This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
or
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
The Australian Digital Health Agency (ADHA)
marked the start of implementing its latest cyber security strategy with a
flurry of requests for information (RFIs) late last month.
ADHA CISO John Borchi told iTnews
the work program is the first phase in realising the cyber-security plan
published by the agency in March this year [pdf].
Borchi said the strategy responds to changes
in the threat landscape in recent years.
One of those changes, he said, was
demonstrated in how the Log4j vulnerability unfolded.
At first, the ADHA’s expectations were in
line with most people in cyber security – the vulnerability would be patched
“pretty quickly”.
That
turned out not to be the case: security teams in vendors around the world are
still discovering dependencies on unpatched software that exposes their systems
to Log4j, and will be doing so for some time.
Borchi
told iTnews that requires “ongoing
vigilance” on the part of organisations like the ADHA, since they’re often in a
better position to monitor the hygiene of small partners like GP clinics.
And
that’s another change the ADHA sees in its operating environment in recent
years – it’s interacting with many more such small third parties and had to
adjust its strategy accordingly.
The
strategy also has to comply with top-level government imperatives, most
importantly the digital health strategy (for example, with its emphasis on the
importance of the MyHealth Record), and the cyber security strategy overseen by
the Department of Home Affairs.
Protecting the health data honeypot.
Borchi
said the foundations of the security strategy are straightforward: “Protecting
the healthcare system from adversaries, and protecting the healthcare data of
Australians.
“Healthcare
data is considered key for criminals, to break into and utilise. So for us the
challenge is making sure the threat is kept at bay, while we improve
interconnectivity of the healthcare system, with more data sharing, and better
information to improve healthcare and patient experiences," he said.
The
requests the ADHA took to market in August are designed to establish the
“people and processes” needed to execute the strategy. They are:
To establish and manage a coordination cell for initiatives under the strategy;
The development of a cyber operating model, which will set down the
principles behind services and the “roles, responsibilities and overall
remit of the cyber security teams”;
The
aim, Borchi said, is to have frameworks and teams in place to ensure that
planning the execution of the strategy doesn’t fall victim to meeting the
day-to-day demands of cyber security.
This
program of work aims to “set up our team and our collaboration within the
partners that we have, so that we are responsive and we work to respond to
those priorities, and respond to the challenges over the next two to three years,"
he said,
"I am pleased to present the Australian Digital Health
Agency’s Cyber Security Strategy 2022 – 25.
The Strategy sets the vision and guiding principles for our
cyber security over the next three years. It sets out our approach to and areas
for action on cyber security, but will also be regularly reviewed o ensure we
proactively adapt to changes in the threat environment and support the secure evolution
of digital health.
The Australian Government recognises the importance of cyber
security to Australia’s growing digital economy and to the Australian community.
Through this Strategy, the Australian Digital Health Agency will build on our
strong foundations and elevate our organisational capability to securely deliver
better health and wellbeing for all Australians, supported by safe, secure
digital systems.
As Australia’s champion for digital healthcare, we are
responsible for the development, deployment, and secure operation of critical national
healthcare assets, including the personal and sensitive healthcare information
of Australians. We take this responsibility seriously.
We are also part of many interconnected IT systems across
the health sector and are charged with helping ensure information can be shared
quickly and easily across those systems to support best practice healthcare. In
doing so we recognise that our work is dynamic, as are the digital and threat environments
we work in. The pandemic has reinforced this, underscoring the need to achieve and
maintain the future focused cyber capabilities that will enable us to be
proactive in how we protect ourselves, each other and the health information of
Australians.
This Cyber Security Strategy sets out our coordinated,
holistic approach to uplifting capability across the Agency in response to this
changing cyber environment. It also provides a clear plan to meaningfully
support Australian healthcare providers and health technology partners to
protect themselves and the critical health information they too hold.
Cyber security is not a technical niche. Everyone at the
Agency and in the healthcare community has a part to play. Our success will be underpinned
by our security culture, secure business practices and by our behaviours – at home
and at work. It will be defined by our dedication to change and willingness to
embrace the challenges ahead. The spirit of innovation and passion to improve
the health and wellbeing of Australians animates the Australian Digital Health Agency.
Our cyber security must also embody this spirit so that
together we can set a new standard for secure innovation, continuous
improvement and digital health reform in Australia.
Amanda Cattermole, PSM
CEO"
This seems to be the guts of the plan and what they actually
plain to do….(p 13 of 22)
Regulatory and Legislative Changes
The Australian regulatory landscape is also continuing to evolve
in response to trends in the cyber threat environment. Changes to legislation
will further shape the role the Agency plays in securing Australia’s
digital health ecosystem.
The Agency continues to monitor and support the
ongoing review of the Privacy Act 1988 (Cth). This includes the introduction of
the Online Privacy Bill to encourage harmonisation and interoperability of
privacy and security obligations between My Health Records Act 2012 (Cth) and the
Privacy Act 1988 (Cth). This will ensure that all digital innovation is
equipped with strong security, privacy, and clinical safeguards.
The strengthened security and privacy
protections introduced by the Trusted Digital Identity Bill will enable secure
and streamlined access to both public and private sector services forming part
of the digital health ecosystem.
The Agency has prioritised recommendations
outlined in the My Health Records Act Review, including increased monitoring of
healthcare and service providers’ compliance with legislative requirements to
effectively manage shared cyber security risks.
The Agency will support the recent and
anticipated amendments to the Security of Critical Infrastructure Act 2018
(Cth) and the Ransomware Payments Bill 2021 (Cth) with a program of awareness
and education initiatives to ensure that critical infrastructure assets and
critical infrastructure sector assets within the digital healthcare ecosystem
are aware of their cyber reporting and management obligations and receive the
appropriate level of cyber security support from the Agency. As an organisation
operating in a critical infrastructure sector, the Agency is equally focused on
a strong internal and external cyber security risk management.
The Australian Government is seeking to
strengthen and coordinate the management and operation of its IT networks
through the establishment of Cyber Hubs. This centralisation aims to consolidate
cyber security services across Australian Government Agencies.
So we have a 22 Page Strategy with 3+ pages essentially blank
and the rest in huge type where the main activities are monitoring what others
are doing and essentially no externally focussed activity to assist the other
actors in the Digital Health Space to do much better. This applies especially
to all the end points which access the #myHR.
I really can’t see much in the way of real activity and
progress and I am pretty sure this is another piece of ADHA Shelfware!
The CEO Introduction to the Strategy isreally a very rich example of ‘bureaucratic waffle’
that really goes nowhere and really might have been written by some automated sentence
generator. Can anyone see any concrete outcomes flowing from this?
As I have read this the question that I struggle to answer
is “Just who would notice or care and what difference would it make if it did
not exist”?
Indeed with this sort of output can the same question be
asked of the ADHA itself?
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
Spike in Remote Patient Monitoring Driven by Handful of Providers
New research found that the
COVID-19 pandemic led to expanded use of remote patient monitoring, but the
increase was largely driven by a small number of primary care providers.
September 09, 2022 - A study
published in Health Affairs found that a small fraction of primary care
physicians drove a more than four-fold increase in remote patient monitoring
(RPM) use during the COVID-19 pandemic.
Even though RPM was being used
prior to the COVID-19 pandemic, changes in care delivery amid in-person
restrictions led to a significant rise in use.
In this study, researchers aimed
to gather data regarding how RPM is used to help educate policymakers as they
make decisions regarding regulations and reimbursement for the care modality.
Researchers collected data on
medical claims for 20 million Medicare Advantage enrollees between Jan. 1,
2019, and March 31, 2021. They gathered several pieces of claim-specific
information, including dates of service, associated procedure codes, motivating
diagnoses, and de-identified provider IDs.
Why mobilised data is the most valuable tool in healthcare
As chief clinical Information
officer (CCIO) at Wrightington, Wigan and Leigh Teaching Hospitals NHS
Foundation Trust, Dr Martin Farrier feels there should be a shift in focus from
what is inputted into an EPR system towards what is outputted, such that the
information can be mobilised and enable improvements to care practices. Dr
Farrier explains why mobilised data is the most valuable tool in healthcare and
that this will especially be the case as we work to achieve the plans set out
in the Data Saves Lives strategy in an Integrated Care System
(ICS) context.
DHI News Team – 13 August 2022
Reflecting on the start of the
pandemic, the data we held was collected for a single purpose and could only
really be used for that purpose. We did not have the tools to extract data
effectively and the data was too often entered in a way that could not be
searched. Typically, that was as free text entry. Seeking to alter the way that
we collect data can make it transferrable. The journey that data makes is
important and its mobility enables it to be more than a single point.
Learning lessons from
Covid-19
Covid-19 forced us to design
systems that didn’t exist. Whilst they were needed for the recording of care,
they were designed with the knowledge that the data generated from the system
would be needed to plan services. Once we managed to develop the systems and
configure our EPR to help create a database of Covid-19 patients that could be
used and updated in real time, we were able to streamline our processes. This
helped garner an accurate list of people at a time when this was unique. We
could identify all the positive tests, and then cross-check that with the
clinical notes and confirm true cases, admissions and outcomes.
How hospitals can address medical device vulnerabilities
Historically, medical devices
weren’t connected, and too often security is still an afterthought for
manufacturers. But make no mistake: they are cyber assets, and often riddled
with vulnerabilities and recalls.
Hospitals rely heavily on
medical devices and Internet of Medical Things (IoMT) devices to deliver high-quality
patient care and improve outcomes. With an average of 10-15
medical devices per bed in a U.S. hospital, a 1,000-bed hospital could
have up to 15,000 medical devices to manage. Unfortunately, with the
proliferation of medical devices and IoMT comes an ever-increasing attack
surface.
Cyberattacks on medical devices
can lead to misdiagnosis or missed treatments, resulting in serious injury, or
loss of life, as well as significant loss of business and reputational damage.
Since these assets are critical to their mission, healthcare organizations must
work diligently to secure them.
Cybersecurity
challenges
Medical device and IoMT
vulnerabilities strike fear in clinicians, biomedical engineers, CISOs and
network security administrators alike, for good reason. Securing these assets
poses many challenges.
Pandemic Led to Surge in Remote Patient Monitoring
Marcus A. Banks
September 06, 2022
Devices
that remotely transmit people's weight, blood pressure, and glucose levels to
physicians exploded in popularity during the COVID-19 pandemic, as people were
socially isolating, according to a study
published September 6 in Health Affairs. This uptick was not evenly
distributed, however, with a small number of primary care physicians generating
the most billing claims.
The
idea is that physicians will adjust patient care plans in response to these
data feeds from remote patient monitoring (RPM) devices, the researchers said,
adding that people with multiple chronic conditions, such as hypertension
or uncontrolled type
2 diabetes, might benefit the most. But the researchers did not find
pinpoint targeting of RPM services to people at greater risk.
At
least one observer noted that the billing distribution was so lopsided — 0.1%
of providers in this sample submitted 69% of the claims — that it could
indicate fraud.
"People
were probably billing these codes without actually doing very much real remote
patient monitoring," Joseph Ross, MD, MHS, a professor of medicine and
public health at Yale University, New Haven, Connecticut, who was not involved
in the analysis but studies trends in clinical adoption of tools such as RPM
devices.
Most older adults hope to age at
home or within their current community. Some 77 percent of adults age 50 or
older would prefer to remain in their current residence, according to a 2021 AARP survey. And that goal to age in place is well
within reach as home healthcare organizations find support through digital
transformation.
CAH
has been somewhat digitally mature for several decades now, but new
technologies are helping make home care even more efficient for workers and
beneficial for patient well-being, according to industry expert Keith
Crownover, associate partner at Stoneridge Partners.
“What
people don’t realize is that the home care industry has been automated to a
high degree since the mid-1990s,” Crownover says. “Home care professionals have
been remote workers forever. They were documenting electronically while the
clinical space lagged somewhat.”
How virtual reality is turning surgical training upside-down
"VR's level of genuineness
gives users a truly authentic experience that you see and feel
immediately," says one surgeon, who offers an in-depth look at the
technology. "It's wildly impressive."
The
field of orthopedics is highly complex and continually evolving, particularly
as the fast and furious pace of new surgical devices and technologies
accelerates.
THE
PROBLEM
The
importance of highly effective, accessible tools and resources, in addition to
exposure to hands-on surgical training, is critical.
"Amid
the digital acceleration of healthcare transformation, we can no longer rely on
the age-old mantra, 'See one, do one, teach one,' to train the next generation
of surgeons," said Dr. Cory Calendine, chief of orthopedic surgery at
Williamson Medical Center and orthopedic surgeon and founder of the Bone and
Joint Institute of Tennessee.
"Rather,
we should implore them to 'Do as many as possible,'" he continued.
"In fact, the more practice a resident or attending surgeon can conduct,
the more proficient they will become."
With
the aggressive pace of new devices, technologies and techniques, it becomes
ever more important to track and measure performance metrics. These shortfalls
in proficiency can come with real consequences for patients, surgeons and their
healthcare institutions.
Direct line between hospital cyberattacks and patient mortality, report
shows
The Ponemon Institute and
Proofpoint study found that more than 20% of those healthcare organizations hit
with a ransomware attack or other IT compromise experienced an increase in
mortality rates.
A
new cybersecurity report this week had some sobering statistics illustrating
just how commonplace network attacks have become across healthcare.
The
survey, which polled more than 640 IT and security leaders, found that 89% of
the surveyed organizations experienced an average of 43 attacks over the past
year – averaging almost an attack each week.
WHY IT
MATTERS
Worse, the Ponemon Institute study, sponsored by Proofpoint, also found that cyber
incursions are now routinely impacting patient safety at U.S. hospitals and
health systems.
The
report, "Cyber Insecurity in Healthcare: The Cost and Impact on Patient
Safety and Care," showed respondents saying cyberattacks are routinely
delaying procedures and tests – with 57% saying that results in poor patient
outcomes and 50% citing increased complications from medical procedures.
Perhaps
the most alarming stat was this one: of those health systems experiencing the
four most common types of cyberattacks, 20% said they have subsequently
experienced increased patient mortality rates.
However, 'high risk'
providers billed the program for $127.7 million for telehealth services in the
first year of the pandemic.
KEY TAKEAWAYS
·The first year of the coronavirus pandemic saw
massive infusions of federal money and relaxed oversight by HHS of telemedicine
services.
·High-risk providers represent only 0.2% of the
audit sample, but they billed Medicare and collected $127.7 million in FFS
payments between March 2020 and February 2021.
·The American Telemedicine Association calls the
report "another clear statement outlining the resounding success of
telehealth during the COVID-19 pandemic."
First the good news.
Only 1,714 of the 742,000
providers who billed Medicare and Medicare Advantage for telehealth services
for about 28 million beneficiaries during the first year of the pandemic
"posed a high risk" to the program integrity, a
federal audit shows.
Now the not-so-good news.
These high-risk providers
represent only 0.2% of the audit sample, but they billed for about 500,000
beneficiaries and collected $127.7 million in Medicare fee-for-service payments
for care provided between March 2020 and February 2021, according to an audit
by the Department of Health and Human Services, Office of the Inspector
General.
The
first year of the coronavirus pandemic saw massive infusions of federal money
and relaxed oversight by HHS of telemedicine services, as more than 28 million
Medicare beneficiaries —about 2 in 5 — used telehealth in that first year of
the pandemic, about 88 times more than in the previous year.
Director, Country Health
Information Systems and Data Use (CHISU)
Global Health
·Digital transformation in healthcare is growing
rapidly year-on-year.
·Health information systems are designed to
manage healthcare data.
·CHISU project is helping countries in their
digital transformation journey.
Digital transformation has been
a hot topic in the healthcare industry in recent years. Spending
on digital transformation surpassed $1.3 trillion worldwide and it is
growing at a whopping 10.4% year on year. In a study
conducted by Deloitte, around 92% of healthcare professionals and
institutes achieved better performance from digital transformation.
It has become a common term in
the media but many people still ask, “What does digital transformation actually
mean?” Most tend to believe that it is all about the latest technology and
systems, and forget that there are different aspects to consider, particularly
how people and technology interact.
Digital transformation happens
when interactions among institutions and clients help enable positive changes
in the health information system. It is more of an organizational change and it
enables improvement in health systems agility, thereby improving operational
excellence and patient experience, as well as reducing costs.
September 08, 2022 - A
group of researchers from Johns Hopkins Medicine may have cracked the code on
medication adherence, outlining
two viable options involving patient education and nurse feedback to increase
the number of patients taking life-saving medications after surgery.
Particularly, the researchers
found that both a patient
education bundle and a nurse feedback program helped reduce the number of
patients foregoing a low-dose blood thinner after an operation.
Medication adherence to post-operative
medications can be a big problem for healthcare organizations working toward
better clinical outcomes. In post-surgery care, adherence to a low-dose blood
thinner can help prevent venous thromboembolism (VTE)—or deep vein thrombosis
(DVT)—but all too often, patients skip the medication.
“According to the U.S. Centers
for Disease Control and Prevention, VTE kills some 100,000 people each year,
with approximately half developing their VTE associated with hospitalization,”
study lead author Elliott Haut, MD, PhD, associate professor of surgery at
the Johns Hopkins University School of Medicine, stated
publicly. “We’ve shown that an effective intervention can help bring those
numbers down for patients who are hospitalized.”
How Healthcare Cyberattacks Can Impact Patient Safety, Care Delivery
Surveyed healthcare security
professionals reported adverse patient safety effects resulting from healthcare
cyberattacks, including a hike in mortality rates and longer hospital stays.
September 08, 2022 - Along
with documented financial losses and reputational harm, healthcare cyberattacks
have been known to endanger
patient safety and adversely impact care delivery.
With the goal of understanding
how various healthcare cyberattack types can impact patient safety, Proofpoint
commissioned Ponemon Institute to survey
IT and IT security professionals in the healthcare sector. The survey included
self-reported responses from 641 experts in the field.
Patient Safety Implications
Specifically, researchers
focused on four common types of healthcare cyberattacks: ransomware, business
email compromise (BEC) attacks, cloud compromises, and supply chain attacks.
Nearly 90 percent of all survey respondents said that their organizations had
experienced at least one cyberattack in the past 12 months.
Although correlation and
causation are difficult to determine with absolute certainty, the results
showed that survey respondents with day-to-day experience in the field have
felt the tangible impacts a cyberattack can have on patient care at alarming
rates.
As value-based care tales hold,
more attention is being paid to transitions of care, and ensuring that patient
information follows patients as they move between different care settings.
The transfer of patients to
post-acute care often has been challenging because the industry has lacked
sophisticated records systems organizations providing care in patients’ homes
or in long-term care settings.
That’s changing with the
emergence and evolution of post-acute care product suites, according to a
recent report
from KLAS Research. And these providers are pushing for technology that’s
appropriate for the care they need to provide, as well as the interactions they
need to have with larger health systems.
“Most providers in post-acute
care settings want technology built for their specific area, but they face
challenges with interoperability, analytics, value-based reimbursements and
care coordination,” the KLAS report notes.
Medical
device startups are tasked with quite the balancing act: They’re developing new
products while simultaneously fundraising to support that development and
working with regulatory agencies to bring the products to market.
So
far, Otolith Labs is staying steady. The Washington, D.C.-based startup—named
for the organs of the inner ear—has built a nerve-stimulating wearable device
that aims to relieve the symptoms of chronic vertigo. It already has the FDA’s
ear since earning the agency’s breakthrough designation last year.
Next
up, Otolith will launch a pivotal trial of the noninvasive Vestibular System
Masking (nVSM) technology. If successful, the results will be submitted to the
FDA for full clearance for the device to make its U.S. commercial debut. All of
those efforts will be supported by series A funding announced Wednesday,
which brought in $20 million for the company.
The
entire round came courtesy of Morningside Ventures. It’s more than six times
bigger than Otolith’s previous financing, which brought in $3.3 million in seed
funding last year from a cadre of investors that included serial entrepreneur
Mark Cuban, himself a subject of inner ear issues.
The
following is a guest article by Itay Bochner, Director of Malware Analysis at OPSWAT.
Patients
can’t get their medicine, psychiatrists can’t add reports to the system and
provide their professional opinion in court, and only last week was the medical
helpline number 111 restored. The manual logging of patient records is
resulting in piles of paper documentation, which doctors are saying could take
months to input into the online system once it’s restored.
The
ransomware attack on Advanced, one of the UK’s biggest software providers for
its National Healthcare System, is turning into one of the biggest cyberattacks
ever to happen in healthcare. Over 20 days have passed since the health
services’ cloud provider was attacked by ransomware. Since then, providers and
patients have had no access to medical records – causing chaos and broader
societal impact.
Even
more alarming, Advanced estimated it could take a few more weeks before they
see a full restoration of services, leaving many questions about why recovery
is taking so long and what could’ve been in place prior to the attack to reduce
recovery time.
Why
the Wait?
While
we can only speculate at this time, the lengthy recovery time could either be
due to Advanced’s production environment and the last backup not being up to
date. Another possibility could be that the backup is also infected with the
malware, and recovering it will not help, forcing them to go way back or build
it again.
It
seems everywhere you look these days you see ads for 5G. It’s the “new thing”
when it comes to telecommunications. It reminds me when “the cloud” was first
introduced – not many people knew what it really was and yet leading vendors
like Microsoft and IBM were pushing it. Cloud was this amorphous “thing” that could
magically solve business problems. The same is happening with 5G right now.
It’s tough to know what is real and what is hype. This is especially true about
5G + healthcare. How will the technology help? Where can it be used
effectively?
These
were the questions in my head when I sat down to read an e-Book from Corning titled 4
Reasons Why 5G and Healthcare Make Sense. I was somewhat familiar with 5G,
but I didn’t know some of the details and what it meant for healthcare. The
biggest surprise for me was that the 5G provided by the major
telecommunications companies won’t likely be available at most healthcare
facilities. Unlike 3G and 4G signals, which can penetrate the walls of
hospitals and medical buildings, 5G signals from outside antennas are unlikely
to be strong enough to be used by people inside. That means healthcare
organizations will need to invest in the necessary infrastructure to make 5G
available inside their buildings.
What
does this look like? Download
the e-Book for the details. For me, the core idea is that healthcare
organizations need to seriously consider investing in a wireless-first 5G
network with a fiber backbone. I see this very similar to when healthcare
started to invest in WiFi. Forward thinking organizations started deploying
WiFi early so they were ready for the need for higher speeds, new devices, and
quicker response times. Not considering 5G for your healthcare organization is
similar to ignoring WiFi. You might be able to do that for a short time, but it
will eventually catch up with you.
Large Health IT Networks Unveil Plans to Become QHIN Under TEFCA
Joining as a QHIN under TEFCA
intends to provide greater interoperability offerings and allow organizations
to participate in a network that works together to share clinical data.
These networks connect to
support health information exchange and further interoperability nationwide.
CommonWell Health Alliance
Health data sharing network
CommonWell Health Alliance has announced
its plan to become one of the first Qualified Health Information Networks
(QHIN) in the Trusted Exchange Framework and Common Agreement (TEFCA).
September 07, 2022 - Almost
four-fifths of hospitals participated in health information exchange (HIE)
networks in 2018, supporting data exchange for about two-thirds of shared
patients, according to a study
published in Medical Care.
Researchers used a combination
of data sources to measure electronic connectivity between US hospitals. Unlike
prior measures based on whether a given hospital does or does not participate
in an HIE network, the study analyzed connectivity from the network perspective
(i.e., when a hospital is connected to some hospitals but not others).
The researchers found that both community
and vendor/national HIEs covered a substantial percent of shared patients,
lending support to the national policy strategy that has fostered the
development of these networks.
However, almost all remaining
patients were treated at hospitals where both hospitals participated in
different HIE networks, or one organization participated in a network while the
other did not.
Adverse Event Rate Similar for Remote, In-Home Physician Visits
New research shows a small
difference in the number of adverse events among patients receiving in-home
physician visits and those receiving remote care.
September 07, 2022 - While
researching the outcomes associated with various types of physician visits, a
study published in JAMA Network Open found that the benefits of in-home
physician visits did not widely differ from those associated with remote
physician visits.
Although the recent growth in
remote care is widely regarded as beneficial for patients and providers,
questions surrounding its benefits compared to in-home care methods remain.
For the study, a group of
researchers examined data from 172 patients at an academic medical center, all
requiring hospital-level care for various conditions, including infection,
heart failure, chronic obstructive pulmonary disease, and asthma. All data used
in the study was gathered from Aug. 3, 2019, to March 26, 2020.
To measure and compare the
results associated with in-home and remote care, researchers studied the number
of adverse events, such as accidents and injuries, using it as the primary unit
of measurement. The number of adverse events was measured using Poisson
regression at a noninferiority scale of 10 events per 100 patients.
Clinical Diagnoses Similar During Telehealth, In-Person Visits
New research shows that
diagnoses provided during a video-based telehealth visit matched the in-person
reference standard diagnoses in 86.9 percent of cases.
September 07, 2022 - While
comparing diagnostic consistency between different methods of care, a
JAMA Network Study found high levels of diagnostic concordance between
telehealth and in-person visits overall.
Although many providers see
telehealth as immensely useful, the reliability and accuracy of the care
modality can be unclear. To investigate the relationship between virtual and traditional
in-person care methods, researchers used clinician diagnostic concordance as a
unit of measurement.
The sample used in the study
contained data from 2,393 participants from an academic integrated
multispecialty healthcare institution. The median age of the participants was
53, and 57.7 percent were female.
Of the 2,393 cases, 2,080 (86.9
percent) displayed diagnostic concordance between virtual and in-person visits.
Researchers also used the International Statistical Classification of Diseases
and Related Health Problems, Tenth Revision, to compare concordance among
different conditions. Researchers found diagnostic concordance levels as low as
64.7 percent for conditions related to the ear and mastoid process and as high
as 96.8 percent for neoplasms.
Tuberculosis kills 1.4 million people every year,
primarily in places where poverty and deprivation conspire to make people
uniquely vulnerable, and unable to get lifesaving care in time.
Google
is now joining a global fight to snuff out the disease, using AI to automate
its detection — and expedite treatment — in communities where physicians are in
short supply. A new study published Tuesday in Radiology, the journal of the
Radiological Society of North America, found that its AI model performed as
well as radiologists at detecting tuberculosis on chest X-rays.
Google
is not the first to develop an AI system to detect TB, nor is its tool likely
to make a dent in death rates anytime soon. But outside experts said its early
results are especially promising given their consistency across diverse
populations of patients. The model met or exceeded performance standards set by
the World Health Organization when tested on historical patient data drawn from
China, India, the United States, and Zambia.
“Unlike
much of the data published about AI, (Google’s) study was large and used
different training sets, which showed their system is robust,” said Edith
Marom, the head of thoracic imaging at Chaim Sheba Medical Center in Israel.
Health
tech company Iodine Software and coding software
platform TruCode are collaborating to upend clinical administration
using artificial intelligence.
Austin,
Texas-based Iodine Software developed artificial intelligence-powered software
solutions to address automation for clinical administration and revenue cycle
management. The company's AwareCDI Suite identifies and captures
mid-revenue cycle leakages, like discrepancies in reimbursement and clinical
documentation, to make sure healthcare services are accurately coded and to optimize
revenues.
Through
the partnership, Iodine Software will integrate TruCode's coding resources
directly into its AwareCDI suite. The combined solutions will provide clinical
documentation improvement teams with easy access to detailed diagnosis and procedure
code reference information directly in their workflows, in addition to access
to complete official code books, according to the company.
The
technology will help support accurate capture of documentation and code
assignment resulting in appropriate claim reimbursement, accurate reporting of
patient outcomes and reduced claims denials, according to the companies.
Expanded
use of telehealth services during the COVID-19 pandemic was associated with
reduced risk of opioid overdoses, a study published in JAMA Psychiatry on
Wednesday found.
The
study split 175,000 Medicaid beneficiaries between those who initiated opioid
use disorder (OUD) care before the pandemic and after the outbreak. Patients in
the COVID-19 pandemic group were more likely to receive OUD-related telehealth
care and corresponding medications for opioid use disorder (MOUD), experts
said. Those who received telehealth care were also more likely to retain
medical treatments. Beneficiaries who were Black or lived in the south were
less likely to receive telehealth services, the study found.
“The
expansion of telehealth services for people with substance use disorders during
the pandemic has helped to address barriers to accessing medical care for
addiction throughout the country that have long existed,” said Wilson Compton,
M.D., deputy director of the National Institute on Drug Abuse and senior author
of the study, in a press
release. “Telehealth is a valuable service and when coupled with
medications for opioid use disorder can be lifesaving. This study adds to the
evidence showing that expanded access to these services could have a
longer-term positive impact if continued.”
Roughly
1 in 8 beneficiaries in the pandemic group received OUD-related telehealth
services compared with 1 in 800 in the prepandemic group, the research
revealed. Access to telehealth services was associated with better treatment
retention and lower risk of medically treated overdose in the pandemic group compared
to those not receiving telehealth services.
The
way medical students perceive emerging technology has a significant impact on
decisions regarding their future medical careers, new survey data show.
According to the new data, students
believe that emerging technologies (ET), such as artificial intelligence, could eventually render some
specialties obsolete. In fact, 23% of the 532 students surveyed shared that
they would not consider pursuing a career in
diagnostic radiology,
as they feel it would limit their future job prospects.
The survey data were published
recently in Academic
Radiology, where corresponding author of the paper Michael
K. Atalay MD, PhD, of the Department of Diagnostic Imaging at
Rhode Island Hospital,
Warren Alpert School of Medicine of Brown University, and colleagues discussed
how current beliefs surrounding technological advancements will affect the
future of medicine:
“Although it is impossible to
predict how the practice of medicine will evolve due to technological advancements,
current perceptions will likely affect the paths that medical students take as
they attempt to plan their careers. The perceived impact of ET on various
specialties may have subtle or substantial impact on decision-making.”
September
06, 2022 · Health Data · Privacy and
Security
Field Notes: Patient Portal – A Technological Tool for Health Literacy
By
Patricia Coffey, MS, RHIA, CPHIMS, CPHI; Marisa S. Owens, RHIA; Minnie Raju,
MS, RN; and Jon W. McKeeby, DSc, MBA, CPHIMS, CPHI
Organizational Background
The
NIH Clinical Center (CC) is a biomedical research hospital and the delivery
setting for NIH intramural clinical research protocols. The hospital contains
200 inpatient beds, 93 day hospital stations, 15 outpatient care clinics, and
more than 1,600 research laboratories. The CC admits patients from all over the
world for clinical trials and natural history studies and provides hospital
services-based support for 17 of the 27 Institutes and Centers (ICs) of the NIH
Intramural Research Program. This large portfolio of research studies requires
an acute focus on patient safety, timely and effective clinical care, and
thorough clinical and research documentation. To support these patient care and
research activities, the NIH utilizes an electronic health record (EHR) solution
called the Clinical Research Information System (CRIS). The CC also utilizes a
patient portal to ensure patients have access to information from their EHRs.
The
CC’s unique, clinical research environment provides support for research
participants (patients) from across the globe. Many of these patients have
rare, life-threatening illnesses, conditions, and diseases. These patients have
great knowledge about their diseases, often seeking out care from a variety of
healthcare organizations. CC patients often travel long distances seeking help,
often as their last hope when dealing with these very rare diseases or
debilitating chronic conditions. They have a history of having many medical
procedures and testing completed with a high volume of results to keep track of
and monitor. They want to be knowledgeable about their health status and be
able to access medical information and results quickly and easily.
CVS to Acquire Home Health Provider Signify Health for $8B
After winning a bidding war,
CVS will buy Signify Health in an all-cash transaction, gaining access to its
nationwide clinician network and analytics solutions focused on home-based
care.
September 06, 2022 - CVS
Health plans
to purchase home healthcare company Signify Health in a deal valuing
approximately $8 billion.
Rumors
of a potential deal surfaced early last month when the Wall Street Journal
reported that CVS Health was going to make a bid for the company, sending
Signify Health's stock soaring. It then emerged that CVS was competing against
UnitedHealth Group, Amazon, and Option Care Health, among others, for the
company. According to Bloomberg,
as of Aug. 22, UnitedHealth Group had submitted the highest bid for Signify
Health, followed closely by Amazon.
But CVS Health won, making a
deal to buy the company for $30.50 per share in cash.
Signify Health includes a
network of more than 10,000 clinicians nationwide that determine patients'
clinical and social needs through home-based visits, connecting them to
follow-up care and community-based resources to meet those needs. It also
offers analytics solutions to help healthcare organizations establish and grow
value-based payment programs and drive care into the home.
'Critical' network failure at all 3 campuses of The Ottawa Hospital
resolved
Sat, September 3, 2022 at 1:46
a.m.·
Operating
rooms were on hold and some appointments were cancelled after a critical
network failure Friday morning across all The Ottawa Hospital (TOH) sites.
According
to information provided to hospital staff and obtained by CBC News, a
"hardware issue" was discovered at about 5 a.m. Friday, resulting in
a network failure that affected multiple software systems.
As
a result the hospital entered into a critical infrastructure failure code
grey, which remained in place Friday afternoon.
Affected
systems included: EPIC (an electronic health records management system),
PACs (picture archiving and communication systems), Cerner (a suite
of medical software), Rhapsody and SPOK Mobile paging.
Want
to eliminate up to 50% of a physician’s EHR workload? Achieving that goal may
be simpler than you think.
Membership fights burnout
The
AMA is tackling the key causes of burnout through advocacy, research and the
development of resources. Join the movement to fight burnout and help us
provide relief for physicians.
The
AMA’s de-implementation checklist outlines processes or
requirements that add little or no value to patients and their care teams, but
place unintended burdens on clinicians. Items on the checklist—part of
the AMA
STEPS Forward® open-access toolkits—can be sorted into items
that don’t need to be done by someone with an MD or DO and items that don’t add
any value to patient care and can be eliminated entirely.
Often,
taking five minutes to change the way your EHR functions can free up an hour or
two of time that was being wasted daily—time that can be spent with patients in
the exam room. In turn, the found time can reduce physician burnout, said
internist Marie Brown, MD, the AMA’s director of practice redesign.
“Stop
doing unnecessary work so you can get back to doctoring,” said Dr. Brown, who
has experienced firsthand the positive impact de-implementation can have.
“Making changes will give doctors more time to spend with their patients and
more time to build trust with their patients. They’ll also take less work
home.”
The federal government has taken its first
step towards overhauling the myGov online services portal, rolling out a
refreshed website ahead of the launch of a new app later this year.
The new website, which is still at my.gov.au,
has a new visual design with a modern logo and a blue colour scheme (replacing
the green), but it also features a new navigational layout.
Government services minister Bill Shorten
said the changes were designed to put inbox messages and linked services up
front, with information on claims and payments organised according to
particular life events.
“The initial topics include raising kids,
changes in living arrangements, ageing, work, education and health and
disability, with more topics and information to be added soon,” he said.
“The pandemic showed us the importance of
having excellent connections with government services online, and these
upgrades will immediately give Australians more options when using the site.”
Labor
had pledged to audit the myGov service, as part of its pre-election
commitments, following criticism that the portal suffered too many crashes and
outages. In June, Shorten said his aim was
to make myGov a more seamless and practical service, characterising the
existing iteration as a “digital workhouse” that soaked up hours of peoples’
time.
The latest refresh is the first step towards the service’s eventual overhaul,
the minister said, which will also include a smartphone app.
“We
want Australia’s government services online to be the world’s best and the app,
to be delivered soon, will further boost and simplify the user experience,”
Shorten added.
“The
latest upgrades to the myGov website means it has the flexibility to adapt to
meet people’s information needs and preferences into the future.”
Since
launching in 2013, myGov has become Australia’s largest authenticated platform,
connecting to government services including Medicare, the Tax Office and
Centrelink. It has more than 25 million active linked accounts and an average
of one million sign-ins per day, according to the Albanese government.
The
federal government has launched its revamped myGov platform, as
its full attention now turns to delivering a long-promised smartphone app for
accessing government services online.
Services Australia flicked the switch on the
new myGov on Monday, having revealed plans to permanently replace the legacy
platform – which was last upgraded in 2017 – last month.
“From today, the myGov website has changed
colour from green to blue, as part of a broader upgrade,” Government Services
minister Bill Shorten said.
The changeover was followed by reports of
issues in myGov accounts for some users on Monday, with the source of the
problems now the subject of an investigation by the services agency.
While
the upgrade is largely cosmetic, including a new layout to help people see the
inbox messages and linked services more easily, additional functionality is
expected to be added over time.
Minister
Shorten said the “upgrades will immediately give Australian’s more options when
using the site” but stressed that they were “only the beginning”.
“The
latest upgrades to the myGov website means it has the flexibility to adapt to
meet people’s information needs and preferences into the future,” he said.
“Users
will also be connected to services based on life events. The initial topics
include raising kids, changes in living arrangements, ageing, work, education
and health and disability…”
Services
Australia has been beta testing the new myGov with users since September 2021
and began actively prompting users to try it out during tax time in July.
Underpinned
by the government’s digital experience platform (GOVDXP), the new myGov is the
result of more than two years of development by US consulting giant Deloitte.
Deloitte
has been involved with the redevelopment since the very beginning, having
landed an near-$1 million contract through a limited tender to develop
a prototype for the new platform.
Since
then, Deloitte has been paid more than $30 million for its work, with
additional contracts awarded through a Systems Integrator Panel also consisting
of Accenture, IBM and Arq Group.
Given
the huge use of this portal one can hardly be critical of the Government moving
slowly and deliberately as it tries to improve things for users.
It
does seem, however that the access app has been a pretty long time coming
(since 2019).
I
guess you can never please everyone. Given how important the myGov system is
for access to be clumsy myHealth Record I am sure we will hear pretty soon if that
is not working well.
In
this case public silence is probably a good thing!
