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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Health System, Vendor Collaboration Needed to Improve EHR Functionality
Industry collaboration is needed to improve EHR functionality and protect the cognitive attention of clinical teams, according to a JAMA Network Open viewpoint.
July 15, 2022 - Health system leaders and IT vendors must work together to improve EHR functionality and address clinician burden, according to a viewpoint published in JAMA Network Open written by Kevin B. Johnson, MD, MS, and William W. Stead, MD.
The authors noted that the term “electronic health record” is a misnomer. Instead, the EHR is a “complex socio-technical infrastructure for automating clinical and administrative workflows within a healthcare facility or system.”
The EHR has many stakeholders, including physicians, health system executives, regulators, and patients whose needs influence EHR capabilities. The authors said that requirements for reimbursement, regulatory compliance, and administrative workflow automation often come before clinical efficiency and effectiveness.
For instance, health IT to automate safeguards, like the “five rights” in medication administration (the right patient, medication, route, time, and dose), is often burdensome and inflexible.
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https://www.digitalhealth.net/2022/07/bias-in-ai-its-a-matter-of-time/
Bias in AI: It’s a matter of time
Artificial Intelligence (AI) feels like a popular buzzword in healthcare over the last few years. In a piece for Digital Health, David Newey, deputy CIO at The Royal Marsden NHS Foundation Trust, explores bias in AI and what needs to be done.
DHI News Team – 14 July, 2022
On the night of my birthday celebrations in December 2021, I received an email followed by several texts alerting me to the cyber vulnerability that was log4j. This piece of innocuous code was originally developed in January 2001 as part of the apache logging services and was in use in technology stacks worldwide. Written 21 years ago without forethought to its future, this code was to prove a cyber security headache for at least 4 months as hackers looked for ways to exploit it.
This example demonstrated the fact that code has consequences, and in particular, historic code has consequences. Even now we can look to other systems such as IBM Z/OS mainframes which, still to this day run COBOL and FORTRAN dating back to the 1950’s, but are now happily virtualised and still working for the US Department of Defence.
But as well its impact on legacy code, time also affects societal attitudes and changing demographics. For marginalised communities, the experience continues to change and evolve, sometimes for the better, sometimes for the worse; but nonetheless they change. Contemporary examples demonstrating a shift in attitudes include the redaction or warnings placed on literature such as Charlotte Bronte’s Jane Eyre or Charles Dickens’s Great Expectations; or the tearing down of statues such as Edward Colston in Bristol. These illustrate how much society has changed since 1958 when the oldest piece of working software code, US Department of Defence MOSCAT (Mechanisation of Contract Administration Services) was written.
Consider now the development of AI machine learning, and its utility in the field of healthcare. The utility of AI is already hotly contested with proponents seeing it as a way to revolutionise medicine, such as in the rapid detection of abnormalities from CT images or digital pathology slides. AI is increasingly being seen as a way to sure up services that already have an acute shortage of trained staff, fighting against a backlog Tsunami driven from Covid-19.
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https://www.digitalhealth.net/2022/07/somerset-integrated-digital-e-record/
Somerset Integrated Digital e-Record being used 13,000 times a month
A digital shared care record that aims to give healthcare professionals across Somerset a complete overview of a patient’s medical record is being accessed around 13,000 times a month following its launch.
Hanna Crouch 13 July, 2022
The Somerset Integrated Digital e-Record (SIDeR) first went live with the Electronic Palliative and Care Coordination System (EPaCCS) in April 2019 with the aim of making the right information available to the right professionals at the right time.
This was followed by the SIDeR Shared Care Record (SSCR) which went live in November 2020 and now has approximately 13,000 uses per month.
Black Pear is the current technology partner for the SIDeR programme and is the first service to use HL7 FHIR, Cloud Computing and Amazon Web Services.
The record includes information such as medication (one-off prescriptions and repeats), allergies, problems (conditions), key alerts, contacts and encounters (including procedures).
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July 12, 2022
FDA clears next-gen software to detect, identify heart murmurs
Eko Technologies announced the FDA has cleared its next-generation software for detecting and identifying heart murmurs in adult and pediatric patients.
According to a company release, the software (Eko murmur analysis software) combines murmur analysis artificial intelligence with its digital stethoscopes and is the first smart stethoscope cleared to identify and differentiate innocent and structural murmurs associated with valvular heart disease.
“Combining pathologic murmur detection with the stethoscope, a tool already deeply embedded in the practice of medicine, will allow for more accurate and efficient screening of heart valve disease in the community,” Patrick McCarthy, MD, executive director of the Bluhm Cardiovascular Institute at Northwestern Medicine, said in the release. “Eko’s platform will help uncover early valvular heart disease in millions of people worldwide who may otherwise be missed, and make a significant impact on our ability to treat patients with life-saving interventions.”
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Mayo Clinic Platform leader Dr. John Halamka is turning 'healthcare data into wisdom'
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Mayo Clinic Platform, the data analytics and digital health arm of the Rochester, Minn.-based medical center, is trying to stop diseases in patients before they emerge, its leader told Becker's.
"Do you remember the film Minority Report?" asked John Halamka, MD, president of Mayo Clinic Platform. "The notion in Minority Report was pre-crime — predicting the crime before it happens. What if we could predict disease before it happens? Then we could make sure that a patient receives appropriate interventions, treatment and monitoring so they don't experience severe disease."
One way the platform is doing that is through an algorithm, given FDA breakthrough status in May, that uses Apple Watch data to detect pulmonary hypertension in people who may not be aware they have it. The team at Mayo Clinic is also researching the use of machine learning for specialties such as radiation oncology, behavioral health and gastroenterology, among others.
The goal of the platform at its 2020 launch was to turn "healthcare data into wisdom," Dr. Halamka said. "And that is going to result in less invasive care, more timely care, less costly care and, ultimately, better wellness."
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OIG report on VHA finds 'multiple events of patient harm' in Oracle Cerner EHR
The VA Office of Inspector General cites nearly 150 adverse events connected to a routing glitch, and says "insufficient mitigations" and "continued risk to patient safety" leave it with big concerns about the so-called "unknown queue."
By Mike Miliard
July 15, 2022 10:07 AM
The final version of the VA Office of Inspector General's report on the electronic health record deployment at Mann-Grandstaff VA Medical Center was published on July 14.As was noted when a draft of the report was released this past month, the VA watchdog undertook a rigorous review of the new Veterans Health Administration EHR, and found 149 instances of patient harm (mostly characterized as "minor," but with a couple significant adverse events detailed by the IG) related to an element of the Oracle Cerner EHR known as the "unknown queue" – a glitch where the tool to manage orders with incomplete routing information failed to alert VA clinicians when those notes didn't arrive where they were needed.
"The new EHR’s unknown queue represented an element that ultimately led to thousands of orders for medical care not being delivered to the requested service, placed patients at risk for incomplete care, and caused multiple events of patient harm," said the OIG report. "Oracle Cerner failed to inform VA end-users of the existence of the unknown queue and put the burden on VA to identify and address the problem."
Healthcare IT News has been chronicling the challenges with the VA's rollout for some time.
Back in May 2021, reports first surfaced of potential patient safety concerns with the EHR at Spokane, Washington-based Mann-Grandstaff, the first go-live site for the VA's massive health IT modernization project.
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More Evidence That Racial Inequities Exist in Pulse Oximeter Use
New research shows that the data collected from arterial blood oxygen readings and pulse oximeters differed for Black and White patients and could impact occult hypoxemia treatment.
July 14, 2022 - A study published in The BMJ shows that differences in the results from arterial blood gas readings and pulse oximetry led to racial inequities in care, preventing Black people from obtaining necessary treatment for occult hypoxemia or low blood oxygen saturation levels.
Researchers conducted a retrospective cohort study using EMR data from the Veterans Health Administration. They used occult hypoxemia as a primary measure, which was calculated using arterial blood oxygen saturation measurements and pulse oximetry.
The evaluation of health disparities is becoming a common practice in healthcare, as their presence became starker during the COVID-19 pandemic. In this study, researchers sought to determine whether differences in occult hypoxemia treatment existed between people of different races.
Occult hypoxemia was defined as arterial blood oxygen saturation of less than 88 percent despite a pulse oximetry reading of 92 percent or more.
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Security Awareness and Training Crucial to Preventing Healthcare Phishing Attacks
Security awareness and training greatly decreased the likelihood of an employee falling for a healthcare phishing attack, KnowBe4 researchers found.
By Jill McKeon
July 14, 2022 - Healthcare phishing attacks are still a top cyberattack vector, but new research shows that consistent security awareness and training can greatly reduce the likelihood of a successful attack.
KnowBe4 analyzed a dataset of over 9.5 million users across 19 sectors, more than 30,000 organizations, and 23.4 million simulated phishing security tests to illustrate the impact that security training can have on reducing cyber risk.
“Security leaders who continue to invest solely in sophisticated technology and security orchestration run the risk of overlooking a best practice proven to reduce their vulnerability: security awareness training coupled with frequent simulated social engineering testing,” the report stated.
“This approach not only helps raise the readiness level of humans to combat cyber crime, it lays the critical foundation necessary to drive a strong security culture throughout an organization.”
KnowBe4 established a baseline “phish-prone percentage” (PPP), which measured the percentage of employees that had clicked on a simulated phishing email with no prior security training. Researchers then revisited the PPP after 90 days and again after one year of security training to see how the results had changed.
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FHIR could ease data gathering for clinical research
A research project is testing a new way to collect data on chronic diseases from EHRs in an effort to pave the way for better nationwide disease tracking.
Jul 14 22
A research initiative that uses data from electronic health records systems to support a national sentinel surveillance system to monitor chronic diseases is working on using HL7’s FHIR (Fast Healthcare Interoperability Resource) standard to facilitate data collection.
The initiative, called the Multistate EHR-based Network for Disease Surveillance, or MENDS, is testing an approach that would use a bulk data application programming interface, or API, to make it easier to collect de-identified patient information from a wide range of EHR systems to better support nationwide disease surveillance.
The work is supported by a grant from the Centers for Disease Control and Prevention to the National Association of Chronic Disease Directors. It’s gaining additional support from the University of Colorado Health Data Compass Research Institute, enabled by a grant from Google.
Progress report
A progress report on the initiative recently was presented by Bob Zambarano, a vice president for healthcare analytics for Commonwealth Informatics, a data consultancy that’s providing technical support for the project. MENDS uses technical elements and design from Massachusetts’ state-level distributed analytics network for chronic disease surveillance.
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Clinicians need to gain confidence; AI will support care
Healthcare organizations that have successfully implemented the technology say early results must demonstrate tangible assistance in the care process.
Jul 14 22
Contributing Editor
Recent studies suggest that the prospects for using artificial intelligence in healthcare are improving, but much work lies ahead in fostering clinician understanding and support for the technology.
In a presentation from the HDM KLASroom, industry experts discussed data from a recent KLAS Research report on AI in healthcare. The panelists contend that the most effectual predictive models are bolstered by clinician understanding on the back end.
“Organizations said that it's great that people can implement predictive models, but they really recommended having change management in place so that organizations can get to outcomes and really help patients or clinicians make better decisions.”
Jennifer Hickenlooper, insights director at KLAS Research, begins by outlining popular applications of AI in healthcare today. Research completed by Orem, Utah-based KLAS Research show that many provider organizations are focused on investing in proven use cases, but that only a few vendors are doing a good job in guiding customers to achieve desired outcomes.
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https://www.medscape.com/viewarticle/977087
Don't Wait for a Cyberattack; Know What Coverage You Have Now
Christine Lehmann, MA
July 13, 2022
Barbara L. McAneny, MD, CEO of New Mexico Oncology Hematology Consultants, Ltd, experienced a data breach about 10 years ago, when a laptop was stolen from her large practice.
She and the other physicians were upset and worried that the individual would attempt to log in to the computer system and hack their patients’ private health information.
McAneny was also worried that the practice would have to pay a hefty fine to the government for having unsecured private health information on a laptop. She could have paid from $50,000 to more than $1.9 million for lost and stolen devices (although that didn’t happen).
McAneny had a standard cyber liability benefit in her med-mal policy that covered up to $50,000 of the data breach costs. That covered the legal advice The Doctors Company provided about state and federal reporting requirements when a data breach occurs and the costs the practice incurred from mailing letters to all of its patients notifying them of the data breach, says McAneny.
“The data breach taught me a lot. Our practice spent a lot of money on increasing our internal controls, cybersecurity, and monitoring. Our IT department started testing our computer firewalls periodically, and that’s how we discovered that cybercriminals were attempting to break into our computer system at least 100 times daily,” says McAneny.
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3D facial recognition helps Martin Luther King Jr. Community Hospital secure access
Staff already were familiar with the technology from their smartphones. So far, the health system has not had any downtime, and the technology has operated with 100% reliability.
By Bill Siwicki
July 14, 2022 11:24 AM
Martin Luther King Jr. Community Hospital has one of the busiest emergency departments in Los Angeles County.
It opened in 2015, and it's one of only three hospitals in Los Angeles to receive a Health Care's Most Wired award, which is an authentication of a hospital's optimal use of information technology. The hospital also was honored with an Outstanding Security Performance Award from ASIS International.
THE PROBLEM
Healthcare networks increasingly have been targeted by threat actors as ransomware attacks, cybersecurity incidents and data breaches all are becoming more common and problematic.
"While working with our IT team to determine possible security enhancements to protect personally identifiable information and protected health information, we recognized our IDF and server rooms were vulnerable to a physical breach," said Mark Reed, director of support services at Martin Luther King Jr. Community Hospital.
"If someone breached a data-sensitive area, they would have access to everything," he continued. "Suppose threat actors access a hospital's data center. In that case, they have access to the inner workings of the entire organization, making it critical that we secure our physical spaces through enhanced access control."
In response, hospital leadership conducted a comprehensive risk assessment and determined the facility needed increased security controls for IT and other sensitive areas. However, there was concern the ID badge-based entry system introduced new challenges and vulnerabilities if ID badges were lost or stolen.
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How to Map Out an Effective and Sustainable Remote Patient Monitoring Program
Analysis | By Eric Wicklund | July 14, 2022
Health system executives at a recent HealthLeaders round-table explained how to create an effective remote patient monitoring strategy, from selecting the right patient population and technology to securing staff buy-in.
KEY TAKEAWAYS
· Healthleaders recently convened a round-table with three health system executives to discuss the challenges and benefits of remote patient monitoring, as well as how to develop a sustainable RPM strategy.
· RPM programs are becoming increasingly popular as healthcare organizations look to connect with patients outside the hospital, clinic and doctor's office to develop better care management routines.
· The programs can include digital health tools that collect important data and allow patient and provider to communicate when needed, as well as allowing providers to adjust treatments on demand.
· This is a two-part series. The second half of this round-table will be published on Friday, July 15.
Healthcare organizations are looking to enhance care management by connecting and collaborating with patients outside the hospital, clinic or doctor's office, and they're often doing this with remote patient monitoring (RPM) platforms. Using digital health technology, they're developing programs that allow a care team to monitor a patient at home, gathering vital signs and other data, communicating with the patient when necessary, and creating treatment plans that can be modified in real-time.
HealthLeaders recently conducted a round-table with three health system executives to talk about their RPM programs and strategies. This panel featured Carrie Stover, MSN, NP-C, national senior director of virtual care for Ascension; Sarah Pletcher, MD, MHCDS, system vice president and executive medical director for strategic innovation at Houston Methodist; and Kathryn King, MD, MHS, associate executive medical director at the Center for Telehealth at the Medical University of South Carolina (MUSC).
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https://www.healthleadersmedia.com/innovation/planning-rpm-strategy-ground
Planning an RPM Strategy From the Ground Up
Analysis | By Eric Wicklund | July 15, 2022
Healthcare organizations are turning to remote patient monitoring to improve care management and give patients an on-demand connection to their care teams, but they need to plan carefully to make sure the program is sustainable and scalable.
KEY TAKEAWAYS
· Healthleaders recently convened a round-table with three health system executives to discuss the challenges and benefits of remote patient monitoring, as well as how to develop a sustainable RPM strategy.
· RPM programs are becoming increasingly popular as healthcare organizations look to connect with patients outside the hospital, clinic and doctor's office to develop better care management routines.
· The programs can include digital health tools that collect important data and allow patient and provider to communicate when needed, as well as allowing providers to adjust treatments on demand.
Healthcare organizations are looking to enhance care management by connecting and collaborating with patients outside the hospital, clinic or doctor's office, and they're often doing this with remote patient monitoring (RPM) platforms. Using digital health technology, they're developing programs that allow a care team to monitor a patient at home, gathering vital signs and other data, communicating with the patient when necessary, and creating treatment plans that can be modified in real-time.
HealthLeaders recently conducted a round-table with three health system executives to talk about their RPM programs and strategies. This panel featured Carrie Stover, MSN, NP-C, national senior director of virtual care for Ascension; Sarah Pletcher, MD, MHCDS, system vice president and executive medical director for strategic innovation at Houston Methodist; and Kathryn King, MD, MHS, associate executive medical director at the Center for Telehealth at the Medical University of South Carolina (MUSC).
This is the second part of a two-part story on that round-table. Part 1 was posted on Thursday, July 14. Quotes have been edited for clarity.
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Cedars-Sinai Develops Predictive Models for Post-Surgery Pain Management
Researchers at Cedars-Sinai Medical Center have developed artificial intelligence tools to help surgeons predict patient outcomes and address medication issues before they arise.
July 13, 2022 - A team of researchers at Cedars-Sinai Medical Center has developed artificial intelligence (AI) and machine learning (ML) algorithms to predict which patients are most likely to successfully manage their pain post-surgery and which patients might need additional assistance.
The algorithms are currently being used to help spine surgeons evaluate surgery success, which has traditionally been limited to how well a patient can walk, bend or move after spine surgery. However, the use of AI allows clinicians to predict additional outcomes related to surgery success, such as pain management.
“The unique thing we’re doing with this project is really focusing in on the pain medication part of it, because opioid addiction continues to be a challenge, and we are looking for ways to improve pain management after surgery,” said Corey Walker, MD, a neurosurgeon focused on spine treatment at Cedars-Sinai, in the press release.
Walker’s team is collaborating with the Cedars-Sinai Department of Computational Biomedicine to develop and study AI algorithms. The algorithms make predictions based on analyses of millions of data points within a subset of the data and then test these predictions against new subsets. By doing so, the algorithms continually improve and update the methodology as they learn more. While clinical trials usually test one or two variables at a time, algorithms like these can evaluate thousands of variables concurrently.
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https://mhealthintelligence.com/news/racial-disparities-exist-in-pulse-oximeter-readings
Racial Disparities Exist in Pulse Oximeter Readings
New research shows racial disparities in the delivery of supplemental oxygen, primarily due to variations in pulse oximeter readings.
July 13, 2022 - A JAMA Network study found racial disparities exist when delivering supplemental oxygen, mainly because of poor pulse oximeter performance among Asian, Black, and Hispanic users.
During the process of transcutaneous monitoring of blood oxygenation, pulse oximetry has the tendency to supply inaccurate oxygenation readings, particularly among racial minorities.
To find more information, researchers conducted a retrospective cohort study that included data from the Medical Information Mart for Intensive Care. The study included 3,069 patients, 83 of whom were Asian, 207 were Black, 112 were Hispanic, and 2,667 were White.
Researchers used the time-weighted average supplemental oxygen rate to determine conclusions. Based on the obtained data, researchers found that Asian, Black, and Hispanic patients had higher pulse oximetry levels and received less supplemental oxygen.
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Market downturn dampens digital health funding, M&A in 2022. These sectors raked in the most cash
Jul 12, 2022 12:10pm
After reaching a fever pitch in 2021, digital health funding cooled down in 2022, raising $10.3 billion across 329 deals in the first six months.
That's down from the $14.7 billion raised during the same period last year, according to a first-half 2022 funding report from Rock Health, a venture fund dedicated to digital health.
But, it should be noted, $10 billion is still a hefty amount of cash pouring into digital health, and this year's funding is on track to outpace funding in 2020. This year's overall funding is now pacing to land around $21 billion, significantly less than 2021’s total of $29.1 billion and well ahead of 2020's $14.7 billion.
While the first quarter of 2022 funding generally matched the same period in 2021, the second quarter of 2022, with $4.1 billion raised, was the lowest funding quarter since the second quarter of 2020 with $2.9 billion.
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FTC to Enforce Against Illegal Location, Health Data Privacy Practices
In a blog post, the FTC committed to enforcing against improper consumer location and health data privacy practices.
By Jill McKeon
July 13, 2022 - In a blog post, the US Federal Trade Commission (FTC) expressed its intentions to enforce against improper and illegal consumer location and health data privacy practices.
Written by Kristen Cohen, acting associate director of the FTC’s division of privacy and identity protection, the blog post reiterated that the FTC would not tolerate the misuse of consumer data for any purpose.
“The conversation about technology tends to focus on benefits. But there is a behind-the-scenes irony that needs to be examined in the open: the extent to which highly personal information that people choose not to disclose even to family, friends, or colleagues is actually shared with complete strangers,” the blog post explained.
“These strangers participate in the often shadowy ad tech and data broker ecosystem where companies have a profit motive to share data at an unprecedented scale and granularity.”
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https://www.theverge.com/2022/7/11/23204414/ftc-medical-location-health-data-enforcement-roe-privacy
FTC says it will crack down on medical and location data sharing after abortion privacy concerns
The statement follows an executive order that called on the Committee to help protect the privacy of abortion seekers
By Corin Faife@corintxt Jul 11, 2022, 5:19pm EDT
The Federal Trade Commission (FTC) says it will step up to protect the privacy of consumers in a post-Roe America, declaring the agency is “committed to fully enforcing the law” against illegal sharing of sensitive medical and location data.
In a blog post published on Monday by Kristin Cohen, the FTC’s acting associate director in the Division of Privacy and Identity Protection, the commission took particular aim at data brokers and third parties who share previously collected information. The post points to a wide range of sources that can potentially collect sensitive information about a user but highlights the combination of location data and health data as presenting a particular risk to consumers.
“The conversation about technology tends to focus on benefits,” Cohen writes:
But there is a behind-the-scenes irony that needs to be examined in the open: the extent to which highly personal information that people choose not to disclose even to family, friends, or colleagues is actually shared with complete strangers. These strangers participate in the often shadowy ad tech and data broker ecosystem where companies have a profit motive to share data at an unprecedented scale and granularity.
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https://www.medpagetoday.com/opinion/kevinmd/99684
Physicians Can Kick Tech's A** Right Back
— Medicine needs specialized doctors who only focus on technology
by Drea Burbank, MD July 12, 2022
Physicians are getting their asses kicked by technology, but this is reversible if they integrate technology as they do laboratory science.
Medicine needs specialized doctors who only focus on technology. This will combat burnout and take control of a system that has no other incentive to adapt to clinical needs.
In 2013, I graduated medical school and went to Silicon Valley to acquire high-tech skills.
During med school, an investigation of the medical specialties available to me revealed that doctors were in for a rude awakening when their profession began to digitize. My mentors were fabulous clinicians but were sorely unprepared to influence the software and ontologies that would shortly conscribe their practices in disturbing ways.
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https://www.healthcareitnews.com/news/how-fix-ehrs-one-health-it-leader-has-some-ideas
How to fix EHRs? One health IT leader has some ideas
"The industry needs to think about how EHR technology most effectively leverages data to the patient's benefit," says Amanda Hansen of AdvancedMD. "There's still work to be done."
July 13, 2022
Amanda Hansen's father had diabetes for most of his life, until his death in March 2017. Like many patients, he had to collect his own medical records and carry a thick stack of paper from provider to provider to control his own healthcare journey.
Seeing the continuous problems he had managing his condition on a paper system drove in Hansen a passion for health IT. She now is president of AdvancedMD, a vendor of medical office software.
The case for electronic health record systems is obvious, but there can be problems with implementation, data interoperability and the overall clerical burden for providers.
Hansen believes health IT vendors have a responsibility to help providers close the loop with patients – especially those with chronic conditions – ensuring providers are ordering the right labs and prescriptions and patients feel engaged and have the right questions to ask.
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https://www.healthcareittoday.com/2022/07/13/rtls-helps-address-staff-duress/
RTLS Helps Address Staff Duress
July 13, 2022
Realtime location systems (RTLS) have long been known to help hospitals with medical device management, but there is a new use-case that is growing in popularity and importance: addressing staff safety and duress. Through RLTS platforms, security teams can be alerted to the exact location of staff who need immediate assistance. As violence towards nurses and physicians increases, this will become a more important use-case for this technology.
Increasing Violence and Duress
A recent survey of healthcare workers (hospitals and long-term care facilities) found:
- 90% had experienced (or been in close proximity to) violence from a patient or a patient’s caregiver in the past month
- 75% had encountered both verbal and physical assaults in the past month
- Almost 50% of workers needed to call for security or another co-worker to assist in the past month
The survey did not capture the number of time healthcare workers felt they were under duress, which presumably would be much higher than the actual number of incidents being reported.
RTLS + Staff Safety
Healthcare IT Today sat down with Kapil Asher, Head of the Healthcare Practice at Kontakt.io, a company that makes an RTLS platform to talk about the use-cases for RTLS in healthcare, including staff safety and duress.
“We’ve implemented a Staff Duress solution,” explained Asher. “Using our real time location sensing technology platform and a wearable RTLS badge, we provide them [healthcare workers] with a panic alarm button. Whenever they feel they’re under attack [or in danger], they can click the button and through our software we route it all the way to Security who can respond to the situation in a much faster manner.”
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What protections would HIPAA provide against criminal prosecution for abortion?
Some advocates have warned that Roe's overturning could put people at risk of having their personal medical records used by law enforcement.
Abortion-rights demonstrators shout slogans after tying green flags to the fence of the White House during a protest to pressure the Biden administration to act and protect abortion rights, in Washington, Saturday, July 9, 2022. (AP Photo/Jose Luis Magana)
By: Louis Jacobson
July 11, 2022
Now that the Supreme Court has overturned Roe v. Wade, more than a dozen states are moving toward outlawing or severely restricting abortion within their borders. Some abortion rights advocates have warned that this could put some at risk of having their personal medical records used by law enforcement.
There is no guarantee that such intrusive tactics will come to pass. In fact, most states that have passed restrictive abortion laws have — for now, at least — specified that the woman who has an abortion would not be criminally prosecuted.
However, anyone in these states who performs or enables an abortion could still face criminal prosecution, as long as a prosecutor was intent on trying it. And the privacy laws currently on the books — notably the Health Insurance Portability and Accountability Act, or HIPAA — wouldn’t provide much protection for medical data if such prosecutions went ahead, a half-dozen experts in health and privacy law told PolitiFact.
“It is clear that HIPAA is poorly protective against subpoenas and direct legal action,” said Eric Perakslis, the chief science and digital officer at Duke University’s Clinical Research Institute.
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https://www.healthleadersmedia.com/technology/ai-powers-progress-upmc-clinical-trial
AI Powers Progress of UPMC Clinical Trial
Analysis | By Scott Mace | July 13, 2022
The Pittsburgh health system is using technology to extract clinical notes and more quickly qualify participants.
KEY TAKEAWAYS
· Natural language processing and AI are culling through identified and consented patient records to speed up the identification process for clinical trials.
· The UPMC project aims to compare rates of colorectal cancer in patients who repeat colonoscopies at 5-year and 10-year intervals.
· As many as 86% of clinical trials do not meet their recruitment goals using traditional, more manual methods of patient identification.
Technology in use at UPMC is accelerating the speed with which the Pittsburgh-based health system can identify and qualify participants in a clinical trial targeting colorectal cancer prevention.
A technology platform that combines natural language processing and artificial intelligence is more efficient than traditional patient identification methods, which are often manual, time-consuming, and costly for clinical trial sites.
"In this case, the trial is about people who have a particular kind of polyp," says Robert Schoen, MD, MPH, chief of the Division of Gastroenterology, Hepatology, and Nutrition at UPMC and a professor of medicine and epidemiology at the University of Pittsburgh. "Then you would go through all those colonoscopy exams and pathology manually, and select them one by one. It's an effective way to do it, but it's very inefficient."
Schoen is principal investigator for FORTE, a study led by NRG Oncology, part of the National Clinical Trials Network, sponsored by the National Cancer Institute.
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https://www.digitalhealth.net/2022/07/special-report-ai-and-data-2
Special Report: AI and Data
In the post-pandemic world, the onus seems to be on artificial intelligence (AI) to carry the healthcare sector forward. Maja Dragovic finds out how the attitudes towards AI in the sector have changed over the last 12 months.
The focus on AI has definitely shifted since the pandemic, with data being seen as a tool to improve the health and care of a population in a safe, trusted and transparent way.
The government’s recent data strategy for health and care has set the direction for the use of data in a post-pandemic healthcare system with AI playing a significant role, especially in screening services where the technology can help scan numerous hospital images for irregularities.
For Chris Scarisbrick, sales director at Sectra, an accelerator of AI use in screening was the development of the National Lung Screening pilot. This involved various vendors being bought in to help meet the increased demand of chest X-rays during the pandemic. However, it transpired that in the long run, using different AI providers resulted in integration and procurement challenges for healthcare providers.
Scarisbrick points out that “at any given time, there might be 50 or 100 startups in the AI space”.
“If an NHS organisation identifies 10 or 15 different use cases where the AI could be brought in to help alleviate their problems, then they have a massive problem in terms of procuring and contracting that number of applications,” he says.
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Mayo Clinic EHR Training Program Boosts User Confidence Postimplementation
The EHR training program increased user confidence in skills by 13.5 points, and survey results showed that participants maintained this confidence level after six months.
July 12, 2022 - A Mayo Clinic EHR training program helped improve user confidence and proficiency in the EHR postimplementation, according to a study published in JAMIA.
Physician leaders in informatics designed an intensive program called reBoot Camp to enhance ongoing education of the EHR after initial implementation. Mayo Clinic offered the program from April 2018 through June 2020. There were 37 two-day and 43 one-day sessions, with 673 unique participants.
Researchers used survey data to study baseline, immediate, and long-term perceptions of program satisfaction and self-assessed skills with the EHR.
Confidence in skills increased by 13.5 points for general EHR use and survey results showed that this confidence level stayed the same after six months.
Informatics leaders designed the training program to reiterate fundamental principles, efficiency tips, and best-practice configurations across multiple specialties and all Mayo Clinic sites.
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Remote Patient Monitoring Linked to Lower COVID-19 Hospitalizations
New research shows that remote patient monitoring can help reduce hospitalizations and intensive care unit stays among patients with COVID-19.
July 12, 2022 - A study published in JAMA Network Open found that implementing a remote patient monitoring (RPM) program led to positive outcomes for COVID-19 patients, including lower hospitalizations, intensive care use, and lengths of stay.
As a result of restrictions spurred by the COVID-19 pandemic, hospitals and providers turned to telehealth and RPM to care for patients. Though the use of virtual care has increased, questions surrounding its effectiveness remain.
To gain answers, researchers performed a cohort study at Froedtert and Medical College of Wisconsin Health Network, an academic health system in Wisconsin. The goal of the study was to gain insight into the effectiveness of RPM by using measurements like patient outcomes and hospitalization rates.
The RPM program enabled COVID-19 patients to track symptoms, temperatures, and pulse oximetry readings through a web or mobile application. It also provided COVID-19 education, including strategies to minimize infection spread and stress management. Further, a virtual care team monitored patient check-ins and comments continuously.
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https://patientengagementhit.com/news/patient-engagement-key-to-healthcare-consumerism-post-pandemic
Patient Engagement Key to Healthcare Consumerism Post-Pandemic
Patients are ready to access healthcare as COVID-19 becomes endemic, with healthcare consumerism soon to be characterized by strong patient engagement.
By Sara Heath
July 11, 2022 - The healthcare consumerism scales are tipping toward stronger patient engagement, with just under one in five patients saying they are more likely to book their annual wellness checks after the pandemic than they were before it, according to the 2022 Health Care Insights Survey from CVS Health.
These findings underscore the need for better patient-provider communication, more virtual and convenient care access options, and a careful eye for social determinants of health and other social factors impacting wellness.
"The pandemic changed nearly everything about our world—including the way many consumers view the importance of their health," CVS Health President and CEO Karen S. Lynch said publicly. "As we look to the future, CVS Health is uniquely positioned to reimagine health care that is centered around people—simpler, more accessible, and more affordable, with better health outcomes."
Although 2020 and 2021 were mostly characterized by decreased patient access to preventive screenings, 2022 and the post-pandemic future are looking like they’ll ring in an era of more patient care access. Patients are focusing on their overall wellness, and part of that is managing their own healthcare, particularly through patient access to primary and preventive care.
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Are Proxy, Caregiver Responses for Patient-Reported Outcomes Valuable?
Researchers found that proxy or caregiver responses to patient-reported outcomes are useful for enhancing or standing in for reports from incapacitated patients.
By Sara Heath
July 12, 2022 - Proxy reports are a good stand-in for patient-reported outcomes when a patient can’t report their own symptoms or is otherwise incapacitated, researchers from the Regenstrief Institute wrote in the Journal of Patient-Reported Outcomes.
These findings come as more healthcare professionals and medical researchers seek to use PROs in decision-making. Ensuring clinicians are aware of a patient’s symptoms is integral to making sure they select the best treatment course. This is particularly true for factors like pain levels or psychological symptoms, which require a patient self-report.
“Unlike blood pressure and blood sugar, symptoms like pain, depression or anxiety can’t be objectively measured,” Kurt Kroenke, MD, a faculty member at the Regenstrief Institute and IU School of Medicine who led the study, said in a statement.
“Our group is very interested in symptoms – signs you can’t measure with an X-ray or a lab test. The only way to determine severity is with validated scales and if patients can’t report for themselves, then the proxy’s report is an important tool available to the clinician treating the patient.”
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https://www.healthcareitnews.com/news/key-relationship-between-health-equity-and-telemedicine
The key relationship between health equity and telemedicine
"As healthcare providers continue to navigate and find ways to improve the telehealth experience, we have to be intentional about bringing all voices to the table," one expert says.
July 12, 2022
Health inequity is the result of the behavior of people. It is not the result of anything natural. It involves structural inequalities in the delivery of care – inequalities that are avoidable.
Trying to correct health inequity is part of the job for Toni Land, head of clinical healthcare experience at Medallia, a patient and customer experience management company.
"Prioritizing health equity is key to the future of healthcare, because there is a significant opportunity for healthcare providers to improve and dismantle inequalities and help people be their best selves," Land believes.
We interviewed her to talk about why she believes this is so, the relationship between telehealth and health equity, and how a hybrid future for telemedicine is important.
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A Sit Down with Epic to Learn About Their Decision to Support TEFCA
July 12, 2022
No doubt those of you in the world of health IT and interoperability saw the news that Epic plans to apply to join TEFCA as an inaugural QHIN (Qualified Health Information Network). This is big news for TEFCA since it’s largely a voluntary effort that isn’t pushed by some sort of stimulus money or penalties like many past government efforts.
We wanted to learn about Epic’s decision to apply to be a QHIN, so we sat down with Matt Doyle, Software Development Lead for Interoperability at Epic, to talk about this announcement. He shared Epic’s view on TEFCA, why they plan to apply to be a QHIN, and the decision to get behind TEFCA. Plus, we ask him how the data differs between Epic’s 3 main healthcare interoperability efforts: CareEverywhere, Carequality, and now TEFCA.
We also ask Doyle about the benefits he expects provider organizations and patients to receive from Epic’s participation in TEFCA. Then, we ask him what he sees as Epic’s broader view around interoperability beyond TEFCA.
If you want to learn more about Epic’s interoperability efforts and their decision to apply to become a QHIN, you’ll enjoy this video interview below.
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The Sequoia Project Releases TEFCA Draft SOP for IAS Exchange Purpose
The Sequoia Project welcomes public feedback on a draft standard operating procedure (SOP) for the TEFCA IAS Exchange Purpose until July 29, 2022.
July 11, 2022 - The Sequoia Project, selected by the ONC as the Recognized Coordinating Entity (RCE) to support the implementation of the Trusted Exchange Framework and Common Agreement (TEFCA), has released draft standard operating procedures (SOPs) for the Individual Access Services (IAS) Exchange Purpose and foreign ownership.
The draft Individual Access Services (IAS) Exchange Purpose Implementation SOP describes specific obligations that IAS Providers are required to follow for individual identity verification. It also outlines when a QHIN, Participant, or Subparticipant is required to respond to an IAS request.
The draft Means to Demonstrate US Ownership and Control of a QHIN SOP sets forth how an entity seeking to be a QHIN shall demonstrate that it satisfies the requirements of Section 4.1(i) of the Common Agreement. It also identifies the conditions under which a QHIN may permissibly have limited ownership by a Non-US Individual(s) or Non-US Entity(ies).
Along with the draft SOP is a draft questionnaire that The Sequoia Project will incorporate into the application for prospective QHINs to complete.
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https://ehrintelligence.com/news/onc-approves-new-testing-method-for-standardized-api-criterion
ONC Approves New Testing Method for Standardized API Criterion
Approving a new testing method provides health IT developers with another option for testing standardized API criteria for the ONC Health IT Certification Program.
July 11, 2022 - ONC has approved a new alternative test method (ATM) from The Drummond Group for testing conformance to ONC’s §170.315(g)(10) Standardized API for patient and population services certification criterion.
The Drummond G10+ FHIR API powered by Touchstone tool provides health IT developers a new option for conformance testing in addition to the previously approved Inferno (g)(10) Standardized API Test Kit.
The approval of the new testing method furthers ONC’s goal to diversify further the suite of test methods used for the ONC Health IT Certification Program, ONC official Rob Anthony said in a HealthITBuzz blog post.
In August 2017, ONC announced a five-year goal to transition and expand the ONC Health IT Certification Program’s testing portfolio. Since then, ONC has stewarded several ATMs, such as the HIMSS Immunization Integration Program (IPP) open-source testing tool developed by the Centers for Disease Control and Prevention (CDC), American Immunization Registry Association (AIRA), and HIMSS.
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House Panel Probes Health Apps to Protect Reproductive Health Data Privacy
The House Committee on Oversight and Reform announced plans to investigate data brokers and health apps over their reproductive health data privacy practices.
By Jill McKeon
July 11, 2022 - The House Committee on Oversight and Reform sent letters to five data brokers and five health apps as part of an investigation into their reproductive health data privacy practices. Led by Rep. Carolyn B. Maloney, chairwoman of the Committee on Oversight and Reform, Rep. Raja Krishnamoorthi, chairman of the Subcommittee on Economic and Consumer Policy, and Rep. Sara Jacobs, the committee requested information and documents related to the sale and collection of reproductive health data.
“The collection of sensitive data could pose serious threats to those seeking reproductive care as well as to providers of such care, not only by facilitating intrusive government surveillance, but also by putting people at risk of harassment, intimidation, and even violence,” the Representatives wrote.
“Geographic data collected by mobile phones may be used to locate people seeking care at clinics, and search and chat history referring to clinics or medication create digital bread crumbs revealing interest in an abortion.”
The Representatives sent individual letters to SafeGraph, Digital Envy, Flo Health, Glow, Gravy Analytics, Placer.ai, Babel Street, Digitalchemy Ventures, GP International, and BioWink GmbH.
In its letters to health apps, the committee cited growing concerns surrounding data privacy and the potential consequences of poor health app data privacy practices, which could put people at risk of “intrusive government surveillance,” along with “harassment, intimidation, and even violence.”
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https://www.healthcareitnews.com/news/how-ai-and-nlp-can-boost-care-remote-patient-monitoring
How AI and NLP can boost care via remote patient monitoring
Project Ronin, which focuses on cancer care via RPM, shows how artificial intelligence, natural language processing and EHRs come together to aid physicians.
By Bill Siwicki
July 11, 2022 10:03 AM
Shannon Hastings is the chief technology officer at Project Ronin, where he helps to lead the organization in delivering systems to help cancer patients and clinicians, including remote patient monitoring for cancer patients.
Ronin uses artificial intelligence, machine learning, natural language processing and electronic health records in its work to manage cancer patients. Its dashboards have explainers on each data point to explain what an AI algorithm is. Internal alerts notify users if AI algorithms go off track.
Healthcare IT News sat down with Hastings to discuss how Ronin's RPM for cancer patients works, the roles of AI and NLP in the RPM, and how EHRs play an important part in this type of care delivery.
Q. In your work, what kind of care is facilitated by remote patient monitoring for cancer patients?
A. What we see is that cancer and its treatments can be very hard on patients and the variety of regimens that those patients go through, whether it be standard, more traditional care or clinical trial care.
Remote patient monitoring enables the physician to be able to understand how the patient is doing with their treatment between the scheduled appointments. So if a patient is having an adverse event and potentially heading to the emergency room, the clinician can intervene and alter care based on patient-reported symptoms or remotely monitored metrics.
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Enjoy!
David.
