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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How a daughter’s cancer treatment inspired an interactive app for sick
kids
After
watching his 13-year-old daughter go through a gruelling year of cancer treatment
Dom Raban realised more could be done to help children feel at ease in
hospital.
Andrea
Downey, 17 September, 2019
Now his app,
Xploro, has been trialled at The Christie NHS Foundation Trust and Royal
Manchester Children’s Hospital, with further plans to expand it across the NHS.
The app
provides an interactive experience for young patients receiving hospital
treatment, allowing them to interact with a personally designed avatar that can
explain treatments, machines that will be used and answer any questions they
have about their hospital stay.
With
more than 10 years experience as the managing director of an interactive design
company, Raban set about looking at digital solutions that would provide
important information about care and treatment to young patients.
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Period tracking apps caught sharing medical data with Facebook
Period
tracking apps are sharing sensitive medical data with Facebook, an investigation
has found.
Andrea Downey
– 13 September, 2019
Data,
including menstruation frequency, use of contraception and symptoms like blood
pressure and acne, are being shared directly with the social media company.
In some
cases, data is shared from the moment a user opens the app.
UK-based
advocacy group Privacy International scrutinised six period tracking apps and
found that five shared their data with Facebook, some before a user even agrees
to privacy settings.
The
apps, Maya by Plackal Tech, MIA by Mobapp Development Limited, My Period
Tracker by Linchpin Health, Ovulation Calculator by Pinkbird, Period Tracker by
GP International LLC and Mi Calendario by Grupo Familia, have been downloaded
several million times between them.
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You Don’t Want Facebook Involved With Your Health Care
Big tech companies want to share data about you with your doctors.
Sept 19, 20197:30 AM
Could your Netflix
viewing habits predict that you will develop inflammatory bowel disease? Might
your use of religious language in Facebook
posts signal that you have diabetes? Could Amazon’s
Alexa start telling you when you are getting sick and offer to sell you
medicines?
All of the big technology companies have been moving into health
care recently, making investments that mobilize their vast troves of consumer
data. Amazon
is selling software that can mine patient
records and is expanding Alexa’s
health and wellness capabilities. Google
is developing A.I.-powered
voice recognition software called “Medical Digital Assist” to help doctors
dictate medical records. Alphabet, Google’s parent company, has a partnership
between Verily (the company’s life sciences arm) and Walgreens
to monitor patient medication “adherence.” Apple
has been steadily developing health and medical apps for its smartwatches that
can integrate personal health tracking data with electronic medical record
systems at partner hospitals. Microsoft
is developing A.I. software for medical records through the Azure for
Health cloud. Even Uber
and Lyft
are getting into the game with “non-emergency medical transport.”
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The founders of Robin Healthcare think doctors need smart assistants, too
Robin Healthcare, a new startup founded by
serial entrepreneurs Noah Auerhahn and Emilio Galan, is hoping to harness the
power of personal assistants to make the business of healthcare easier for the
physicians who practice it.
The
company’s technology, which works much the same way as a
Google Home
or
Amazon Alexa
or Echo, is placed in hospital rooms and transcribes and formats doctor
interactions with patients to reduce paperwork and streamline the
behind-the-scenes part of the process that can drive doctors to the point of
distraction, the company’s co-founder said.
“I
had a background doing claims data work in healthcare at UCSF finishing my
clinical training,” says Galan. “And I was hearing lots of doctors telling me
not to practice.”
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HIT Think
How to hardwire quality measure capture at the point of care
September 20,
2019, 3:50 p.m. EDT
Some
60 percent of health plans report that they review gaps in care based on manual
requests to providers. Only 9 percent of health plans can identify gaps in care
in real time, according to the Workgroup for Electronic Data Interchange in its
report entitled “Closing Gaps in Care through Health Data Exchange.”
Most
organizations work through manual processes to improve quality measures and
performance ratings. As a result, payers and providers report spending millions
of dollars on tasks such as the following:
- Chasing supplemental data feeds
- Requesting extracts from the EMR
Provider
organizations sometimes fail to deliver (and payers fail to receive) consistent
and accurate clinical data captured through professional billing. As a result,
they run the risk of diminished performance on various pay-for-performance
incentive programs.
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Free federal tools available to aid physicians treating chronic pain
September 20,
2019, 3:27 p.m. EDT
A
new tool from the federal Agency for Healthcare Research and Quality can help
physicians find pain-related information on a particular patient.
The
agency says the tool consolidates information scattered in the electronic
health record into a single view or dashboard.
AHRQ
estimates that 50 million American adults have chronic pain on a daily basis,
which interferes with daily life or work for 20 million individuals.
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Providers aren’t consistently screening for social determinants of health
September 20,
2019, 12:29 a.m. EDT
Few
physician practices and hospitals in the United States screen patients for all
five key social needs associated with health outcomes.
That’s
the finding of a cross-sectional study conducted by The Dartmouth Institute for
Health Policy and Clinical Practice.
Researchers
leveraged national survey data from 2,190 physician practices and 739 hospitals
to assess the prevalence of screening for five social needs—food insecurity,
housing instability, utility and transportation needs, and experience with
interpersonal violence.
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Pop health IT helps Partners in Recovery reduce psychiatric hospital
admissions by 50%
Combining
psychiatric and primary care data, including social determinants of health, has
also helped reduce ER spending from $2,265 per patient per month to just $875.
September 20,
2019 11:43 AM
Partners
in Recovery, based in Peoria, Arizona, is an outpatient behavioral health
provider organization serving more than 8,000 patients in the Phoenix area. The
organization’s unique service focus is treatment for persons with chronic and
severe mental illnesses, including conditions such as schizophrenia and
schizoaffective disorder, bipolar disorder, and major depressive disorder.
THE
PROBLEM
Partners
in Recovery recognized that a large portion of its patients also had
undiagnosed and untreated chronic medical conditions, including hypertension,
respiratory illness, diabetes, heart disease and obesity. Together, these
factors contributed to significant overutilization of the emergency department
and hospitals – with some Partners patients visiting EDs 70 or more times per
year.
“A
high rate of undiagnosed and untreated health conditions is common among
individuals with mental and behavioral health conditions, with one study attributing
60% of premature deaths to these causes,” said Christy Dye, CEO of Partners in
Recovery.
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Patients Fear That Medical AI Can’t Handle Their Unique Needs
September 20, 2019
A
new
study
has concluded that patients are skittish about interacting with medical AI
technology in part because they fear that AI won’t address their unique
characteristics adequately.
The
study looked at how receptive consumers were to the use of “medical AI,” which
researchers defined as any machine using an algorithm or statistical model to
perform perceptual, cognitive and/or conversational functions in patient care.
To
conduct their research, the study authors looked at consumer preferences regarding
medical AI. A central focus of the study was the impact of “uniqueness
neglect,” patient belief that their medical AI wouldn’t take their unique
issues into account when making judgments.
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HIT Think
Why there is no reason to overpay for AI, no matter how exciting it is
September 19,
2019, 3:49 p.m. EDT
Eventually,
many conversations about artificial intelligence include HAL.
An
acronym for Heuristically programmed ALgorithmic computer, HAL played a
prominent and disconcerting role in Stanley Kubrick’s mind-bending 1968 film
2001: A Space Odyssey. In the film, sentient computer HAL learns that the
humans suspect it of being in error and will disconnect it should that error be
confirmed. Of course, HAL is having none of that, and terror ensues.
So
influential was Kubrick’s adaptation of an Arthur C. Clarke short story that
HAL is now a part of the ways in which AI is often conceived.
So,
given that it is 2019, a full 18 years past the marvelous technological era
predicted by Kubrick’s title, we must be well beyond HAL. Right?
Not
even close, as it turns out. Nothing like HAL exists in any industry. Sure,
IBM’s Deep Blue defeated chess champion Garry Kasparov in 1997, and Watson
emerged victorious on Jeopardy in 2011, but efforts to revolutionize oncology
using Watson have not come to fruition. The self-aware supercomputer that talks
to us like a brilliant sidekick is not on the horizon. (Sorry, Janet.)
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ED patient encounters not accurately documented in EHR
September 19,
2019, 12:08 a.m. EDT
Documentation
in electronic health records did not match observed and recorded physicians'
behaviors during patient encounters, according to a study of emergency
department residents.
The
study, published on Wednesday in the journal
JAMA
Network Open, involved emergency departments in two academic medical
centers where residents’ patient encounters were observed to compare real-time
performance with EHR documentation.
“No other study has attempted to quantify the
accuracy of electronic physician documentation using concurrent observation,”
the authors contend.
In
the study, nine residents were shadowed by trained observers for 20
encounters—10 encounters per physician per site—to gather real-time
observational data, with the associated EHR data subsequently reviewed.
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Ransomware: Cyber-insurance payouts are adding to the problem, warn
security experts
"It seems like a fix but it really isn't". Paying the
ransom might be the cheapest short-term option to get your data back, but it
causes long-term problems.
Cyber-insurance
companies that encourage ransomware victims to give into the demands of hackers
and pay for decryption keys are making the problem of file-locking malware
attacks much worse in the long run, cybersecurity experts have warned.
In
a number of cases, the victims have given in to the extortion demands of the
attackers, often paying cyber criminals hundreds of thousands of dollars for
systems to be restored.
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How cloud hosting can help with management of SDOH data
Two
consultants explain how the agility of remote hosting can boost readiness for
social determinant of health initiatives – and spotlight the privacy and
security concerns that must be prioritized.
September 18,
2019 03:41 PM
With
the shift to value-based care, many healthcare providers are discovering a more
direct focus on addressing social determinants of health is a way to tackle
some of the root causes of illness, behavioral health challenges, readmissions
and emergency room overuse.
Data
generated "in real life" in consumer tracking apps and social
networks can be especially useful for informing and bolstering population
health as well as screening for and managing social determinants of health
risks.
A
valuable asset
The cloud can, in turn, be a valuable asset in allowing healthcare providers
and health systems, as well as other organizations, to collect, analyze and
share that data. But that means taking a different view toward non-traditional
"health data" that will be used to SDOH ends.
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Widespread Support for Adopting Tools Needed to Tap Potential of
Electronic Health Records
Stakeholders laud federal agency for advancing standardization,
improvements in data sharing
Article September 18, 2019
Widespread Support for Adopting Tools Needed to
Tap Potential of Electronic Health Records
Dozens
of organizations representing electronic health record (EHR) developers, health
information technology professionals, doctors, and other relevant interests
recently backed draft government regulations that would give patients and
providers easier access to medical records. Given the widespread support, the
Office of the National Coordinator for Health Information Technology (ONC)
should finalize its proposed regulations as soon as possible so that patients
and clinicians can reap the benefits of new tools to foster greater data
exchange.
Although
EHRs are now used in nearly every U.S. hospital and physician’s office, many
patients seeing a new doctor or specialist may still need to bring paper
medical records. Too often, current systems cannot easily share information
with each other—a concept known as interoperability—or translate the data
received into the proper format.
Application
programming interfaces (APIs) already allow services, such as travel and
personal finance websites and smartphone applications, to organize and display
information from multiple sources. If broadly used in health care, APIs based
on common standards could also sync data across EHR systems and feed that
information into apps that let patients share their medical records with
caregivers or
alert clinicians to best practices for treatment.
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Google is finally absorbing a healthcare business 10 months after the move
was first announced
Shona Ghosh
Sep 19, 2019,
1:04 AM
- Google has finally absorbed the healthcare arm
of AI firm DeepMind, the British company it acquired in 2016
for £400 million ($US500 million). The integration is happening some 10
months after Google originally announced it.
- DeepMind
Health is
now officially part of Google’s dedicated healthcare unit, Google
Health,
which is headed up by big-name healthcare CEO David Feinberg.
- The announcement comes one month after the DeepMind cofounder
who had headed up its health business, Mustafa Suleyman, confirmed he was
on a leave of absence
from the business for reasons that are unclear.
- The integration brings DeepMind’s controversial Streams app, a
non-AI service that helps medical practitioners monitor patients with a
kidney condition, under Google Health’s management.
Google
has finally absorbed the healthcare unit of its artificial intelligence company
DeepMind, the British company it acquired for £400 million ($US500 million) in
2016.
The
change means that DeepMind Health, the unit which focuses on using AI to
improve medical care, is now part of Google’s own dedicated healthcare unit.
Google Health
was
created in November 2018, and is run by big-name healthcare CEO David
Feinberg.
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Healthcare cybersecurity – the impact of AI, IoT-related threats and
recommended approaches
An interview
with Richard Staynings, Chief Security Strategist, Cylera.
September 18,
2019 05:28 AM
Currently
leading healthcare security strategy at Cylera, a biomedical HIoT security
startup, Richard Staynings has more than two decades of experience in both
cybersecurity leadership and client consulting in healthcare. Last year, he
served on the Committee of Inquiry into the SingHealth breach in Singapore as
an expert witness. He recently spoke to Healthcare IT News on some of the
current developments in healthcare cybersecurity.
Q.
Artificial intelligence (AI) applications in healthcare are all the rage now,
and so are cybersecurity threats, given the frequency and intensity of
healthcare-related incidents. In particular, some of the cyberattacks have
become more sophisticated through the use of AI to get past cyber defenses. On
the medical devices front, AI is also being used to constantly manage and
secure the rising number of healthcare IoT devices as they connect and
disconnect from hospital networks. What do you think the application of AI in
healthcare cybersecurity will be like in the next few years?
A.
Healthcare is widely considered to be an easy and soft target because “who in
their right mind would attack the weak and defenseless?” … or so the
thought goes! The fact is that healthcare presents a rich target for cyber
criminals because of the value of the data hosted and processed. When you
couple that with a chronic historical underinvestment in the development of
capable cybersecurity teams and tools across healthcare, you can see why
perpetrators are so keen to break walk in. But it’s no longer the theft
of medical records, or PII that concerns me, it’s the wholesale theft of
intellectual property from research universities and pharmaceuticals by rogue
nation states, (one in particular) and the potential to hold both hospitals and
their patients to ransom by just about anyone. That’s what really worries me
most.
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10-hospital health system adds evidence-based clinical decision support
tech
The clinical
pathways system is designed to help make appropriate decisions related to
specific clinical questions. The drug tool is designed to help pharmacists,
physicians and nurses with access to point-of-care drug information.
September 19,
2019 05:11 AM
Covenant
Health, a 10-hospital health system based in Knoxville, Tennessee, has added
UpToDate Advanced and Lexicomp systems – evidence-based interactive clinical
decision support and drug information tools, respectively – to its health IT
line-up. The systems are from vendor Wolters Kluwer Health.
WHY IT
MATTERS
The
regional health system opted to expand its longtime access to UpToDate at one
hospital to all 10, as well as to approximately 100 clinics, spanning 23
counties in East Tennessee.
UpToDate
Advanced equips Covenant Health caregivers with interactive clinical pathways
to help make appropriate decisions related to specific clinical questions. The
system’s Lab Interpretation feature is designed to help clinicians quickly
analyze abnormal lab results and decide on next steps while helping to reduce
unnecessary testing and prevent missed diagnoses.
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How one provider org used SDOH, analytics and texting to help reduce
pre-term births
The Parkland
Center for Clinical Innovation increased prenatal visit attendance by 24%,
reduced early preterm delivery by 27%, and reduced first-year baby costs by
54%.
September 19,
2019 11:01 AM
The
Parkland Center for Clinical Innovation aims to improve health for underserved,
vulnerable populations. Its staff says health begins where people live,
learn, work and play, so they endeavor to bring together data science and
social determinants of health to create connected communities of care.
THE
PROBLEM
“One
of the vulnerable populations we’ve been focusing on are women at risk of
pre-term delivery since their health and pregnancy is heavily influenced not
only by their medical history, but their social and economic situation and
environment,” said Dr. Steve Miff, president and CEO of the Parkland Center for
Clinical Innovation. “Our data scientists and clinicians took a fresh look at
this challenge and explored how data science and SDOH can drive better
segmentation, engagement, and ultimately better outcomes and lower costs for
those who need help the most.”
As
top healthcare problems go, pre-term birth is a big one because one in 10
children in the United States is born prematurely. This challenge is even more
significant among inner city African-American and Hispanic women due to SDOH
challenges.
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Group To Offer Health Data Access To Android Phone Users
September 19, 2019
In
recent times, Apple has been making a number of public moves focused on getting
its customers to pull their health data onto their iPhone. Using Apple’s Health
app, consumers can have their health data downloaded automatically from any
institution with which it has partnered.
To
date Apple’s list of partners stands at more than 200, including scattered
individual medical practices and a wide range of health systems, including
Allina Health, Baptist Health, Baylor, Scott & White Health, Catholic
Health Initiatives, Christiana Care Health System, Cone Health, Emory
Healthcare, Erlanger Health System, Geisinger, Henry Ford Health System, Inova
Health System, Johns Hopkins, Legacy Health, Mary Washington Healthcare and
MedStar Health.
Not
only that, there’s every reason to believe Apple’s health data sharing universe
will continue to expand. Though iPhone adoption still lags behind Android
adoption, it still controlled 47% of the mobile OS segment as of March 2019,
compared with 52.1% of phones using Google Android,
according
to Statista.
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Special Report: Cloud
Cloud
seems to offer enormous potential benefits for healthcare – from unlocking a
new wave of innovation to big data. But where is the NHS at with regards to the
cloud, what has changed and has the mood towards it shifted? Jennifer Trueland
investigates.
It’s almost
exactly a year since the UK Government
published its vision for digital, data and technology in
health and care. One of the key architectural principles is that we should
“start with the assumption that all our services should run in the public
cloud, with no more locally managed servers”.
At the moment
this is more aspiration than reality. Though cloud-based services are far more
prevalent in the health services of all four UK countries than they were a
couple of years ago, they are still far from mainstream.
But all this
could be about to change as more and more healthcare organisations recognise the
benefits.
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CMS official notes proposed interoperability rule will impact health
plans, too
September 18,
2019, 3:08 p.m. EDT
The
federal government expects to use its leadership, clout and some emerging
federal regulations to push health payers to share more data.
Those
regulations, now open for comment, lay out crucial first steps that will engage
health plans in nationwide interoperability efforts, said Alexandra Mugge,
deputy chief health informatics officer for the Centers for Medicare and
Medicaid Services at the AHIMA19 Health Data and Informatics Conference in
Chicago.
Speaking
at the annual conference of the American Health Information Management Association,
Mugge says CMS’ Interoperability and Patient Access Proposed Rule is a first
step in an effort to improve data sharing among all healthcare entities while
increasing the pressure against those that block information exchange.
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Mayo Clinic CIO: 'This artificial intelligence stuff is real'
"And it
is coming quickly to a care setting near you," said Cris Ross at Health
2.0 on Tuesday, touting "small AI and big AI" tools that can help
revamp IT systems to improve the experience of clinicians and patients alike.
September 18,
2019 08:56 PM
SANTA
CLARA – Mayo Clinic Chief Information Officer Cris Ross put it plainly during
his keynote speech at Health 2.0 this week: "Our systems are not
adequately supporting our doctors, in lots and lots of ways."
And
he counts his own world-class health system as one of them. Mayo Clinic
completed a landmark
four-year, 90-hospital, $1.5 billion Epic implementation in
2018. But while it was "an enormous project and by all objective
measures we did just fine," said Ross, "we're also still at place
where our doctors are frustrated and our patients are not seeing a particular
difference by us doing that."
Providers
want to know that they have meaningful work, where they are operating in an
efficient and effective way and that they're delivering the best treatment
that's appropriate, he explained.
"But
they're also looking for joy in practice," said Ross. "Being a
provider is hard. And we make the bar even harder by layering on unbelievable
levels of complexity and regulation, which makes their work incredibly hard. We
have to help them with that and try to find a way to bring some joy back to
their work."
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Sepsis Quality Care: How Is the U.S. Performing?
September 18, 2019
The
following is a guest article by Anne Dabrow Woods, DNP, RN, CRNP, ANP-BC,
AGACNP-BC, FAAN, Chief Nurse, Health Learning, Research & Practice, Wolters
Kluwer.
Sepsis
affects
1.5
million people in the U.S. annually, and it is a leading cause of morbidity
and mortality, attributing over
$20 billion
in annual hospital fees. As hospitals and health systems focus on this deadly
and preventable condition during Sepsis Awareness Month, it’s important to reflect
on the state of the industry and how the nation is performing following
increased regulatory attention in recent years.
Sepsis
in not a new diagnosis. In fact, the third definition of sepsis and septic
shock was published in 2016. As an industry challenge, the complexities of
getting out in front of sepsis and reducing its impact have plagued healthcare
organizations for years. Too often clinicians fail to recognize the severity of
an infection and that the patient actually has sepsis. The failure to recognize
and diagnose sepsis can lead to a deadly outcome.
The
key to sepsis survival is early detection and intervention, and research has
demonstrated that decreasing variability of care positively impacts patient
outcomes. Recognizing that the sepsis challenge requires a multi-pronged,
multi-disciplinary approach that draws on the latest industry evidence, the
Centers for Medicare and Medicaid Services (CMS) instituted a program in 2015
to put standardized protocols to the test through a sepsis treatment bundle.
These standards of practice have been implemented and supported nationally to
improve the outlook, and hospitals are wise to prioritize implementation of the
protocols as sepsis performance scores are now published on the
publicly-available Hospital Compare website.
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Sep 16, 2019,
08:00am
IT Technologies Intersect To Transform The Health Care And Pharmaceutical
Sectors
Vishal
Gupta
Global CTO and senior vice president of
technology at Unisys. Leads the global technology and product organization
across six global centers
The World Health Organization (WHO) is celebrating seven decades of public health progress,
which it says, "Have added 25 years to global life expectancy, saved
millions of children’s lives, and made huge inroads into eradicating deadly
diseases."
As WHO notes, there’s still a long way to go. One of the ways
forward is via the intersection of various IT technologies. These technologies
have the potential to help the health care and pharmaceutical industries -- and
those they serve -- to continue moving in the right direction to build a
healthier, secure and more convenient world.
Clinics and hospitals are clearly big users of technology. They
regularly employ systems like ultrasound and X-ray machines. The global diagnostic
ultrasound market alone is expected to surpass $7 billion by 2024. Yet the health care vertical spends just 3 to 5.9%
of its revenue on IT, while the financial services sector spends 4.4 to 11.4%
of its revenue on IT solutions. No wonder that nearly two-thirds of health care
providers say they are behind the curve on their digital
health initiatives. The good news is that some of the
innovative technologies below can help the health care vertical make
significant progress.
-----
The Apple Watch's Next Trick Could Be Battling Pseudoscience, But
Questions Remain
Sep 16, 2019,
1:30pm
Before
launching into its battery of Apple Watch announcements on Wednesday, Apple set
the tone, as it often does, with a moving promotional video. Among the many
characters featured was a mother who described how the Apple Watch helped catch
a pregnancy-endangering heart condition. She rushed to the hospital, and her
baby was saved. Later, Apple announced it would expand its health initiatives
by
embarking
on three new health research studies in the U.S. that will use data
gathered by its smartwatch. The Apple Watch, like most wearables, is billed as
a product that can help you live a healthier life. These studies are Apple’s
latest effort to prove that’s more than marketing bluster.
Though
the announcement was light on details, we know the company is partnering with a
half-dozen top medical institutions in America to investigate a range of topics
including women’s health, the effect of mobility on cardiovascular health, and
the impacts of everyday sound exposure on hearing.
The
studies will be conducted through Apple’s upcoming Research app, and they have
the potential to be some of the largest-ever studies involving worn sensors.
Don’t be surprised if these studies ultimately breed new features. In fact, all
this altruistic-sounding research is probably a shrewd business decision since
the company can’t legally market medical capabilities without research and
health authority clearance in the U.S. Even if they don’t turn into features,
the studies lend Apple credibility and goodwill.
-----
HHS wants to give you your health data — do you want it?
09/16/2019
02:48 PM EDT
Encouraging
patients to access and share detailed health records is one of the Trump
administration’s major health care policy goals. So far, though, patients
aren’t really responding.
HHS
may soon begin to understand why as it pursues plans to force insurers and
providers to adopt new data standards that, in theory at least, should allow
more people shift their health information to their smart phones and laptops.
The
technology allowing patients to grab their own data — application programming
interfaces, or APIs — is already used in e-commerce and to power businesses
like ride share networks. But patient access to APIs is "pretty far from
the mainstream" despite a decade of development efforts, said A. Jay
Holmgren, a Harvard health policy researcher
who has studied adoption rates. A recent
JAMA study found only about 0.7 percent of patients who log
into patient portals where they can access records wind up sending them to
their smartphones.
-----
VA starts training program for new Cerner EHR system
September 17,
2019, 12:49 a.m. EDT
The
Department of Veterans Affairs wants to ensure that VA personnel are properly
trained to support the agency’s 10-year Electronic Health Record Modernization
initiative.
Under
the newly launched VA Innovative Technology Advancement Lab (VITAL) training
program, the agency has selected 76 initial trainees for advanced training;
they will support continuous performance improvement and seek to address
real-world healthcare challenges. As the decade-long deployment continues,
participants will be added, according to the VA.
For
the first cohort of VITAL, 76 trainees were selected from among more than 40
point-of-care clinical and support roles at the Electronic Health Record
Modernization’s initial operating capabilities sites, including Mann-Grandstaff
VA Medical Center in Spokane, VA Puget Sound Health Care System in Seattle and
Tacoma, and other Veterans Integrated Service Network facilities in Alaska,
Idaho, Oregon and Washington state.
-----
NHS trust deploys clinical messenger solution from Dutch startup Siilo
The
announcement comes as hospitals become increasingly aware of the need to
share patient information over secure platforms.
September 17,
2019 04:51 AM
St
George’s University Hospitals NHS Foundation Trust in London has begun the
rollout of the secure clinical messenger solution Siilo enabling healthcare
professionals to share patient information.
The
hospital trust sees the Siilo messaging app as a way to not only provide a
safe, secure and easy way to share information about patients, but also
eradicate the use of WhatsApp.
The
app, which is used by more than 150,000 healthcare professionals across Europe,
is being made available to consultants, junior doctors, specialist physician
associates, specialist nurses and other staff at the hospital.
-----
Health system takes an ‘Epic first’ approach to integrating all data,
including SDOH
Contra Costa
Health Services takes on whole person care by gathering every bit of data, not
just medical care data, and getting it into its Epic EHR. The results have been
startling.
September 17,
2019 03:48 PM
Recognizing
that medical services only address part of a person’s overall health, the
California Department of Health Care Services (DHCS) designed the Whole Person
Care (WPC) program to address the physical health, behavioral health and social
needs of high-need, high-cost Medi-Cal beneficiaries.
DHCS
negotiated the program as part of its Medi-Cal 2020 Section 1115 waiver renewal
with the Centers for Medicare & Medicaid Services (CMS). The WPC pilots are
testing whether local initiatives coordinating physical health, behavioral
health and social services (housing supports, food assistance, other public benefits,
etc.) can improve health outcomes and reduce medical costs.
Up
to $1.5 billion in federal funds are available over the five years of the
program, matched by $1.5 billion in local funds from the pilots. Each WPC pilot
differs in size, target population(s) and interventions based on community
needs, priorities and resources.
-----
Medical images and details of 24.3 million patients left exposed on the
internet
3:19 pm, September 17, 2019
When
we think about our data being leaked onto the internet, we often picture it as
our financial records, our passwords, our names and addresses… but what about
our private medical information?
Researchers
at Greenbone Networks
discovered that confidential images
of X-rays, CT and MRI scans related to millions of patients has been left
unprotected on hundreds of servers used by health providers worldwide.
Analysing
2,300 medical image archive systems around the world in the last two months,
Greenbone’s team found 590 were freely accessible, containing records of 24.3
million patients in 52 different countries.
Exposed
information included patients’ names, dates of birth, dates of examination, the
attending physician, and some medical information about the purpose of the
examination. In addition, 13.7 million of the compromised records included the
social security numbers of American patients.
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AHRQ Encourages Use of Fast Healthcare Interoperability
Resources (FHIR®) Standard
Notice Number: NOT-HS-19-020
Key Dates
Release
Date: September 9, 2019
Related Announcements
None
Issued by
AGENCY FOR HEALTHCARE RESEARCH AND QUALITY (AHRQ)
Purpose
The purpose of this notice is to encourage the Agency for
Healthcare Research and Quality (AHRQ)-funded researchers to explore the
use of the Fast Healthcare Interoperability Resources (FHIR®) standard to
capture, integrate, and exchange healthcare data for research purposes and to
enhance capabilities to share research data.
Background
The
Health Level Seven International (HL7®) FHIR is a standard for exchanging
health information electronically. FHIR specifies the content of the data
exchanged between healthcare applications, and how the exchange is implemented
and managed, typically through an application programming interface (API).
Software developers can seamlessly connect their application to another through
a FHIR API to transmit electronic healthcare data. FHIR enables the exchange of
many different healthcare data types such as clinical information,
demographics, and billing and claims data.
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Israel Prepares to Unleash AI on Health Care
In a small country with digitized records, big data could make medicine
cheaper and more effective
By Dov Lieber
Sept. 15,
2019 10:01 pm ET
Israel
is becoming a testing ground for the power of artificial intelligence to
improve health care.
Digital
medical records for the vast majority of Israelis are currently stored in
databases maintained by the handful of semipublic HMOs that provide most health
care in Israel. While the biggest health-maintenance organizations already
leverage their records in partnerships with private companies to develop
technology for more advanced health care, Israel’s government wants to take
such efforts to a new level.
The
government last year announced a $264 million initiative to begin to combine
those millions of records into a giant unified system, one that takes decades
of individual patients’ information and puts it all in the same format so
medical data looks the same across all health-care institutions. Corralling the
records and organizing them in ways that maximize their usefulness to AI
programs and data analytics, the government hopes, will make the data of even
greater value to researchers and health-care companies. And the greater goals,
officials say, based largely on the promise of AI technology, are to make
health care less expensive, more effective and better tailored to individuals
everywhere.
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Emory, Purdue accelerator programs join HHS initiative to address health
security threats
Sep 16, 2019
12:57pm
The
U.S. Department of Health and Human Services wants to tap into startups and
entrepreneurs to help solve systemic health challenges.
The
federal agency is expanding its innovation accelerator network that
supports small and start-up biotechnology innovators to accelerate the
development of products for biodefense and other health security needs. HHS'
Office of the Assistant Secretary for Preparedness and Response (ASPR)
unveiled
the network last year with eight accelerators. The network is spearheaded
by ASPR's Biomedical Advanced Research and Development Authority (BARDA).
The
five new accelerators include Emory University & Georgia Institute of
Technology (Coulter Translational Program) in Atlanta; Plug and Play Tech
Center in San Francisco; University of Missouri Midwest BioAccelerator
(MU-MBAr) in Columbia, Missouri; University Enterprise Labs in partnership
with gener8tor in St. Paul-Minneapolis; and Purdue University in West
Lafayette, Indiana.
These
organizations expand the existing network, providing geographic coverage into
areas of the country previously under-represented in the network, HHS officials
said.
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Moody's: Cyberattacks could cause significant financial disruption for
hospitals
Sep 12, 2019
3:47pm
Cyberattacks
pose a greater fiscal and credit risk to nonprofit hospitals than any other
sector of municipal finance due to the increasingly interconnected nature of
hospital operations and information technology.
Hospitals
with strong risk management strategies will be better positioned to respond to
these operational and financial disruptions, according to a report from Moody's
Investors Service.
Small
hospitals face the biggest risk, because many lack the necessary
cybersecurity resources and will be less able to absorb any financial
impact, according to report authors Jennifer Barr, a Moody's analyst, and Lisa
Goldstein, Moody's associate managing director.
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Beth Israel, Dana-Farber leaders offer a prescription for better digital
health: Actionable data at the point of care
Sep 13, 2019
10:40am
BOSTON—With
an all-time high
$14.6
billion in funding going toward digital health startups globally last
year, investors are betting big on the promise of tech to address major
healthcare challenges and disrupt the industry.
Are
these digital solutions delivering?
They
could be doing more, according to John Halamka, M.D., chief information
officer at Beth Israel Deaconess Medical Center and professor of medicine at
Harvard Medical School.
There
are early successes, such as artificial intelligence and machine learning that
are aiding radiologists, pathologists, and oncologists by analyzing reams
of data and providing more effective clinical decision support. And
physicians—armed with data from wearables and medical devices—can diagnose and
treat patients quickly using telehealth visits, Halamka said while
speaking at the Digital Health Impact conference in Boston this week.
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Healthcare data’s moment of lift
The unlocking of patient data is leading us to a future when health care
will be a vastly improved experience with superior outcomes. However, there
will be guard rails around consumer access to personal health records.
Data
wants to be free. Data also wants to be in free markets.
A
slew of newly announced initiatives points to the inexorable shift of data away
from walled gardens and tightly controlled environments into the world of free
markets. Consider these:
- A group of healthcare institutions
and technology providers has launched an open-source initiative titled CommonHealth
to let Android-powered device users gain access to medical records. The
initiative will dramatically increase the number of consumers who will
have access to their medical records, essentially replicating Apple’s
remarkably successful efforts to give iOS users access to health records
from over a hundred participating hospitals and health systems.
- Allscripts, a health IT company,
has opened
up access to their Electronic Health Records (EHR) system to Apple,
enabling patients from hospitals using the Allscripts platform to access
their records over their iOS devices such as iPhones.
- Epic has launched a massive data
compilation effort entitled Cosmos to aggregate over 20 million
patient medical records from providers in a participation agreement
designed to make the data pool available for analysis in improving care
decisions.
OK,
I'm not so sure about the last one, but you get the drift. Patient medical
information is being set free so that their rightful owners, i.e., consumers,
can access and share them freely. ET go home. At last.
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US needs cyber-savvy doctors as connected device use rises, FDA panel says
Published Sept. 11, 2019
Thinking
about medical device cybersecurity risk is a little like considering a
potential airplane crash, Thermo Fisher Scientific cybersecurity researcher Jay
Radcliffe told FDA's Patient Engagement Advisory Committee Tuesday.
The
impact if the risk played out could be high, but the probability of it being
realized is low.
Unlike
a plane crash, it's usually difficult for patients to conceptualize these
risks, which underscores the importance of training healthcare providers in
cybersecurity to help guide patients, presenters and panelists advised the
agency.
And
the fact that risks are difficult to quantify or mitigate doesn't change the
responsibility FDA and manufacturers have to inform patients and providers of
all known vulnerabilities through well-tailored communications, the panel
said.
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Cybercriminals shop for admin access to healthcare portals
Administrator
access to backend systems is becoming the holy grail for attackers.
When
people think about hackers and their targets, most assume cybercriminals are
after bank account numbers or financial institutions. But
a new study from cybersecurity firm IntSights shows hackers
are now honing in on healthcare institutions for lucrative information to
steal.
"If
you would have told me 15 years ago, 'Hey let's go target the database manager
for this insurance company,' I wouldn't even know where to begin," said
IntSight chief security officer Etay Maor.
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Amazon's battle for pharmacy business is fought over phone, fax
September 16,
2019, 3:42 p.m. EDT
Getting
into the pharmacy business was easy for Amazon.com: It paid $753 million to buy
the mail-order startup PillPack. The hard part has been prying patients away
from their local drugstore.
Since
being acquired by the internet giant, PillPack has run into stiff opposition,
from chains like CVS with thousands of stores to family-owned operations with a
single shop. Having seen their business of selling shampoo and razor blades
chipped away by online sellers, the drugstores are trying to keep Amazon from
wresting away their piece of the $333 billion U.S. prescription-drug industry.
PillPack’s
selling point is simple. For people who take multiple medicines a day, it will
replace a confusing jumble of pill bottles with neatly sealed packets stamped
with the time they’re supposed to be taken. But to make the process seamless
for customers, PillPack needs to ask a patient’s pharmacy or doctor to transfer
their prescriptions. While it’s always faced some pushback, PillPack contends
that after Amazon said it was buying the startup in June 2018, its faxed
requests for prescription transfers started being slow-walked or even
completely disregarded.
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New guidance available to help improve cyber recruiting
September 16,
2019, 3:47 a.m. EDT
The
Healthcare and Public Health Sector Coordinating Council has released a new
toolkit to help a variety of healthcare organizations recruit and retain
cybersecurity personnel.
The
initiative is designed to address the growing need for cyber talent faced by
healthcare providers, insurers and other stakeholders as threats to data
systems continue to grow. The council worked with the federal government to
produce the toolkit.
HSCC
also has created a Cybersecurity Working Group (CWG), as threats have become
more numerous, more frequent and more severe, requiring concerted and
coordinated mitigation efforts across the healthcare industry.
Guidance
is particularly aimed at small to mid-sized health delivery organizations and
companies that don’t have extensive resources for security but need a place to
start.
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Mobile tech, IoT and AI driving the need for next-generation storage
September 16,
2019, 3:26 p.m. EDT
There’s
an insatiable demand for data storage, fueled by the ongoing rise in mobile devices
and apps, the Internet of Things, artificial intelligence and many other
factors. Not surprisingly, demand is up for next-generation storage
technologies.
In
a recent report, Zion Market Research said the global next-generation data
storage market totaled $50.4 billion in 2018 and is expected to reach about
$114.9 billion by 2025, growing at a compound annual growth rate (CAGR) of 12
percent between 2019 and 2025.
Next-generation
data storage involves technically-advanced products that are more efficient
than conventional products at handling voluminous information on a daily basis,
the report said.
-----
Clinician burnout: Physicians name the technologies they think could best
solve it
At Health
2.0, National Coordinator for Health IT Dr. Don Rucker and other clinical IT
leaders explore the root causes of the burnout epidemic – and offer a wishlist
of tech innovations that could help.
September 16,
2019 06:56 PM
SANTA
CLARA – At Health 2.0 on Monday, National Coordinator for Health IT Dr. Don
Rucker listed a litany of challenges faced daily by physicians and nurses, and
contributing to the ongoing scourge of clinician burnout: onerous documentation
requirements, boilerplate electronic health records and the "monster
burdens" of prior authorization and compliance with too many overlapping
quality measures.
A
lot of people single out suboptimal EHR experience as as root cause of the
burnout epidemic, and it certainly is one of them. But "burnout is
multifactorial," said Dr. Michael Pfeffer, chief information officer at
UCLA Health.
It
can be caused by EHR frustrations, admin burdens, regulatory headaches,
malpractice concerns and the rise of consumerism: Pfeffer says he hears often
from physicians dismayed by poor online reviews from patients that they're
powerless to fix.
Ultimately,
burnout is about "loss of control," added HIMSS Chief Clinical
Officer, Dr. Charles Alessi. The EHR may have become the "epithet to hang
everything on," he said, but this deep satisfaction among so many
clinicians has a wide array of contributing factors.
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Health 2.0: Providers must reinvent themselves to achieve quadruple aim
Dr. Albert
Chan, chief of digital patient experience at Sutter Health, says health systems
have to get better at interpreting data in novel ways to make good on their
promise to patients.
September 16,
2019 01:24 PM
SANTA
CLARA – At the Health 2.0 Provider Symposium on Monday, one physician leader
opened the morning by taking a trip back in time, to 1999.
It
was a year of red pills (The Matrix, where Neo gulped down a tablet that showed
him the true nature of reality) and blue pills (Viagra, which earned Pfizer
$281 million that year, boosting its profits by 14%).
It
was a year of a technology panic that wasn't (Y2K) and of the first major
warnings about a different sort of emergency: the Institute of Medicine's
landmark '99 report, "To Err is Human: Building a Safer Health
System," which shocked the world by showing 44,000-98,000 people die each
year as a result of avoidable medical errors.
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Michigan HIE Group Creates Shared Environment For Modeling
Interoperability
September 16, 2019
If
you’re running an HIE, you’re always hoping to see your participants step up
their interoperability game. The thing is, few HIEs go the extra mile to make
it happen, in many cases because they just don’t have the resources to tackle
the problem.
Given
this fact, I was interested to see the recent announcement by a Michigan HIE
which is taking a far more hands-on approach to helping participants develop
better interoperability capabilities.
Michigan
Health Information Network Shared Services (MiHIN) is launching a new
not-for-profit organization dedicated to supporting research on national
interoperability.
MiHIN
is Michigan’s state-designated entity for sharing electronic health information
statewide. It’s a non-profit, public-private collaboration whose participants
include the State of Michigan, other state HIEs, health systems, providers,
health plans, pharmacies and the Governor’s Health Information Technology
Commission.
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Time To Get Clear About Digital Care Limitations
September 16, 2019
Today.
I stumbled across a story featuring what has to be one of the more unfortunate
uses of digital health technology I’ve ever encountered.
According
to a news
item,
Ernest Quintana, a 79-year-old grandfather who was an inpatient at Fremont,
Calif-based Kaiser Permanente Medical Center, was in the ICU because his lungs
were failing.
At
one point during his stay, the report says, a hospital robot entered Quintana’s
room and a video visit with an off-site doctor began. (The hospital uses the
robot to allow physicians to go on virtual rounds.)
During
the consult, the physician told Quintana that his condition was terminal,
apparently for the first time, a message which the family felt should never
have been delivered via video. Adding insult to injury, his granddaughter had
to pass along the bad news, because the dying man had trouble hearing the
doctor.
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EY Participatory Health Framework
A
report from the American Hospital Association and consulting firm EY
says that participatory health, or “healthcare with no
address,” is coming. It predicts that health systems will respond to consumers
who want on-demand, connected, and data-driven services.
The
report says a participatory health framework will require health systems to
offer:
- Health and wellbeing support.
- A personal health cloud containing
the patient’s own data, including biometrics.
- AI analysis of the data to create
new insights and solutions.
- A demand-driven global marketplace.
The
report predicts that physicians will become “data-driven conductors” who will
take responsibility for managing the lifestyle and wellness of patients.
The
authors observe that while the future is more patient-centric and
participative, health systems must move toward value while continuing to earn
most of their revenue for volume.
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Weekly News Recap
- Surescripts cuts off prescription
data access to Amazon’s PillPack mail order pharmacy.
- The premier of Queensland,
Australia promises to investigate a 14-hospital downtime of several hours
that was caused by a Cerner upgrade.
- Apple announces that it will
partner with several high-profile healthcare institutions to conduct
studies related to hearing, women’s health, and heart health using its new
Research app.
- Mayo Clinic signs a 10-year partnership
with Google in which Google Cloud will provide Mayo with data hosting,
cloud computing, analytics, and machine learning and AI.
- Bayfront Health St. Petersburg
(FL) pays $85,000 to settle HHS OCR’s first case under the Right of Access
requirement to give patients complete copies of their medical record
within 30 days.
- Hackers breach DDS Safe, a
cloud-based records retention and backup solution that is sold to dental
practices, and use it to install ransomware on the computers of hundreds
of dental practices.
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Enjoy!
David.
