI Caution Consumers Against Health Information Loss
Analysis | By Scott Mace | June 24, 2022
A new resource developed by the two groups can be customized to help patients guard their data on third-party health sites.
With third-party applications gaining more access to patients' health information, the College of Healthcare Information Management Executives (CHIME) and the Workgroup for Electronic Data Interchange (WEDI) have announced the launch of the “THINK BEFORE YOU CLICK” campaign.
The organizations are endorsing a seamless flow of data to these applications to enhance access and improve better health outcomes. Consumers must mitigate their risk, however, and the groups are offering five-step checklist designed to educate and empower consumers to take the necessary precautions before they transmit their health information to third-party apps.
This checklist is non-branded and is made available for free to any organization seeking to educate and protect its members.
“With new federal regulations allowing patients to direct providers and health plans to share their health information to a third-party app, there is concern that unintended disclosures of sensitive data could occur,” Russell Branzell, president and CEO of CHIME, said in a press release “Providing consumers with this simple-to-use checklist with recommended actions they can take before transmitting their data is a service we feel will help consumers protect themselves and their personal information.”
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As API Adoption in Healthcare Skyrockets, Cybersecurity Risks Follow
API adoption is rapidly increasing across the healthcare sector, but the cybersecurity risks that come along with APIs cannot be ignored.
By Jill McKeon
June 23, 2022 - Application Programming Interface (API) adoption is steadily increasing in the healthcare sector, but APIs do not come without cybersecurity risks. In fact, Gartner predicted that API attacks would become the most common attack vector by 2022.
In healthcare, evidence suggests that API adoption could revolutionize interoperability efforts and health data exchange. In addition, providers are increasingly implementing APIs to comply with the CMS Interoperability and Patient Access final rule. Meanwhile, the HL7 Fast Healthcare Interoperability Resources (FHIR) standard is quickly gaining recognition in the health IT space.
In a recent report, Imperva partnered with the Marsh McLennan Global Cyber Risk Analytics Center to analyze API-related incident data and quantify the cost of API insecurity. Researchers discovered that the lack of security APIs may cause $12 billion to $23 billion in average annual API-related cyber loss in the US and anywhere from $41 billion to $75 billion globally.
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GE Healthcare debuts wireless, wearable hospital patient monitor
By Conor Hale
Jun 23, 2022 01:16am
GE Healthcare is rolling out a set of wireless, portable sensors designed to be worn by patients during their hospital stay, making it easier for clinicians to keep track of their vital signs without routine check-ins.
The goal is to help keep a closer eye on inpatients and people recovering from surgery—while allowing them to stretch their legs and interact with visitors, without being confined to a hospital bed—and also alert healthcare providers to any early signs of deterioration that may require a move to intensive care.
The Portrait Mobile system includes a waterproof, smartphone-like mobile monitor, which collects information from wearable sensor patches that capture the patient’s breathing rate, pulse and oxygen saturation.
Designed to complement GE’s portfolio of wired, bedside vital sign monitors and telemetry devices, Portrait Mobile has received a CE Mark for use in Europe but has not yet been cleared by the FDA.
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Survey: Virtual Visits Have Their Benefits (and Distractions)
Analysis | By Eric Wicklund | June 22, 2022
A new survey finds that both patients and providers see value in telehealth visits as a complement to in-person care but not a replacement. And they don't like distractions.
A survey of patient and provider attitudes toward telehealth find that both see the virtual visit as a complementary to the in-person visit, but not as a replacement. And they both certainly know when a virtual visit isn't working.
Compiled by the New York-based telehealth scheduling company Zocdoc, the survey, taken separately of patients and care providers between May 2020 and May 2022 and combined with an analysis of appointment bookings, charts the increase in telehealth visits during the pandemic and a decrease in recent months as the COVID-19 crisis has waned. It found that roughly one-third of all visits were virtual in 2020, as the pandemic peaked, and that number dropped to 17% as of May 2022.
The one exception is in mental health services. Some 74% of mental health appointments were for virtual services in May 2020, and that number rose to 85% in May 2021 and has increased to 87% in May 2020. The numbers show that both patients and providers are finding a comfort zone in telehealth for mental and behavioral health services.
Perhaps more intriguing are the challenges that come with a virtual visit. According to the survey, providers noted the following distractions:
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https://www.healthcareittoday.com/2022/06/23/how-iot-medical-devices-save-and-improve-lives/
How IoT Medical Devices Save and Improve Lives
June 23, 2022
The following is a guest article by Erik Kling, Interim Head of IoT Americas at Vodafone Business.
IoT, or the Internet of Things, has transformed our homes with connected lights and smart appliances. It’s also revolutionized all areas of business, including manufacturing. Sensors connected to the internet can track goods throughout the supply chain — from sourcing materials to delivering completed products to consumers.
IoT technology has improved the way we live, but its most profound impact may be in healthcare, where it’s saving lives and improving health.
Before IoT revolutionized healthcare, doctors and care providers were limited to in-person visits, texts, and telehealth. Patients had to take time out of their day to journey to their care facilities for routine visits. Now, monitoring via IoT allows patients to remain at home while doctors remotely and continuously monitor patient progress.
Healthcare devices represent one of the fastest-growing IoT sectors, and it’s predicted to reach $176 billion by 2026. Use cases appear endless: The technology is used in hospital and home settings. Patients can use IoT to perform self-maintenance, and the elderly can use IoT wearables to communicate with care providers during an emergency.
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Larry Ellison’s Vision of a National EHR Database as Part of Cerner Acquisition
June 23, 2022
A couple weeks ago, Oracle’s acquisition of Cerner closed and Oracle held an event to announce the vision for the The Future of Healthcare. Much has been written about Larry Ellison’s vision of what he called a “National EHR Database.” I wanted to give it a few weeks to sit before I commented, but it’s certainly worthy of comment.
First, it’s worth noting that Larry Ellison’s main job as CEO of Oracle is to set the vision for the company and that includes setting the vision for what he wants Oracle to accomplish with the acquisition of Cerner. CEOs visions at large corporations of what they’d like to accomplish don’t necessarily have to match reality. Many notably share a vision they know can’t be achieved in order to “inspire” their employees to go beyond what they thought was possible. In some cases, this can work really well and what seemed impossible becomes possible.
To be clear, I’m not sure if this was Ellison’s goal with a “National EHR Database” or not. It’s quite possible that this is a vision of how he thinks healthcare should work or how he was told how it should work and that’s the vision he shared. If we’re honest with ourselves, his vision is one where patients would benefit in many ways. The question that most are asking though is whether this vision is grounded in any sort of reality and whether it ignores the complexities of healthcare that make this impossible to achieve.
What’s clear is that Ellison laid out a vision where Oracle had a National EHR database that had a longitudinal record for every patient. That’s his goal and what he wants his team at Oracle (including Cerner) to achieve. It will be fun to follow up with this in a year or two and see what he and the Oracle think about this vision.
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Some Good News, and Some Bad, in Report on Physicians and Their EHR Experiences
Analysis | By Scott Mace | June 23, 2022
The latest KLAS Arch Collaborative survey finds that healthcare organizations with the highest number of clinicians satisfied with their electronic health record experience are employing superusers.
KEY TAKEAWAYS
· According to the latest report from the KLAS Arch Collaborative, the percentage of clinicians who feel leadership is doing well declined from 2017 to 2021, but has rebounded in 2022.
· Organizations that emphasize high-quality patient care in the EHR are reporting more positive clinician EHR experiences.
· More physicians are also reporting signs of burnout.
A new report from the KLAS Arch Collaborative, which addresses how healthcare organizations build trust with clinicians to ultimately improve their electronic health record experience, shows a vast gap between those who are satisfied and those who aren't.
Clinician perceptions of three key EHR stakeholders—their organization/IT leadership, their EHR vendor, and end users themselves—impact their Net EHR Experience Score (NEES). The impact is strongest with the first group, organization/IT leadership, according to the report.
The NEES uses a point scale of -100 to +100 to measure agreement or disagreement that those surveyed trust their organization/IT leadership to deliver good EHR experiences. The gap between both ends of the spectrum is vast, with 27,455 clinicians surveyed strongly agreeing that they do have such trust, and 21,058 clinicians strongly disagreeing. The NEES score between the two represents a gap of 124.1 points on the NEES scale.
Several factors determine whether clinicians trust their organization/IT leadership, including EHR satisfaction, clinician burnout, EHR training, and support.
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How FHIR APIs Can Support Genomic Data Sharing for Research, Patient Care
As part of ONC’s Sync for Genes program, two healthcare organizations demonstrated how HL7 FHIR APIs can facilitate genomic data sharing.
June 22, 2022 - Phase four of ONC’s Sync for Genes program revealed that Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs) can support genomic data sharing for clinical and research use cases.
The Sync for Genes program, launched by ONC in 2017 in partnership with the National Institutes of Health’s All of Us Research Program, aims to support genomic data sharing across the care continuum.
Phase one of the project focused on testing use cases included in HL7’s Clinical Genomics Workgroup’s Domain Analysis Model. These results contributed to the Genomics Reporting Implementation Guide as part of the FHIR Release 3.0.
Phase two demonstrated how stakeholders could share and leverage genomic data for newborn screening, cancer treatment, pharmacogenomics, and bone marrow matching.
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https://ovsecondopinion.substack.com/p/virtual-care-has-its-gaps-its-time?s=w
Virtual care has its gaps - it’s time we talked about it
We teamed up with Omada Health to quantify how much of patient care can be delivered virtually vs. in person
Jun 17 2022
For this piece, we wanted to get a deeper industry perspective. So we teamed up with Omada Health CEO Sean Duffy. If you haven’t heard of Omada, it’s one of the OG digital health companies that started out in preventing diabetes and now works across diabetes, hypertension and more. So this analysis represents both of our views.
As an industry, we all talk a lot about virtual-first care. But let’s get real. Telemedicine and remote care have limits. There are times when it works extremely well. And there are times when the patient needs to be seen in person.
We all know that to be true on a deeper level. And yet, we wondered if there would be a way to actually quantify that. How much of our care services could be administered in a virtual setting and what type of treatment needs to stay brick and mortar? And how will that ratio change in the future - and why? As we move from hype to balance, we think that the real work lies ahead. Both ambulatory care managers and new digital entrants alike need to think through the right balance between virtual and in-person.
As a next step, we asked the data and clinical teams at Omada to analyze when, how, and why office-based encounters are required for safe and effective care. That involved parsing through the catalog of coded, categorized medical services and procedures via the American Medical Association’s CPT (Current Procedural Terminology) code library.
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https://revealnews.org/article/facebook-data-abortion-crisis-pregnancy-center/
Facebook and Anti-Abortion Clinics Are Collecting Highly Sensitive Info on Would-Be Patients
Grace OldhamDhruv MehrotraJune 15, 2022
This story is a collaboration with The Markup.
Facebook is collecting ultra-sensitive personal data about abortion seekers and enabling anti-abortion organizations to use that data as a tool to target and influence people online, in violation of its own policies and promises.
In the wake of a leaked Supreme Court opinion signaling the likely end of nationwide abortion protections, privacy experts are sounding alarms about all the ways people’s data trails could be used against them if some states criminalize abortion.
A joint investigation by Reveal from The Center for Investigative Reporting and The Markup found that the world’s largest social media platform is already collecting data about people who visit the websites of hundreds of crisis pregnancy centers, which are quasi-health clinics, mostly run by religiously aligned organizations whose mission is to persuade people to choose an option other than abortion.
Meta, Facebook’s parent company, prohibits websites and apps that use Facebook’s advertising technology from sending Facebook “sexual and reproductive health” data. After investigations by The Wall Street Journal in 2019 and New York state regulators in 2021, the social media giant created a machine-learning system to help detect sensitive health data and blocked data that contained any of 70,000 health-related terms.
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New class action lawsuit claims Meta's discreet patient data tracker was active across 664 provider websites
By Dave Muoio
Jun 22, 2022 01:45am
Facebook parent company Meta was hit with a class action lawsuit late last week alleging the tech company has been collecting sensitive patient-status data through hospital websites in violation of the Health Insurance Portability and Accountability Act (HIPAA).
The case was filed on Friday in the Northern District of California by an anonymous patient of Baltimore’s Medstar Health System on the behalf of “millions of other Americans whose medical privacy has been violated by Facebook’s Pixel tracking tool.”
The filing came just days after the publication of an investigation by The Markup detailing how the tech company’s analytics tool was found on roughly a third of the country’s top hospitals’ websites.
Both the report and the lawsuit detailed the tracker’s collection of identifiable information such as IP addresses alongside other potentially sensitive information including doctor names and recent web activity related to their health conditions. The two documents also said that patients using provider websites with the tracker would not have consented to the collection of these data.
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VA hits pause on future rollouts of EHR until 2023 while lawmakers raise fresh concerns about patient safety risks
Jun 23, 2022 03:00am
The Department of Veterans Affairs (VA) will push off deployment of a new electronic medical records system to additional medical facilities until 2023 to address outages that have plagued the software at current sites.
The VA acknowledged in a statement that there have been "unanticipated outages and system degradations" from the onset of the new Oracle Cerner electronic medical record system rollout. The EHR system has been rolled out to three VA facilities to date.
The VA had planned to deploy the new health records software, which was developed by Cerner, now owned by Oracle, at the Puget Sound VA Health Care System, including American Lake and Seattle VA Medical Centers, this August, but will now push that project to March 2023 instead, a VA spokesperson confirmed.
Plans to deploy the platform to the VA Portland Health Care System at the Portland and Portland-Vancouver VA Medical Centers has been delayed from this November to April 2023.
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Wrist-worn trackers can detect Covid before symptoms, study finds
Sensor tech can alert wearer to Covid early, helping to prevent onward transmission
Andrew Gregory Health editor
Wed 22 Jun 2022 08.30 AEST Last modified on Wed 22 Jun 2022 21.52 AEST
Health trackers worn on the wrist could be used to spot Covid-19 days before any symptoms appear, according to researchers.
Growing numbers of people worldwide use the devices to monitor changes in skin temperature, heart and breathing rates. Now a new study shows that this data could be combined with artificial intelligence (AI) to diagnose Covid-19 even before the first tell-tale signs of the disease appear.
“Wearable sensor technology can enable Covid-19 detection during the presymptomatic period,” the researchers concluded. The findings were published in the journal BMJ Open.
The discovery could lead to health trackers being adapted with AI to detect Covid-19 early, simply by spotting basic physiological changes. This could help provide an early warning system to users that they may be infected, which may in turn help to prevent the spread of the disease more widely.
Researchers from the Dr Risch Medical Laboratory in Liechtenstein, the University of Basel in Switzerland, McMaster University in Canada and Imperial College London tested the Ava bracelet, a fertility tracker that people can buy online to track the best time to conceive. The study also notes that of the 28 researchers listed, six “are employed by Ava AG”.
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How to get started with machine learning and AI
We wrap our heads around the basics of AI/ML and show you how to get a model off the ground.
Matt Ford - 6/22/2022, 11:00 PM
"Artificial Intelligence" as we know it today is, at best, a misnomer. AI is in no way intelligent, but it is artificial. It remains one of the hottest topics in industry and is enjoying a renewed interest in academia. This isn't new—the world has been through a series of AI peaks and valleys over the past 50 years. But what makes the current flurry of AI successes different is that modern computing hardware is finally powerful enough to fully implement some wild ideas that have been hanging around for a long time.
Back in the 1950s, in the earliest days of what we now call artificial intelligence, there was a debate over what to name the field. Herbert Simon, co-developer of both the logic theory machine and the General Problem Solver, argued that the field should have the much more anodyne name of “complex information processing.” This certainly doesn’t inspire the awe that “artificial intelligence” does, nor does it convey the idea that machines can think like humans.
However, "complex information processing" is a much better description of what artificial intelligence actually is: parsing complicated data sets and attempting to make inferences from the pile. Some modern examples of AI include speech recognition (in the form of virtual assistants like Siri or Alexa) and systems that determine what's in a photograph or recommend what to buy or watch next. None of these examples are comparable to human intelligence, but they show we can do remarkable things with enough information processing.
Whether we refer to this field as "complex information processing" or "artificial intelligence" (or the more ominously Skynet-sounding "machine learning") is irrelevant. Immense amounts of work and human ingenuity have gone into building some absolutely incredible applications. As an example, look at GPT-3, a deep-learning model for natural languages that can generate text that is indistinguishable from text written by a person (yet can also go hilariously wrong). It's backed by a neural network model that uses more than 170 billion parameters to model human language.
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Alphabet is spending billions to become a force in health care
Can it finally shake up the stodgy multi-trillion-dollar industry?
Jun 20th 2022 (Updated Jun 22nd 2022)
Rich countries pour heart-stopping amounts of money into health care. Advanced economies typically spend about 10% of gdp on keeping their citizens in good nick, a share that is rising as populations age. America’s labyrinthine health-industrial complex consumes 17% of gdp, equivalent to $3.6trn a year. The American system’s heft and inertia, perpetuated by the drugmakers, pharmacies, insurers, hospitals and others that benefit from it, have long protected it from disruption. Its size and stodginess also explain why it is being covetously eyed by big tech. Few other industries offer a potential market large enough to move the needle for the trillion-dollar technology titans.
In 2021 America’s five tech behemoths collectively spent more than $3bn on speculative health-care bets (see chart)—and may have invested more in undisclosed deals. Some of their earlier health-related investments are starting to pay off. Amazon runs an online pharmacy and its telemedicine services reach just about everywhere in America that its packages do, which is to say most of it. Apple’s smartwatch keeps accruing new health features, most recently a drug-tracking one. Meta has scrapped its own smartwatch plans earlier this year but offers fitness-related fun through its Oculus virtual-reality goggles. Microsoft is expanding its list of health-related cloud-computing offerings (as is Amazon, through aws, its cloud unit).
Yet it is Alphabet, Google’s corporate parent, whose health-care ambitions seem to be the most vaulting. Between 2019 and 2021 Alphabet’s venture-capital arms, Google Ventures and Gradient Ventures, and its private-equity unit, CapitalG, made about 100 deals, a quarter of Alphabet’s combined total, in life sciences and health care. So far this year it has injected $1.7bn into futuristic health ideas, according to cb Insights, a data provider, leaving its fellow tech giants, which spent around $100m all told, in the dust. Alphabet is the fifth-highest-ranking business in the Nature Index, which measures the impact of scientific papers, in the area of life sciences, behind four giant drugmakers and 20 spots ahead of Microsoft, the only other tech giant in the running. The company has hired former senior health regulators to help it navigate America’s health-care bureaucracy.
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Oracle sets lofty goals after completing acquisition of Cerner
A national patient database, improved clinician interfaces and support for patient engagement are among goals set for the combined companies by Larry Ellison.
Jun 22 2022
Editor-in-Chief, HDM
With Oracle’s $28.3 billion acquisition of Cerner now complete, the networking and technology giant is describing some of the advances it hopes to achieve in healthcare through the purchase of the electronic health records system company. That includes an effort to create a national patient records database that could prove difficult and controversial.
In a 90-minute web-based presentation June 9 titled “The Future of Healthcare,” Oracle executives – including co-founder and chief technology officer, Larry Ellison – outlined ambitious plans to use Oracle’s technology platforms and prowess to ease caregivers’ workloads, decrease administrative burden and defragment patients’ often-dispersed health records.
The presentation also featured Cerner CEO David Feinberg, MD, who briefly spoke in a recorded segment and was identified as president and CEO of newly named Oracle-Cerner.
Components of the strategies mentioned during the presentation are either already underway throughout the industry or otherwise have been found to be extremely complicated and vexing to solve, industry experts note.
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Groups ask HHS for quicker decisions on emerging standards
WEDI, HL7 and others urge the agency to promote ‘a more nimble and responsive approach to standards adoption.’
Jun 22 2022
Editor-in-Chief, HDM
In a letter to Department of Health and Human Services Secretary Xavier Becerra, several healthcare standards organizations are calling for streamlining and making more predictable the process for submitting attachments as well as modernizing existing rules to improve patient care and reduce burdens on clinicians.
The Workgroup for Electronic Data Interchange, HL7 and the other organizations are making the suggestions in response to a request for comments from the National Committee on Vital and Health Statistics.
In addition to WEDI and HL7, the other organizations collaborating on the response include the CAQH Committee on Operating Rules for Information Exchange, the National Council for Prescription Drug Programs and X12.
“In response to the NCVHS recommendations to the Department of Health and Human Services, our organizations came together to collaborate on common recommendations and context to share with HHS given our unique leadership roles within this industry space,” the letter notes.
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Study: Many digital health startups lack clinical trials, regulatory filings
Of the 224 companies analyzed, 98 received a clinical robustness score of zero.
By Emily Olsen
June 21, 2022 12:06 pm
Many venture-backed digital health startups aren't clinically robust, as measured by the number of regulatory filings and clinical trials, according to a study published in JMIR.
The analysis examined digital health companies using the Rock Health Digital Health Venture Funding Database, FDA data on 510(k), De Novo and premarket approval filings, and the number and type of clinical trials listed on ClinicalTrials.gov. Researchers then assigned a "clinical robustness" score for each company, the sum of the number of regulatory filings and clinical trials weighted equally.
Of the 224 startups included in the study, 98 had a clinical robustness score of 0, while 45 received a five or higher. The average score was 2.5, with 1.8 clinical trials and 0.8 regulatory filings, and the median score was one.
Companies that aimed to diagnose conditions had the highest average score at 2.8, then treatment-focused companies, at 2.2, and finally prevention startups, with a score of 1.9.
Startups that sold their products to employers received an average clinical robustness score of 3.1, compared with 2.7 for providers, 2.2 for consumers and 2.0 for payers.
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Sequoia Project publishes QHIN Fee Schedule and more draft SOPs
The coordinating entity for TEFCA has released new details on Exchange Purposes, Individual Access Services Provider Privacy and Security Notice and Practices.
By Mike Miliard
June 22, 2022 09:49 AM
The Sequoia Project on Tuesday published additional standard operating procedures for participation in the Trusted Exchange Framework and Common agreement. It also released the fee schedule for Qualified Health Information Networks.
WHY IT
MATTERS
Tapped by the Office of the National Coordinator for Health IT to lead TEFCA's
rollout, the Sequoia Project has been publishing a series of documents for
healthcare organizations seeking to become a QHIN under the program or
otherwise prepare for TEFCA participation.
Among the newest batch: Common Agreement QHIN Fee Schedule 1 (Version 1) and Exchange Purposes Standard Operating Procedures for QHINs, participants and sub-participants.
Sequoia Project is also seeking feedback on the draft Individual Access Services Provider Privacy and Security Notice and Practices SOP, which details the requirements and standards for IAS providers to follow in implementing a privacy and security notice.
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Turning Challenges Into Opportunities: 5 Trends in Healthcare IT
June 22, 2022
The following is a guest article by Ed Macosky, Chief Innovation Officer at Boomi, the intelligent connectivity and automation leader.
The COVID-19 pandemic emphasized the importance of being prepared for the worst case scenario. In the healthcare industry, organizations with deeply ingrained cultures of preparedness weathered the crisis better than those that did not have a plan in place. Technology helped these organizations adapt, respond, and move more quickly in the face of the unknown.
Two plus years later, the healthcare industry is still experiencing extraordinary change.
Agility Requires Digital Transformation
It’s now clear that agile organizations that invested in cloud-based, digital technologies were able to pivot when remote care suddenly became the norm. They were able to deliver personalized and seamless experiences from first touch to after-patient care across facilities, providers, and vendors. Investing in innovation and technology can help healthcare organizations deliver high-level services and patient care.
Here are five IT trends that can help healthcare organizations turn challenges into opportunities as they strive to become more agile and better prepared for the next crisis.
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Health Plans Are Mapping Out a Technology Strategy for Home Care
Analysis | By Scott Mace | June 22, 2022
PopHealthCare is planning to expand from its current slate of 19 states to cover the entire country, with a strategy that includes bringing healthcare services directly into the home.
KEY TAKEAWAYS
· Health plans are expanding their platform to include home-based healthcare services, and sometimes acting as the primary care provider of record.
· These new services are part of the evolution to risk-based care.
· New technologies, including telehealth, allow for more services in the home and connections to providers in other locations.
The return of the house call, combined with today's data analytics, may hold the key to managing populations and moving healthcare from fee-for-service to risk-based payments.
So says Eric Galvin, newly-appointed chief executive officer of PopHealthCare, who recently outlined his plans to leverage three decades of operations, underwriting, finance, and human resources experience to expand Emcara Health, PopHealthCare's value-based medical group, from its current 19-state footprint to all 50 states.
"We're about a 13-year-old company whose roots were in revenue analytics for health plans," he says. "That grew and evolved into more of a full-bodied risk adjustment program offering."
Emcara Health's care team visits the homes of patients and conducts health assessments, including ascertaining social determinants of health evident during the visit. In some instances, particularly in rural settings, they're the primary care provider of record.
"If that's the case, we very much are the quarterback of care, and would be interacting with specialists as needed," Galvin says.
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https://ehrintelligence.com/news/trust-in-health-it-leadership-key-to-provider-ehr-experience
Trust in Health IT Leadership Key to Provider EHR Experience
Care organizations where providers have high trust levels in health IT leadership are uniquely set up to address clinician burnout and support the EHR experience.
June 21, 2022 - Trust in organizational health IT leadership has a significant impact on providers’ overall EHR experience, according to a KLAS Arch Collaborative report.
The KLAS Arch Collaborative is a group of healthcare organizations working to improve the EHR experience through surveys.
KLAS calculates net EHR experience score (NEES) by measuring clinician perceptions of three key EHR stakeholders—their organization/IT leadership, their EHR vendor, and themselves as end-users. However, the impact on NEES is strongest for organization/IT leadership.
Several factors play into whether clinicians trust their organization/IT leadership, including EHR satisfaction, clinician burnout, EHR training, and support.
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https://mhealthintelligence.com/news/smartphone-based-tympanometry-system-can-test-ear-function
Smartphone-Based Tympanometry System Can Test Ear Function
Researchers determined that a smartphone-based tympanometry system can evaluate middle ear function on par with standard tympanometry systems.
June 20, 2022 - Pocket-sized health solutions are becoming increasingly innovative, with researchers from the University of Washington (UW) and Seattle Children's announcing their newly developed smartphone-based tympanometry system that can evaluate middle ear function.
According to the World Health Organization, more than 430 million people worldwide suffer from some form of hearing disability. But most cases are preventable through routine screening examinations, such as tympanometry, followed by the appropriate care.
Tympanometry is a test of ear function that can be used along with other tests to detect hearing disorders, particularly in the middle ear. The assessment is typically expensive, costing between $2,000 and $5,000.
To expand innovative efforts surrounding ear assessment, UW and Seattle Children's developed a smartphone-based tympanometry system, which can enable the testing of ear function from the comfort of a patient's home.
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https://patientengagementhit.com/news/61-of-patients-want-better-patient-engagement-in-2022
61% of Patients Want Better Patient Engagement in 2022
Stronger patient engagement and activation will help patients get in for preventive screenings and wellness checks, consumers said in a survey.
By Sara Heath
June 20, 2022 - Patients are ready to start accessing medical care and preventive screenings in a post-pandemic world, but they’re going to need a strong patient engagement boost, according to new data fielded by Survey Monkey for Actium and which was obtained via email.
Currently, about one in five healthcare consumers say doing their taxes is less painful than managing their healthcare. Meanwhile, patients are staring down two years of reduced healthcare access and primary care, leaving many with stark care gaps and lapses in preventive screening.
Some 50 percent of respondents to the 1,230-person survey said their health got worse during the pandemic. Sixty-one percent said they didn’t get enough exercise, while 50 percent said they gained too much weight, 42 percent said they were eating too poorly, 39 percent said their mental health declined, and 27 percent said they’ve neglected their dental health.
That comes amid a backdrop of limited healthcare access over the past two years. Primary care and preventive screening rates are low, data has shown, meaning the poor health habits developed during the pandemic plus limited monitoring means even more acute issues could be on the way.
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State by state, some patients are losing telehealth access to doctors
Telehealth access has been rolling back gradually and quietly over the past few months as pandemic-era emergency health orders have lapsed.
June 19, 2022, 8:00 PM AEST
By David Ingram
Many states are making it difficult for people to have virtual visits with doctors in other states, partly reversing the explosion in telehealth that occurred during the coronavirus pandemic and calling into question the durability of one of the major technological shifts from the past two years.
The rollback in telehealth access has been happening gradually and quietly over the past few months as pandemic-era emergency health orders have lapsed in one state after another, reimposing some of the old rules about when doctors can practice in multiple states.
At Johns Hopkins Medicine, some patients and their families now have to switch doctors or drive hours to different states when previously video calls from their homes would have been allowed under the looser regulations, said Dr. Brian Hasselfeld, the health system’s medical director for digital health and telemedicine.
The major barrier is licensing: a requirement rooted in the 19th century that a doctor must have a license from the state where a patient is located, even if the doctor is licensed elsewhere.
“Most states now are back to the pre-pandemic licensure rules, where you must be licensed in our state if you’re going to see patients in our state,” Hasselfeld said.
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Telehealth with a technician in the home reduces spend by 22% for Scottsdale Physician Group
And it dramatically improved the patient experience: In one case, the physician group dropped a patient’s ER visits from nearly twice a month to zero.
By Bill Siwicki
June 21, 2022 11:07 AM
In 2018, Scottsdale Physician Group in Scottsdale, Arizona, saw a need that simply was not being met.
THE PROBLEM
Some patients were not getting the medical care they needed, when they needed, because of a variety of issues. These patients could be bed-bound, homebound, have little to no support structure, have an inability to access transportation to medical appointments, have infirmities, have high fall risks or other concerns.
These patients were getting care, but unfortunately the care they received was in high-cost environments such as hospitals – and discharged to post-acute facilities. In other words, because of the aforementioned issues, or most likely a combination of those issues, they ended up calling 911 when the medical conditions inevitably worsened, which further increases costs and is horrible for them clinically and emotionally.
“No matter how close the nearest primary care physician office is, if they can’t get out of bed or leave their home, they simply are not going to get care before their conditions worsen,” said Blue Beckham, chief strategy officer at Scottsdale Physician Group. “It is precisely these patients who are consuming the healthcare dollar at an increasing rate.
“If we look at a typical acute episode for this type of patient, it looks like this: Call 911, get evaluated, transported to the hospital ER, evaluated again, seen by ER physician who calls for consults, multiple consults, run blood work, get some imaging, review findings, admit the patient,” he explained.
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Where Are We At With FHIR? with Joe Gagnon and Dr. Don Rucker from 1upHealth
June 21, 2022
It feels like FHIR has gone through all the hype cycles you can imagine in the decade or so that FHIR’s been around. I’ve heard FHIR described as the solution to healthcare’s woes and heard others describe its limitations. We all know the reality is somewhere in between, but where are we at with FHIR today.
After my previous experience talking with 1upHealth about FHIR, I knew that they’d know the intimate details associated with FHIR and could provide a great update. Plus, Don Rucker’s decision to join 1upHealth had me curious about why he chose that company after his time at ONC. In the video interview below, I discuss both of these things with Joe Gagnon, CEO at 1upHealth and Don Rucker, MD, Chief Strategy Officer at 1upHealth.
Along with describing his decision to join 1upHealth, Rucker and Gagnon dive into where we’re at on FHIR providing a modern infrastructure and foundation for access to clean, computable, accessible data. What data is available today using FHIR and what data still isn’t available. I also ask them about the weaknesses that still exist with FHIR.
Gagnon and Rucker also share how FHIR can play a role at a population health level and not just the individual patient level. We also dive into where they’re seeing real world success with FHIR in healthcare. Then, I ask them if there’s another standard coming after FHIR or if FHIR is going to be the healthcare interoperability standard for the next decade.
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https://www.healthleadersmedia.com/innovation/building-business-case-asynchronous-telehealth
Building a Business Case for Asynchronous Telehealth
Analysis | By Eric Wicklund | June 21, 2022
Compelled by consumers who don't always want to schedule a video visit or drive to the doctor's office or ER, health systems are finding new value in asynchronous, or store-and-forward, telehealth.
KEY TAKEAWAYS
· Many health systems took advantage of expanded coverage and access to telehealth during the pandemic to try out asynchronous services, which give consumers the ability to access care without the hassle of driving to a doctor's office or ER or scheduling a video visit.
· Asynchronous telehealth platforms typically allow people to fill out an automated questionnaire on their health concern, which is then screened by the health system and sent to a care provider, who can review the data and send back a diagnosis and care plan.
· The platform is designed to easily treat non-acute concerns quickly, such as infections, colds, and viruses, and allows providers to ask for more information, including images, or shift the encounter to a video visit or in-person care when necessary.
Not every telehealth encounter has to include video, or even be a real-time conversation. Many healthcare organizations are finding that an asynchronous – also called store-and-forward – platform works better for certain services.
"It can be a very simple, efficient format for what we want to do," says Brett Oliver, MD, chief medical information officer for Baptist Health, an eight-hospital, 400-site health system based in Louisville, Kentucky serving parts of Illinois, Indiana, and Tennessee. "And that's what our patients really want."
Unlike synchronous telehealth, which basically consists of a two-way, real-time audio-video feed between patient and care provider, asynchronous telehealth doesn't involve real-time communication, and most often doesn't include video. Consumers enter information into an online platform at their own time and convenience, usually through a questionnaire, and a care provider accesses that data on the other end then responds with a diagnosis and treatment plan. It can be done by phone or computer and include images and even video, but the key factor is that both patient and provider can access the platform at the time and place of their choosing.
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https://histalk2.com/2022/06/19/monday-morning-update-6-20-22/
Acquisitions, Funding, Business, and Stock
Optum UK will acquire Leeds-based healthcare software vendor EMIS Group Plc for $1.5 billion in cash.
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https://www.spokesman.com/stories/2022/jun/19/watchdog-reveals-flaw-in-cerner-computer-system-ca/
Watchdog reveals flaw in Cerner computer system caused nearly 150 cases of harm at Spokane VA hospital
Sun., June 19, 2022
orionds@spokesman.com(202) 853-2524
WASHINGTON – A computer system at Spokane’s VA hospital has caused harm to at least 148 veterans in the Inland Northwest, a draft report by a federal watchdog agency reveals.
The draft report also claims that Cerner Corp., which is being paid at least $10 billion for the electronic health records system, knew about a flaw that caused the harm but failed to fix it or inform the Department of Veterans Affairs before the system launched at Mann-Grandstaff VA Medical Center in October 2020.
VA Secretary Denis McDonough said this spring he was not aware of any harm caused by the system and he would halt its rollout if safety experts determined it increased risk to veterans, yet the draft report shows a VA patient safety team briefed the department’s deputy secretary in October 2021 about the harm and ongoing risks. Despite those warnings, the VA has since launched the system at more facilities in Washington, Idaho, Oregon and Ohio.
The draft report by the VA’s Office of Inspector General, or OIG, found the electronic health record system developed by Cerner failed to deliver more than 11,000 orders for specialty care, lab work and other services – without alerting health care providers the orders had been lost. Those lost orders, often called referrals, resulted in delayed care and what a VA patient safety team classified as dozens of cases of “moderate harm” and one case of “major harm.”
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Enjoy!
David.
