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."

Monday, January 09, 2023

Weekly Australian Health IT Links – 9 January, 2023.

Here are a few I have come across the last week or so. Note: Each link is followed by a title and a 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.

General Comment

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We are gradually seeing more activity and the New Year starts – enjoy!

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https://www.theaustralian.com.au/nation/ai-breakthrough-could-save-time-and-money-in-mri-scans/news-story/575764eed604cf1d0362cab0257160ad

AI breakthrough could save time and money in MRI scans

By BEN SPENCER

The Times

6:07PM January 1, 2023

An artificial intelligence breakthrough could cut the time of an MRI to as little as 15 minutes and save up to £250 ($445) per scan.

For the past 20 years, patients have had dye injected into a vein before undergoing certain types of scan to make complex anatomy stand out more clearly. But scientists have shown they can do away with the dye by using AI ­instead.

The researchers used 4000 heart scan images to train machines to detect problems that would not usually be seen without dye. They effectively predict what a contrast-enhanced image would look like.

Results published in the ­Circulation medical journal show the technology can be used to detect scarring after a heart attack and performs better at picking up problems than traditional scans.

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https://www.healthcareitnews.com/news/anz/northern-territory-completes-second-stage-rollout-acacia-phr

Northern Territory completes second stage rollout of Acacia PHR

It is also being implemented in renal services at the Top End.

By Adam Ang

January 04, 2023 09:45 PM

The Northern Territory government has completed the second stage rollout of its new patient health record system.

Following its first implementation at Katherine Hospital, the A$259 million ($182 million) Acacia system is now also in use at the 30-bed acute care Gove Hospital.

Moreover, the PHR system is being rolled out in renal services across the Top End region, which includes Darwin, Katherine, Kakadu, and Arnhem Land. It was initially deployed in four renal dialysis sites late last year and is now coming to more sites in central Australia early this year.

"Staff on site now use Acacia to capture same-day data on dialysis treatments," a media release noted.

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https://build.fhir.org/ig/AuDigitalHealth/ci-fhir-r4/Organization-tas-family-clinic.html

Australian Digital Health Agency FHIR Implementation Guide 0.0.1

Australian Digital Health Agency FHIR, published by Australian Digital Health Agency. This is not an authorized publication; it is the continuous build for version 0.0.1). This version is based on the current content of https://github.com/AuDigitalHealth/ci-fhir-r4/ and changes regularly. See the Directory of published versions

Example: Organization-tas-family-clinic

Formats: Narrative, XML, JSON, Turtle

Generated Narrative: Organization

Resource Organization "tas-family-clinic"

Profile: ADHA Core Organization

type: Healthcare Provider (Organization type#prov)

name: Tasmanian Family Medicine Clinic

telecom: reception@dfmc.example.com, fax: (03) 5550 5557(WORK), ph: (03) 5550 5556(WORK)

address: LPO Box 235 Strahan TAS 7468 AU

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https://www.digitalhealth.gov.au/careers/it-support-analyst

IT Support Analyst

APS4 ($84,807 - $89,609)
Technology Services Division > Info/Comm Tech (ICT)
Canberra

Closing - 19 Jan 2023

Division Overview 

Technology services – responsible for the operation of high-quality, trusted, reliable and secure national digital health infrastructure and health support systems.

Primary Purpose of Position

The Agency is seeking a suitability qualified IT Support Analyst passionate about delivering consistent excellence, client-focused, agile and solutions-based thinker, to join our Technology Services Division.  

This role provides fantastic opportunities for candidates at all levels of their career, from just graduated and seeking to grow their experience to seasoned IT Support Analysts who are looking for career progression or just a new work home to showcase their skills. 

As an IT Support Analyst, you will be required to work as part of a high-performing Division within a complex environment. The primary responsibilities of this role include organising activity workflow, conducting investigations, and undertaking procedural, administrative support, or operational tasks. In addition, you will also be accountable for the IT Service Desk, User Support, and Basic Administration of the Agency’s Business Applications/Systems, End User Computing, and other related technology.

You will work in our amazing IT Support team, specifically responsible for the business systems and general IT used across the Agency, and collaborating deeply across the Branch and broader Agency to deliver outcomes.

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https://www.innovationaus.com/fixing-regional-mobile-is-the-albanese-govts-nbn-moment/

Fixing regional mobile is the Albanese govt’s NBN moment

Mark Gregory
Contributor

4 January 2023

The Australian Competition and Consumer Commission (ACCC) has decided not to grant authorisation for the proposed regional mobile network arrangements between Telstra and TPG Telecom.

In doing so the ACCC has thrown down the gauntlet to the Albanese Government by arguing that infrastructure competition in regional and remote areas will remain a key plank of ACCC telecommunications competition policy.

The ACCC’s ideological position is unsound, and you don’t have to look very far to find evidence of this.

New Zealand has a successful telecommunications market with mandatory domestic roaming and a government funded black spot program that has funded more than 800 active sharing (neutral host) mobile towers used by all of New Zealand’s mobile network operators.

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https://www.afr.com/world/north-america/were-the-decades-and-billions-spent-on-james-webb-telescope-worth-it-20220713-p5b18b

Were the decades and billions spent on James Webb telescope worth it?

Thankfully, we have people who can conceive an instrument that records infinitesimal waves of energy emitted around the time the Earth was formed.

David Von Drehle

Jan 1, 2023 – 12.00am

“There are more things in heaven and earth, Horatio, than are dreamt of in your philosophy.” So says Hamlet to his school chum after a chilling encounter with a ghost. The line went through my mind as I looked at the first image released by NASA from the James Webb Space Telescope, the marvel of engineering and audacity recently parked and unfolded in an orbit roughly 1 million miles from home.

Operating so far away gives the Webb supersensitivity to infrared light that cannot be seen by the human eye. It can see much, much farther than the low-orbiting Hubble Space Telescope. And because light travels at a constant speed, seeing farther in distance is the same as looking more deeply back in time.

The image is a picture from 4.6 billion years ago. This is only the first of many mind-boggling concepts contained in the spellbinding frame. A pitch-black background is speckled with thousands of distinct lights, some starlike in their brilliance, others smudgy, and still others smaller than pinpoints.

All these distinct lights are contained in a tiny speck of space. How tiny? Scientists proposed this way of envisioning: take a single grain of sand, hold it out at arm’s length and compare it to your entire field of vision. That is the speck of space Webb looked at to acquire its first observation.

Those thousands of lights in that speck of space are not individual stars like our sun. They are entire galaxies. The one galaxy we know best, our own Milky Way, contains anywhere from 100 billion to 400 billion stars.

And here it might be helpful to spend a moment with the concept of a billion.

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Enjoy!

David.

 

Sunday, January 08, 2023

I Suspect There Is Going To A Big Change In How We Search The Internet And Soon – Or Maybe Not!

I am old enough to remember when a then tiny company transformed our usage of the Internet with the introduction of its search engine which did away with the older search indices (Yahoo, Altavista,  and the like) – mainly because it was simply much better and much more useful!

And then we had this announcement last week:

Microsoft aims for AI-powered version of Bing

By on

Incorporating technology behind ChatGPT.

Microsoft is in the works to launch a version of its search engine Bing using the artificial intelligence behind OpenAI-launched chatbot ChatGPT, The Information reported, citing two people with direct knowledge of the plans.

Microsoft could launch the new feature before the end of March, and hopes to challenge Google, the news website reported

Microsoft said in a blog post last year that it planned to integrate image-generation software from OpenAI, DALL-E 2, into Bing.

OpenAI and Microsoft declined to comment.

Microsoft had in 2019 backed San Francisco-based artificial intelligence company OpenAI, offering US$1 billion (A$1.46 billion) in funding.

The two had formed a multi-year partnership to develop artificial intelligence supercomputing technologies on Microsoft's Azure cloud computing service.

OpenAI made its latest creation ChatGPT chatbot available for free public testing on November 30.

More here:

https://www.itnews.com.au/news/microsoft-aims-for-ai-powered-version-of-bing-589497

To date Bing has been very much a second string search engine – working pretty much as well as Google but having the disadvantage of not being a verb!

The addition of ChatGPT capability seems likely to rather swing the balance towards Bing but under what feels like almost an existential threat I reckon Google will have a similar matching product out at the same time, if not before, the updated Bing arrives!

The battle of the bots – and their technology will be something to watch this year! I am sure there is more to come….

David.

 

AusHealthIT Poll Number 665– Results – 8th January, 2023.

Here are the results of the poll.

Do You Think ChatGPT Is An Important Technological Innovation?

Yes                                                                                           16 (38%)

No                                                                                            24 (57%)

I Have No Idea                                                                           2 (6%)

Votes: 42

A fairly clear outcome suggesting most don’t think ChatGPT is important while a large minority disagree.

Any insights on the poll are welcome, as a comment, as usual!

A good number of votes. and a fairly clear outcome. 

2 of 42 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many thanks to all those who voted! 

David.

 

Saturday, January 07, 2023

Weekly Overseas Health IT Links – 7th January, 2023.

Here are a few I came across last week.

Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment

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https://ehrintelligence.com/news/va-medical-center-shrinks-workforce-to-address-ehrm-budget-shortfalls

VA Medical Center Shrinks Workforce to Address EHRM Budget Shortfalls

VA leaders asked Mann-Grandstaff VA Medical Center to reduce its employee workforce to offset EHRM budget concerns regarding increased payroll and reduced revenue.

By Sarai Rodriguez

December 30, 2022 - The rising budget associated with the Department of Veterans Affairs’ (VA) Electronic Health Record Modernization (EHRM) project has led to workforce cuts at Mann-Grandstaff VA Medical Center, according to reporting from The Spokesman-Review.

Since the start of its implementation, the Oracle Cerner EHR system has been plagued by prescription errors, incorrect patient information, and delays in follow-up care caused by lost referrals.

An investigation at current implementation sites revealed nearly 500 major incidents and at least 45 days of downtime have been recorded with the Oracle Cerner EHR system since the system go-live in 2020.

Additionally, the Oracle Cerner EHR system had 930 hours of “incomplete functionality” and 40 hours of “outage” between Sept. 8, 2020, and June 10, 2022.

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https://mhealthintelligence.com/news/patients-satisfied-with-sdoh-needs-addressed-via-telehealth

Patients Satisfied with SDOH Needs Addressed Via Telehealth

Survey results show that patients were satisfied with clinicians using telehealth to tackle social determinants of health needs, with 63 percent saying that their medical and social needs were met.

By Mark Melchionna

December 30, 2022 - Published in Cureus, a recent survey indicated that most patients were satisfied with telehealth, stating that their medical and social concerns were met during virtual visits, which supports the future use of virtual care to address social determinants of health (SDOH).

Amid the rapid uptake of telehealth during the COVID-19 pandemic, patient satisfaction remains a key factor contributing to the high usage of this modality. In addition, the pandemic highlighted how SDOH impacts patient care. 

Researchers conducted a survey to review levels of patient satisfaction with the care they receive through telehealth and whether clinicians could address both medical and social needs through virtual care.

The survey polled patients at a university-affiliated primary care training clinic in Detroit. The survey aimed to gauge patient satisfaction with the technical components of their virtual visit, the visit, and the screening tool used to assess SDOH needs.

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https://healthitsecurity.com/news/pro-russian-hacktivist-group-killnet-poses-threat-to-us-healthcare-cybersecurity

Pro-Russian Hacktivist Group KillNet Poses Threat to US Healthcare Cybersecurity

HC3 warned the sector of a pro-Russian hacktivist group called KillNet, which could endanger healthcare cybersecurity.

By Jill McKeon

December 30, 2022 - The Health Sector Cybersecurity Coordination Center (HC3) issued an analyst note about KillNet, a pro-Russian hacktivist group that is known to be a threat to the US healthcare sector. The group has been active since at least January 2022 and is known for executing distributed denial of service (DDoS) attacks against countries supporting Ukraine.

“While KillNet’s DDoS attacks usually do not cause major damage, they can cause service outages lasting several hours or even days,” the analyst note stated.

“Although KillNet’s ties to official Russian government organizations, such as the Russian Federal Security Service (FSB) or the Russian Foreign Intelligence Service (SVR), are unconfirmed, the group should be considered a threat to government and critical infrastructure organizations, including healthcare.”

A senior member of KillNet threatened the US Congress “with the sale of the health and personal data of the American people because of the Ukraine policy of the U.S. Congress,” HC3 noted.

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https://www.healthcareitnews.com/news/top-10-healthcare-it-news-stories-2022

Top 10 Healthcare IT News stories of 2022

Workforce challenges, patient engagement efforts, ongoing interoperability hurdles and some big announcements from legacy EHR and Big Tech players were among the news and reports that captured the most attention this past year.

By Andrea Fox

December 30, 2022 11:13 AM

While Healthcare IT News readers have had a lot to focus on this year with cybersecurity imperatives and AI innovations, they also were very interested in new product launches, new regulator approvals, acquisitions and selloffs – including one of the most significant health IT M&A deals yet. But the top most-read story of the year had to do with a challenge nearly every healthcare organization is facing: clinician burnout, and how to help address it. 

Report: 90% of nurses considering leaving the profession in the next year. "Nurses are thinking about leaving, and the pandemic isn't solely to blame," Shawn Sefton, RN, chief nursing officer and vice president of client services at Hospital IQ, told Healthcare IT News in March. The software services company surveyed more than 200 nurses working in U.S. hospitals and 90% were considering leaving the nursing profession in the next year, with 71% of the nurses with more than 15 years of nursing experience reporting they wanted out as soon as possible. With key findings suggesting mass burnout, high turnover and a diminishing U.S. nurse workforce, Sefton said leaders couldn't continue to ignore burnout any longer and discussed actions healthcare organizations can take to eliminate some of the key problem drivers.

VA, Healthy Together collaborate on mobile access to health records. While the VA has been mired in controversy over implementation failures and delays related to its Oracle-Cerner EHR rollout and impacts to patient safety, the agency is forging ahead on its goals to improve digital operations and veterans' access. One example is partnering with Healthy Together, which uses the agency's API to provide veterans with secure mobile access to their health records.

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https://www.healthleadersmedia.com/innovation/digital-health-takes-center-stage-ces-2023

Digital Health Takes Center Stage at CES 2023

Analysis  |  By Eric Wicklund  |   December 30, 2022

The massive consumer electronics show returns to Las Vegas in January with a renewed focus on consumer-facing technology that personalizes and improves the healthcare journey.


KEY TAKEAWAYS

·         CES 2023 will take place January 5-8, 2023, in Las Vegas, taking over the Las Vegas Convention Center and the Venetian Convention and Expo Center on the Las Vegas Strip.

·         The massive consumer electronics show will see a renewed focus on healthcare technology, ranging from digital health panels to wearables, AI software, and healthcare applications in smart homes, vehicles and other consumer goods.

·         Healthcare organizations are taking new interest in this event as providers look for new technologies and strategies to connect with consumers outside the hospital, clinic, or doctor's office.

CES 2023 kicks off next week in Las Vegas, shining a spotlight on the consumer electronic industry and bringing renewed attention to the growing influence of digital health.

What once was a small corner of one exhibit hall at the Las Vegas Convention Center exhibiting early smartwatches and fitness trackers will now be found throughout the massive conference. Digital health has been integrated into smart home devices that track daily activities alongside room temperature, lights and visitors at the front door; as well as in electronic games and home entertainment platforms. It's in TVs that can connect to the internet and enable connections with family, friends and caregivers, and new cars that can monitor a driver's health.

Virtual and augmented reality (VR and AR) will be featured prominently in Vegas this year, as will AI and robotics. And expect remote monitoring tools and platforms to make their presence known in wearables that track a wide range of vital signs and activities and the aforementioned smart home technology. In short, while healthcare was once a side benefit or add-on to consumer electronics, it's now part of the form and functionality.

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https://healthitanalytics.com/news/ml-model-accurately-predicts-need-for-massive-transfusion-during-surgery

ML Model Accurately Predicts Need for Massive Transfusion During Surgery

A recent study described the success of a machine-learning model in predicting the need for massive transfusion during surgery, allowing for early intervention among high-risk patients.

By Mark Melchionna

December 29, 2022 - Published in JAMA Network Open, a recent study described how adding preoperative data and intraoperative hemodynamic monitoring data to a machine learning (ML)-based prediction model led to accurate real-time predictions of the need for massive transfusion during surgery.

Many healthcare providers are using predictive analytics to improve the timeliness and quality of treatment while reining in costs. For example, a study published in December found that a disease management outreach program supported by predictive analytics effectively reduced medical spending among chronic heart failure patients.

In various clinical settings, massive hemorrhage is the leading cause of death. When managing this condition, acute bleeding control and supplementation for intravascular volume and blood component deficiencies are required, according to the study.

Researchers noted the importance of massive transfusion in preventing complications amid uncontrolled intraoperative hemorrhage. Further, because of the time required to prepare blood product for massive transfusions and the need for additional medical personnel, they noted that the ability to predict the need for massive transfusion early is critical for necessary hemorrhage management. 

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https://www.bankinfosecurity.com/ransomware-recovery-at-toronto-kids-hospital-to-last-weeks-a-20817

Children's Hospital Expects Weekslong Ransomware Recovery

Treatment and Diagnostic Delays at Toronto Hospital Blamed on Malware Attack Akshaya Asokanasokan_akshayaDecember 28, 2022

Nearly a week after a ransomware attack forced a network shutdown at Toronto's Hospital for Sick Children, patients are still experiencing delays in treatment and diagnostic procedures. The hospital says it has restored some systems, phones and websites, but the recovery process could take weeks.

Hackers targeted the hospital's network on Dec. 19, forcing it to take down its affected network for the recovery. Popularly known as SickKids, the hospital is one of Canada's largest research-focused centers for children.

In a statement, the hospital said the hack affected a few of its internal clinical and corporate systems, as well as some hospital phone lines and webpages. The hospital did not provide details on the ransomware attack but said at the time the incident did not result in any user data leaks.

In its latest update, however, the hospital acknowledged that while it has restored some of the affected systems, such as phone lines and websites, it would take a few more weeks to completely restore all services.

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https://www.dailymail.co.uk/health/article-11574427/Stroke-victims-48-CENT-likely-make-recovery-diagnosed-using-AI-technology.html

Stroke victims up to 48 PER CENT more likely to make full recovery when diagnosed using AI technology, trials suggest

·         AI that helps speed-up stroke diagnosis has helped tripled patient recovery rate 

·         The software has been used at 22 NHS hospitals so far to help 100,000 patients

·         But considering its success the Government now wants to roll it out more widely

By Kate Pickles Health Editor For The Daily Mail

Artificial intelligence software used in NHS hospitals has spared tens of thousands of patients from permanent disability, initial findings suggest.

The technology, which assists doctors to quickly diagnose patients who have had a stroke, has tripled the number who go onto live normal lives.

Initial analysis of the data, involving more than 100,000 suspected stroke patients, claims the proportion who made near full recoveries increased from 16 to 48 per cent.

Experts suggest this is down to faster diagnosis and speedier treatment - a key part of stroke recovery.

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https://www.healthcareitnews.com/news/telehealth-helps-stop-suicidal-ideation-many-patients-study-finds

Telehealth helps stop suicidal ideation for many patients, study finds

One person dies from suicide every 11 minutes in the U.S. A new study shows that telemedicine can be used to treat more severe mental illness – contrary to previous thought.

By Bill Siwicki

December 29, 2022 10:30 AM

Recently, the Journal of Medical Internet Research published some significant data highlighting the efficacy of psychiatric care delivered through telehealth: Those in the treatment group were 4.3 times more likely to have suicidal ideation remission.

This is noteworthy because telehealth has not traditionally been equipped to treat those with the most severe symptoms of mental health due to the oversight necessary to actually provide safe, effective treatment, said Dr. Mimi Winsberg, chief medical officer at Brightside Health, which led the study.

We spoke with Winsberg to get an in-depth look at this study and what the results mean for the future of telehealth and mental healthcare.

Q. Please talk about your new study that examines the impact of telepsychiatry on reduction in suicidal ideation over time. Who was involved? What kind of care did they receive? What role did technology play?

A. The study, which was published in JMIR Formative Research, sought to determine if Brightside Health's telehealth platform, which is equipped with precision prescribing clinical decision support, could successfully reduce suicidal ideation among enrolled patients, versus a control group who tracked their symptoms on the platform without receiving care.

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https://www.healthcareitnews.com/news/top-10-cybersecurity-stories-2022

Top 10 privacy and cybersecurity stories of 2022

Cybersecurity breaches in healthcare continued at an alarming rate throughout the year, affecting operations and patient safety, while government agencies and policymakers focused on ways to improve resilience.

By Andrea Fox

December 29, 2022 12:00 PM

Also known as the "Wall of Shame," the U.S. Department of Health and Human Services' Cases Currently Under Investigation details hundreds of breaches reported by healthcare organizations across the United States over the last 24 months. The number of threats, and the cost of those threats – continue to rise.

While healthcare industry organizations work with federal lawmakers on ways for government to help address the relentless cybersecurity attacks on critical healthcare infrastructure, the industry is hyper-focused on issues like how to move the needle on third-party cybersecurity, collaborating to improve cyber preparedness and best practices for initiating cybercrime investigations. Here are Healthcare IT News’ most-read privacy and cybersecurity stories of 2022.

EHR vendor hit with lawsuit following data breach. In January, Tennessee-based QRS, which provides EHR and practice management software, was accused of failing to implement recommended threat measures to prevent and detect cyberattacks stemming from an August 2021 data breach of its patient portal. "QRS failed to reasonably secure, monitor and maintain the protected health information and personally identified information stored on its patient portal," the plaintiff said.

CommonSpirit still working to restore EHR systems after ransomware attack confirmed. The October cyberattack caused a widespread outage at CommonSpirit hospitals and medical facilities across several states. After the 2017 merger of DignityHealth and Catholic Health Initiatives, the system became the second-largest non-profit hospital chain with more than 350 hospitals nationwide. Lost access to medical records and patient portals, delayed medical procedures, canceled appointments and other disruptions plagued operations at upwards of 140 facilities. After further investigation, CommonSpirit discovered that the breach had also exposed protected data held by Virginia Mason Franciscan Health.

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https://www.healthcareittoday.com/2022/12/29/how-the-right-technology-can-simplify-a-healthcare-workers-life/

How the Right Technology can Simplify a Healthcare Worker’s Life

December 29, 2022

The following is a guest article by Marcus Mossberger, Future of Work Strategist at Infor.

If the wrong technology can make a healthcare worker’s life miserable, the right technology can do the opposite. Find out how the right technology can improve retention during the “Great Resignation.” 

Virtually every study on healthcare worker burnout and turnover cites technology as one of the leading culprits. For example, KLAS Research released a report on clinician turnover that found that nurses are more likely than other clinicians to leave their jobs, heavily influenced by their struggles with electronic health record (EHR) systems.

Frustration with disconnected processes and workflows is just one of many reasons healthcare workers are quitting their jobs as part of the “Great Resignation.” Today’s workers are willing to sacrifice salary and benefits for jobs that offer more flexibility, more professional growth, more fulfillment, and more appreciation for what they do.

Interestingly, the common solution to counter all these new non-technology reasons for leaving is technology. The hospital and health system C-suite must adopt new, strategic approaches to technology—embracing an effective, objective, and sustainable workplace well-being technology platform. 

Burned Out and Leaving Fast

Let’s start with why healthcare workers—clinical and nonclinical—are burned out. As mentioned, ongoing struggles with their EHR systems are a huge factor. But they’re also suffering from cognitive overload. Whether delivering care or submitting a claim for payment, virtually every task at a hospital or health system is getting more complex, complicated, and time-consuming.

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https://ehrintelligence.com/news/10m-usda-grant-enhances-epic-systems-ehr-for-care-coordination-in-ny

$10M USDA Grant Enhances Epic Systems EHR for Care Coordination in NY

St. Lawrence Health will use part of a multimillion-dollar USDA grant to enhance its Epic System EHR, enabling EHR data exchange between all hospitals, clinics, and emergency response services.

By Sarai Rodriguez

December 28, 2022 - The US Department of Agriculture (USDA) has doled out $10 million in grant funding to St. Lawrence Health, a northern New York-based health system, to bolster its Epic System EHR, according to Watertown Daily Times reporting.

The project, expected to take three years, will start with St. Lawrence Health's county-wide EHR implementation across all hospitals, clinics, and emergency response services in the local rural area.

A portion of the $10 million funding will be used to launch an inter-facility transport coordination center, providing emergency and medical personnel with patient information through St. Lawrence Health’s Epic Systems EHR.

The health system said it is “aimed at increasing the number of emergency personnel and making it easier for them to figure out to which hospital a patient should be transported.”

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https://www.healthcareitnews.com/news/top-10-ai-and-machine-learning-stories-2022

Top 10 AI and machine learning stories of 2022

Efforts to harness artificial intelligence to streamline healthcare operations and improve patient outcomes accelerated this year, as providers strove to fine-tune algorithms and arrive at deeper insights into clinical and operational patterns.

By Andrea Fox

December 28, 2022 02:42 PM

Healthcare's comfort level with artificial intelligence and machine learning models – and skill at deploying them across myriad clinical, financial and operational use cases – continued to increase in 2023. 

More and more evidence shows that training AI algorithms on a variety of datasets can improve decision support, boost population health management, streamline administrative tasks, enable cost efficiencies and even improve outcomes. 

But there's still a lot work to be done to ensure accurate, reliable, understandable and evidence-based results that ensure patient safety and account for health equity.

There’s no doubt that AI’s application in healthcare has gone beyond "real” in 2019 to significant investment by providers and payers last year. This year, we’ve reported on deeper industry discussions focused on trust and best practices. We’ve featured industry perspectives on the values of deep learning and neural networks and how to clear data hurdles along with announcements of successful studies and of course, new healthcare AI technology partnerships. Here are Healthcare IT News’ most-read AI stories of 2022. 

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https://www.healthcareittoday.com/2022/12/28/chicago-providers-charge-fees-to-answer-clinical-questions-submited-via-portals/

Chicago Providers Charge Fees To Answer Clinical Questions Submitted Via Portals

December 28, 2022

Anne Zieger

Back when patient portals were first introduced, one of the original concerns clinicians raised was that they were afraid that they would get too many patient messages and find themselves overwhelmed.

Over time, most stopped complaining about this problem, though I’d wager it was because they simply had worse things to worry about during the painful initial period of EHR adoption.

It may also have been that complaining wouldn’t help. At least in the early days, health system administrators were very excited about giving patients the ability to trade messages with clinicians, as they believed that getting patients to do so was a great way to get them more engaged with their care.

More recently, however, providers have begun to reevaluate their position on charging for medical advice requested via a portal.

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https://www.healthleadersmedia.com/technology/fhir-apis-will-accelerate-patient-information-access-2023

FHIR APIs Will Accelerate Patient Information Access in 2023

Analysis  |  By Scott Mace  |   December 28, 2022

In a lengthy interview with HealthLeaders, ONC Chief Micky Tripathi says simplified data exchange will benefit providers, patients, and even public health.


KEY TAKEAWAYS

·         Although EHR vendors must support FHIR APIs at end of 2022, providers aren't required immediately to upgrade to the latest software versions that support them.

·         However, by the end of the third quarter of 2023, providers need to be running those software versions to participate in CMS payment rules.

·         The ONC has received more than 500 information blocking complaints, but "in theory," the OIG cannot yet enforce the rules, having not yet published its own final rules.

Federal rules state that certified EHRs must support the standard FHIR application programming interfaces (APIs) by the end of this year. It's one more step toward transforming patient information access in a years-long process dating back to the birth of the EHR, and will touch the day-to-day information sharing of providers, patients, and even public health agencies.

HealthLeaders recently spoke with Micky Tripathi, PhD, MPP, director of the Department of Health and Human Services' Office of the National Coordinator for Health Information Technology, about the standardized FHIR API rule and how it will impact health systems and patients in 2023. This interview has been lightly edited for brevity and clarity.

HealthLeaders: What can healthcare IT professionals expect as API standardization is implemented at the end of 2022, as the legislation directs?

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https://www.stripes.com/veterans/2022-12-25/spokane-va-computer-system-8540650.html

Spokane VA has reduced staff despite ongoing effects of troubled computer system as veterans wait longer for care

By  Orion Donovan-Smith

The Spokesman-Review • December 25, 2022

WASHINGTON (Tribune News Service) — In the middle of December 2021, Bernadine Bank handed a letter to the chief of medicine at Mann-Grandstaff VA Medical Center.

After thanking her supervisor for the opportunity to start the Spokane hospital’s gynecology clinic five years earlier, Bank got right to the point.

“It is with a heavy heart that I write to inform you of my resignation from the VA,” the doctor wrote. “I think it will come as no surprise that I am leaving mainly because of the Cerner EMR.”

By then, it had been more than a year since the Department of Veterans Affairs began using Spokane as the testing ground for an electronic medical record system, or EMR, developed by Cerner Corporation under a $10 billion contract signed by the Trump administration in 2018.

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https://www.healthcareitnews.com/news/ai-fast-addressing-data-requirements-and-advancing-interoperability-says-one-expert

AI is fast addressing data requirements and advancing interoperability, says one expert

Leveraging AI, machine learning and neural networks can help healthcare standardize data, comply with info blocking requirements and improve health outcomes.

By Andrea Fox

December 27, 2022 11:47 AM

New rules and requirements add to the complexity of healthcare – something that artificial intelligence can address, according to Vignesh Shetty, senior vice president and general manager of Edison AI and Platform for GE Healthcare (GEHC).

Healthcare IT News asked Shetty about the progress that has been made on the 360-patient view since he last spoke with us about the exciting advances in data-driven insights, as well as how algorithms achieve challenging data exchanges.

Q. In terms of the 360-patient view, what progress has been made toward improving health outcomes?

A. From MRI scanners used by doctors to detect tumors to mobile x-ray units in the ER or ICU used to image the lungs of COVID patients, doctors and patients are benefiting from artificial intelligence embedded in medical devices. 

The goal is to have AI tools ready when and where they’re needed to contribute to faster diagnoses and, ideally, better patient outcomes.

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https://www.nature.com/articles/s41746-022-00735-1

Published: 27 December 2022

Factors associated with long-term use of digital devices in the electronic Framingham Heart Study

Chathurangi H. Pathiravasan et. al.,

npj Digital Medicine volume 5, Article number: 195 (2022) Cite this article

Abstract

Long-term use of digital devices is critical for successful clinical or research use, but digital health studies are challenged by a rapid drop-off in participation. A nested e-cohort (eFHS) is embedded in the Framingham Heart Study and uses three system components: a new smartphone app, a digital blood pressure (BP) cuff, and a smartwatch. This study aims to identify factors associated with the use of individual eFHS system components over 1-year. Among 1948 eFHS enrollees, we examine participants who returned surveys within 90 days (n = 1918), and those who chose to use the smartwatch (n = 1243) and BP cuff (n = 1115). For each component, we investigate the same set of candidate predictors for usage and use generalized linear mixed models to select predictors (P < 0.1, P value from Z test statistic), adjusting for age, sex, and time (app use: 3-month period, device use: weekly). A multivariable model with the predictors selected from initial testing is used to identify factors associated with use of components (P < 0.05, P value from Z test statistic) adjusting for age, sex, and time. In multivariable models, older age is associated with higher use of all system components. Female sex and higher education levels are associated with higher completion of app-based surveys whereas higher scores for depressive symptoms, and lower than excellent self-rated health are associated with lower use of the smartwatch over the 12-month follow-up. Our findings show that sociodemographic and health related factors are significantly associated with long-term use of digital devices. Future research is needed to test interventional strategies focusing on these factors to evaluate improvement in long-term engagement.

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https://www.thetimes.co.uk/article/ai-cure-for-bed-blocking-can-predict-hospital-stay-fpvjn5ql6

AI cure for bed blocking can predict hospital stay

Eleanor Hayward

Health Correspondent

Monday December 26 2022, 12.01am GMT, The Times

Technology that accurately predicts when patients will be ready to leave hospital upon their arrival in A&E is being introduced to solve the NHS bed-blocking crisis.

The artificial intelligence (AI) software analyses data including age, medical conditions and previous hospital stays to estimate how long a patient will need to remain.

Hospital managers can then alert social care services in advance about the date when patients are expected to be discharged, allowing care home beds or community care packages to be prepared.

Nurses said the technology had “revolutionised” their ability to discharge patients on time, meaning people who would otherwise have been stuck in hospital had got home for Christmas.

The latest NHS England figures show that 13,697 hospital beds a day — about 15 per cent of the total — are taken up by patients who are fit to be discharged, the majority held up by delays in arranging social care.

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Enjoy!

David.

 

Friday, January 06, 2023

Time Has Come To Resist Much Of The Rubbish That Spews From Social Media.

This thoughtful piece appeared last week:

Social media may be terminal. I hope they’re right

There is a reason that so little has gotten better and so much has gotten worse. The cost of so much connection and information has been the deterioration of our capacity for attention and reflection.

Ezra Klein

Dec 26, 2022 – 5.00am

For what feels like ages, we’ve been told that Twitter is, or needs to be, the world’s town square. That was Dick Costolo’s line in 2013, when he was Twitter’s CEO (“We think of it as the global town square”), and Jack Dorsey, one of Twitter’s founders, used it, too, in 2018 (“People use Twitter as a digital public square”). Now the line comes from the “chief twit,” Elon Musk (“The reason I acquired Twitter is because it is important to the future of civilisation to have a common digital town square”).

This metaphor is wrong on three levels.

First, there isn’t, can’t be and shouldn’t be a “global town square.” The world needs many town squares, not one. Public spaces are rooted in the communities and contexts in which they exist. This is true, too, for Twitter, which is less a singular entity than a digital multiverse. What Twitter is for activists in Zimbabwe is not what it is for gamers in Britain.

Second, town squares are public spaces, governed in some way by the public. That is what makes them a town square rather than a square in a town. They are not the playthings of whimsical billionaires. They do not exist, as Twitter did for so long, to provide returns to shareholders. (And as wild as Musk’s reign has already been, remember that he tried to back out of this deal, and Twitter’s leadership, knowing he neither wanted the service nor would treat it or its employees with care, forced it through to ensure that executives and shareholders got their payout.) A town square controlled by one man isn’t a town square. It’s a storefront, an art project or possibly a game preserve.

Third, what matters for a polity isn’t the mere existence of a town square but the condition the townspeople are in when they arrive. Town squares can host debates. They can host craft fairs. They can host brawls. They can host lynchings. Civilisation does not depend on a place to gather. It depends on what happens when people gather.

So much genius and trickery and money have gone into a mistaken metaphor. The competition to create and own the digital square may be good business, but it has led to terrible politics. Think of the hopeful imaginings that accompanied the early days of social media: We would know one another across time and space; we would share with one another across cultures and generations; we would inform one another across borders and factions. Billions of people use these services. Their scale is truly civilisational. And what have they wrought? Is the world more democratic? Is gross domestic product growth higher? Is innovation faster? Do we seem wiser? Do we seem kinder? Are we happier? Shouldn’t something, anything, have gotten noticeably better in the short decades since these services fought their way into our lives?

I think there is a reason that so little has gotten better and so much has gotten worse. It is this: The cost of so much connection and information has been the deterioration of our capacity for attention and reflection. And it is the quality of our attention and reflection that matters most.

In a recent paper, Benjamin Farrer, a political scientist at Knox College in Illinois, argues that we have mistaken the key resource upon which democracy, and perhaps civilisation, depends. That resource is attention. But not your attention or my attention. Our attention. Attention, in this sense, is a collective resource; it is the depth of thought and consideration a society can bring to bear on its most pressing problems. And as with so many collective resources, from fresh air to clean water, it can be polluted or exhausted.

Twitter makes it easy to discuss hard topics poorly.

Borrowing a concept from Elinor Ostrom, the first woman to win the Nobel in economic science, Farrer argues that attention is subject to a problem known as the tragedy of the commons. A classic example of a tragedy of the commons is an open pasture that any shepherd can use for his flock. Without wise governance, every shepherd will send his flock to graze, because if he doesn’t, the other shepherds will do so first. Soon enough, the pasture is bare, and the resource is depleted.

Farrer argues that our collective attention is like a public pasture: It is valuable, it is limited, and it is being depleted. Everyone from advertisers to politicians to newspapers to social media giants wants our attention. The competition is fierce, and it has led to more sensationalism, more outrageous or infuriating content, more algorithmic tricks, more of anything that might give a brand or a platform or a politician an edge, even as it leaves us harried, irritable and distracted.

One telling study recruited participants across 17 countries and six continents and measured skin conductivity — a signal of emotional response — when participants saw positive, negative and neutral news. Negative news was, consistently, the most engaging. If you’ve ever wondered why the news is so focused on tragedy and conflict or why social media furnishes more outrage than inspiration, that’s the reason. Negativity captures our attention better than positivity or neutrality.

This is not a new dynamic, and it is by no means unique to Twitter. “The mission of the press is to spread culture while destroying the attention span,” Karl Kraus, an Austrian satirist, wrote in the early 1900s. But it is worse now. The tools available to those who would command our attention are far more powerful than in past eras.

Twitter’s problems did not begin and will not end with Musk. They are woven into the fabric of the platform. Twitter makes it easy to discuss hard topics poorly. And it does that by putting its participants in the worst state of mind for a discussion.

Twitter forces nuanced thoughts down to bumper-sticker bluntness. The chaotic, always moving newsfeed leaves little time for reflection on whatever has just been read. The algorithm’s obsession with likes and retweets means users mainly see (and produce) speech that flatters their community or demonises those they already loathe. The quote tweet function encourages mockery rather than conversation. The frictionless slide between thought and post, combined with the absence of an edit function, encourages impulsive reaction rather than sober consideration. It is not that difficult conversations cannot or have not happened on the platform. It is more that they should not happen on the platform.

But they do. Of course they do. And this is what critics of the platform, including me, need to reckon with.

“The whole issue of police violence against Black people was fully exposed because of Twitter,” Sherrilyn Ifill, a former president of the NAACP Legal Defence Fund, told me. “Because of videos of Walter Scott running in that park and Philando Castile and Freddie Gray and so many others. Presenting this incontrovertible evidence of the truth we’d been living with and that was so disparaged by white political leaders has forever transformed the conversation over public safety.”

Twitter has real strengths, many of which are the flip side of its weaknesses. It is as flat a medium as any that has existed. It is as fast a medium as has ever existed; that can be maddening, but it can also draw attention to something that is happening and has to change right now. It is an unusually confrontational medium, and that has permitted movements such Black Lives Matter and #MeToo to flower and for socialists to get a new hearing in American politics — and it has also, of course, given new succor and life to the racist right. Put simply, Twitter’s value is how easy it makes it to talk. Its cost is how hard it makes it to listen.

It is a failure of imagination to think that our choice is the social media platforms we have now or nothing. I keep thinking about something that Robin Sloan, a novelist and former Twitter employee, wrote this year: “There are so many ways people might relate to one another online, so many ways exchange and conviviality might be organized. Look at these screens, this wash of pixels, the liquid potential! What a colossal bummer that Twitter eked out a local maximum, that its network effect still (!) consumes the fuel for other possibilities, other explorations.”

What’s surprised me most as Twitter has convulsed in recent weeks is how threadbare the social media cupboard really is. So many are open to trying something new, but as of yet, there’s nothing that feels all that new to try. Everything feels like a take on Twitter. It may be faster or slower, more decentralised or more moderated, but they’re all variations on the same theme: experiments in how to capture attention rather than deepen it, platforms built to encourage us to speak rather than to help us listen or think.

Permit me a weird turn here. I became interested this year in how Quakers deliberate. As a movement, Quakers have been far ahead of the moral curve time and again — early to abolitionism, to equality between the sexes, to prison reform, to pressuring governments to help save Jews from the Holocaust. That is not to say Quakers have gotten nothing wrong, but what has led them to get so much right?

The answer suggested by Rex Ambler’s lovely book The Quaker Way is silence. In a typical Quaker meeting, Ambler writes, community members “sit in silence together for an hour or so, standing up to speak only if they are led to do so, and then only to share some insight which they sense will be of value to others.” If they must decide an issue collectively, “they will wait in silence together, again, to discern what has to be done.” There is much that debate can offer but much that it can obscure. “To get a clear sense of what is happening in our lives, we Quakers try to go deeper,” he writes. “We have to let go our active and fretful minds in order to do this. We go quiet and let a deeper, more sensitive awareness arise.”

We do not make our best decisions, as individuals or as a collective, when our minds are most active and fretful.

I find this powerful in part because I see it in myself. I know how I respond in the heat of an argument, when my whole being is tensed to react. And I know how I process hard questions or difficult emotions after quiet reflection, when there is time for my spirit to settle. I know which is my better self.

Democracy is not and will not be one long Quaker meeting. But there is wisdom here worth mulling. We do not make our best decisions, as individuals or as a collective, when our minds are most active and fretful. And yet “active and fretful” is about as precise a description as I can imagine of the Twitter mind. And having put us in an active, fretful mental state, Twitter then encourages us to fire off declarative statements on the most divisive possible issues, always with one eye to how quickly they will rack up likes and retweets and thus viral power. It’s insane.

And it will get so much worse from here. OpenAI recently released ChatGPT, an artificial intelligence system that can be given requests in plain language (“Write me an argument for the benefits of single-payer health care, in the style of a Taylor Swift song”) and spit out remarkably passable results.

What ChatGPT can do is a marvel. We are at the dawn of a new technological era. But it is easy to see how it could turn dark — and quickly. AI systems such as this make the production and manipulation of text (and code and images and eventually audio and video) functionally costless. They will be deployed to produce whatever makes us most likely to click. But these systems do not and cannot know what they are producing. The cost of creating and optimising content that grabs our attention is plummeting, but the cost of producing valuable and truthful work isn’t.

These are technologies that lend themselves to cacophony, not community. I fear a world in which the business models behind them run on our attention or profit off our anger. But other worlds and other models are possible.

A few weeks back, I spoke to Audrey Tang, Taiwan’s minister of digital affairs. I asked her what it would mean for social media to be run democratically, given the mistrust many Americans have — and for good reason — of the state. (Imagine if the Trump administration had owned Twitter.) “Does the social sector mean anything in the American context?” she asked me.

More here:

https://www.afr.com/technology/social-media-may-be-terminal-i-hope-they-re-right-20221225-p5c8qo

First, I am sorry ChatGPT was dragged in again!

The point to me is that social media is / can be already pretty dark and that the last thing we need is AI fuelled amplification of an already ‘off and rolling’ trend.

I reckon computers and uncritical humans may have a good deal in common and in some contexts be capable of considerable harm!  What critical faculties we have need to be brushed up a further deployed to keep the show on the road!

What do others think?

David.