This blog is totally independent, unpaid and has only three major objectives.
The first is to inform readers of news and happenings in the e-Health domain, both here in Australia and world-wide.
The second is to provide commentary on e-Health in Australia and to foster improvement where I can.
The third is to encourage discussion of the matters raised in the blog so hopefully readers can get a balanced view of what is really happening and what successes are being achieved.
Quote Of The Year
Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"
or
H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."
The question was “ChatGPT –
Revolution or Hype?” Others have also asked, in similar vein "is ChatGPT a form of magic or the apocalypse?"
There was then a secondary question:
“How will ChatGPT change the world?”
Chat GPT’s answer to that is pretty
balanced and sensible:
“ChatGPT is a
tool that can be used to generate human-like text. This technology has the
potential to be used in a wide range of applications, such as chatbots, virtual
assistants, and automated content generation. It could also be used in areas
like customer service, marketing, and education. By automating certain tasks
and making it easier to generate large amounts of high-quality text, ChatGPT
has the potential to improve efficiency and productivity in many industries.
Additionally, it could make it possible for people to interact with technology
in more natural, human-like ways. However, it's important to note that ChatGPT
is just a tool, and its impact will depend on how it's used and implemented in
the real world.”
In the AFR we got a pretty clear
answer to the headline question a day or so earlier too!
Microsoft invests $14b in ChatGPT maker OpenAI
Dina Bass
Seattle | Microsoft is investing
$US10 billion ($14 billion) in OpenAI, whose artificial intelligence tool
ChatGPT has lit up the internet since its introduction in November, amassing
more than a million users within days and touching off a fresh debate over the
role of AI in the workplace.
The
new support, building on $US1 billion Microsoft poured into OpenAI in 2019 and
another round in 2021, is intended to give Microsoft access to some of the most
popular and advanced artificial intelligence systems.
Microsoft
is competing with Alphabet, Amazon.com and Meta Platforms to dominate the
fast-growing technology that generates text, images and other media in response
to a short prompt.
At
the same time, OpenAI needs Microsoft’s funding and cloud-computing power to
crunch massive volumes of data and run the increasingly complex models that
allow programs like DALL-E to generate realistic images based on a handful of
words, and ChatGPT to create astonishingly human-like conversational text.
While
Microsoft didn’t give details of the new investment, a person familiar with the
discussions, who asked not to be identified, said it totals $US10 billion over
multiple years. The shares gained 1 per cent to $US242.58 in New York on Monday
(Tuesday AEDT).
The
deal will give a boost to Microsoft’s Azure cloud, while providing OpenAI with
additional specially designed supercomputers to run its complex AI models and
fuel its research. Microsoft plans to use OpenAI’s models throughout consumer
and corporate products and release new categories of products based on OpenAI’s
work, the two companies said in blog posts.
The
Azure usage fuelled by this deal is key for Microsoft as it battles to expand
that business, said Bloomberg Intelligence analyst Anurag Rana. “This could
even help Microsoft close the gap further with AWS,” he said, referring to
Amazon’s market-leading cloud service.
OpenAI
noted on Monday that it uses Microsoft’s cloud-based service Azure to train all
of its models and that Microsoft’s investment will allow it to accelerate its
independent research. Azure will remain the exclusive cloud provider for
OpenAI, the company said.
The
deal has a complicated structure because investors in OpenAI are limited in the
return on their investment since it is a capped-for profit company.
Microsoft
will get nearly half of OpenAI’s financial returns until its investment is
repaid up to a predetermined cap, one of the people said. All profits beyond
what is owed to investors and employees are returned to OpenAI, which is
governed by the OpenAI non-profit organisation.
The
service gives Microsoft’s cloud customers access to various OpenAI tools like
the GPT-3.5 language system that ChatGPT is based on, as well as the DALL-E
model for generating images from text prompts. That enables Azure customers to
use the OpenAI products in their own applications running in the cloud.
Microsoft
itself is currently using the developer’s language AI to add automation to its
Copilot programming tool, and wants to add such technology to its Bing search
engine, Office productivity applications, Teams chat program and security
software. The company is putting DALL-E into design software and offering it to
Azure cloud customers.
That $US 10 Billion is pretty impressive
until you realise the Market Cap of the company is $1.85 Trillion!
So we can conclude that MS is making
a significant but not company changing investment in ChatGPT.
For that reason I reckon we all will
need to just setting in for a wait of 1-2 years to see what comes of it all and
to see if it was worth it! The way things are moving we will probably have a
different question top of mind by then! Nevertheless, from the above it is
clear MS has pretty big plans! I do worry about many of the jobs ChatGPT cited....
If MS thinks ChatGPT is a revolution
and not hype, it probably is!
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
How trust leaders can leverage their electronic patient record systems
Dr
Victoria Betton, associate at Public Digital and director of PeopleDotCom,
looks at how leaders of NHS trusts can leverage their electronic patient record
systems.
It started
with unintended consequences
DHI News Team
– 19 Jan, 2023
When I worked
in an NHS trust, my colleagues and I had to make a 5% cut to our annual
departmental budgets each year.
There was
little discussion about the implications for patients, intended or unintended
consequences for clinical services, nor modelling of the impacts. All that
mattered was that I had to find a way to cut my budget and hit the cost
improvement target.
I wish I had
fully appreciated then, what I know now about complex systems – that each division and function is a
subset of a wider whole and that a change in one has an impact on the other.
A complex
adaptive system
Too often
digital teams are dealing with their own resource challenges in a departmental
silo. As I interviewed CIOs, CCIOs and other digital health practitioners for
the new NHS Providers’ guide, Making the most of your electronic patient record system,
many told me how they are grappling with the challenge of continually improving
and adapting their EPR so that it creates genuine value. They are doing this
within the context of NHS trusts fighting for their lives amid a workforce
crisis and unprecedented demand. The context could hardly be more challenging.
2023 predictions: Digital health leaders on what lies ahead
After
another significant year in the digital health space, we asked some digital
health leaders what they think is in store for 2023. Here is what they predict:
Jordan Sollof
– 18 January, 2023
Saffron
Cordery, interim chief executive of NHS Providers
“Next year
will continue to be challenging for the NHS, and in the digital space funding
will remain constrained. Despite this, NHS board leaders will continue to
look to digital ways of working to address some of the big strategic challenges
the sector faces.
“Through our
existing Digital Boards programme, delivered in partnership with Public
Digital, and supported by HEE and NHS England, we know that trust leaders
endeavour to expand and evolve their digital capabilities to meet current and
future operational demands and rise to heightened expectations of patients and
staff. Where possible, this will mean investing in digital teams, but will also
include upskilling existing staff.
“For those
with electronic patient care records (EPRs) already in place, ‘optimisation’
will be at the forefront of their strategic thinking, while consideration will
be needed on alignment or even convergence with system partners. And for those
who have secured funding for their EPR programmes, procurement and
implementation will dominate the board’s agenda.
“Our new
Digital ICS programme, delivered in partnership with the NHS Confederation and
Public Digital, and supported by HEE and NHS England, will help the new ICS
leadership use digital to drive their system ambitions, including digital’s
role in reducing health inequalities. We look forward to working alongside
integrated care boards over the course of 2023 to further realise these digital
opportunities.”
Google Research and DeepMind develop AI medical chatbot
Google
Research and DeepMind have developed a large language model for the medical
community, which could generate safe and helpful answers using datasets
covering professional medical exams, research and consumer queries.
Cora Lydon –
18 Jan 202
The
AI-powered chatbot, MedPaLM, combines HealthSearchQA, a free-response dataset
of medical questions found online developed by Google and DeepMind, with six
existing open-question answering datasets.
The six other
datasets come from MedQA, MedMCQA, PubMedQA, LiveQA, MedicationQA and MMLU.
MedPaLM
addresses multiple-choice questions and answers posed by both medical
professionals and non-professionals.
Large
language models (LLMs), such as MedPaLM, are designed to understand queries and
generate appropriate responses in plain language. To do this they draw
information from large datasets.
The technology
is benchmarked with MultiMedQA, an open-source medical question-answering
benchmark. Testing into the new open-source Google LLM involved evaluating its
performance by studying its responses for factuality, precision, conceivable
harm and bias.
January 18,
2023 - A recent study from UC Davis Health found
that the uptake of telehealth during the first two years of the COVID-19
pandemic improved patient outcomes and led to noticeable financial and
environmental benefits , largely due to the cut in carbon footprint associated
with virtual visits.
As telehealth
became more widely used throughout the COVID-19 pandemic, researchers focused
on its effect on various aspects of healthcare.
The study
from UC Davis Health aimed to gather further information regarding the carbon
footprint occupied by telehealth. Researchers gathered data from five
University of California healthcare systems from during the initial two years
of the pandemic. They then analyzed various components related to travel
distance, time, and costs.
“Our study
documented the many benefits of utilizing telehealth for ambulatory visits,”
said Sristi Sharma, a UC Davis preventive medicine physician and lead author of
the study, in a press release. “It is the first, large-scale study to evaluate
the round-trip distance, time, and cost-saving, and greenhouse gas emissions
prevented from telehealth use during the pandemic.”
The Microsoft-backed free chatbot is improving fast
and can not only write emails, essays but can also code. ChatGPT is also
polyglot and that could facilitate and increase exponentially phishing attacks.
Contributing
writer, CSO | 16 January 2023 21:00 AEDT
ChatGPT,
OpenAI’s free chatbot based on GPT-3.5,
was released on 30 November 2022 and racked up a million users in five days. It
is capable of writing emails, essays, code and phishing emails, if the user
knows how to ask.
By
comparison, it took Twitter two years to reach a million users. Facebook took ten
months, Dropbox seven months, Spotify five months, Instagram six weeks. Pokemon
Go took ten hours, so don't break out the champagne bottles, but still, five
days is pretty impressive for a web-based tool that didn't have any built-in
name recognition.
There
are so many good reasons to be panicking about OpenAI's ChatGPT
right now. It writes better essays than the average high school or college
student. It can write and debug code.
"It
allows people with zero coding and development knowledge to be a
developer," says Sergey Shykevich, threat intelligence group manager at
Check Point Software Technologies. Shykevich, who is based in Israel, has been
monitoring the chatter on the dark web.
Federal Officials Urge Healthcare Industry’s Adoption of FHIR for
Interoperability
The
Department of Defense, among others, is already using the data standard to
streamline health information exchange, expedite scientific discoveries and
ensure health equity.
Dave
Nyczepir is a Senior Editor for Manifest.
The
best way to ensure electronic health record systems can share data
interoperably is for industry to adopt the Fast Healthcare
Interoperability Resources standard, or FHIR, say federal officials.
While
the deployment of a single, consolidated electronic health record, called the Military Health System GENESIS, has the Department of Defense on a
path to interoperability, the FHIR data standard that serves as its backbone
isn’t congressionally mandated.
FHIR
application programming interfaces streamline health information exchange by
standardizing data and eliminating the need for sharing agreements, which is
why the government required certified EHR vendors to make the APIs available to
customers by the end of 2022. Still, unlike credit card companies, which have
accepted data standards industrywide, the healthcare industry hasn’t fully rallied
behind FHIR.
“We
probably need to get the Chief Data Officers Council to make sure that it
covers all the agencies. Congressional mandate, law is another tool,” said Ken
Johns, CTO for the Defense Healthcare Management Systems Program Executive Office,
at the AFCEA Bethesda Health IT Summit 2023 on Tuesday. “Probably what will be
most successful is for industry to agree to standardize.”
We
often hear about various reports on the inefficacy of machine learning
algorithms in healthcare – especially in the clinical arena. For instance,
Epic's sepsis model was in the news for high rates of false alarms at some
hospitals and failures to flag sepsis reliably at others.
Physicians
intuitively and by experience are trained to make these decisions daily. Just
like there are failures in reporting any predictive analytics algorithms, human
failure is not uncommon.
As
quoted by Atul Gawande in his book Complications, “No matter what measures are
taken, doctors will sometimes falter, and it isn’t reasonable to ask that we
achieve perfection. What is reasonable is to ask that we never cease to aim for
it.”
Predictive
analytics algorithms in the electronic health record vary extensively in what
they can offer, and a good percentage of them are not useful in clinical
decision-making at the point of care.
The
potential for artificial intelligence (AI) and machine learning (ML) to improve
human health cannot be understated, but it does face challenges.
Among
the big challenges is dealing with siloed data sources, so researchers are not
able to easily analyze data from multiple locations and initiatives, while
still preserving privacy. It’s a challenge that can potentially be solved with
an approach known as federated
learning.
Today
in a research
report first published in Nature Medicine, AI
biotech vendor Owkin has revealed just how
powerful the federated model can be for healthcare. Owkin working alongside
researchers at four hospitals in France was able to build a model with its open
source technology that it claims will have a significant impact on the ability
to help effectively treat breast cancer. The Owkin AI models were able to
identify accurately novel biomarkers that could lead to improved personalized
medical care.
“Owkin
is an AI biotech company and we really have this ambitious goal, which is to
cure cancer,” Jean du Terrail, senior machine learning scientist at Owkin, told
VentureBeat. “We are trying to leverage the power of AI and machine learning,
in addition to our network of partners, to move towards this goal.”
Owkin
is one of the
hottest biotech startups in the market today. The company raised $80
million in funding back in June 2022, from pharmaceutical giant Bristol Myers
Squibb, bringing total funding to the unicorn startup, over $300 million since
the company was founded in 2016.
Interoperability, Data Quality Leads the Way as Top Exec Priorities
Healthcare
systems and hospital executives are focusing on interoperability initiatives as
they seek to improve data quality and information sharing challenges in 2023.
January 19,
2023 - While the healthcare industry is turning its attention to
interoperability, a new survey found
that barriers such as poor data quality and information sharing remain
challenging to over 60 percent of healthcare executives.
In Health
Gorilla’s 2023 State of Interoperability report, responses from nearly 130
executive healthcare decision-makers were collected to evaluate new
opportunities and challenges for healthcare interoperability as the new year
continues.
The survey,
conducted in collaboration with Flexpa and the Health Management Academy, found
that health systems will be ramping up their interoperability investments by 5
to 20 percent in 2023.
Additionally,
the survey discovered that health system executives had mixed reviews about the
quality of the data received through health information exchanges.
Patient Data Access is Insufficient for 60% of Healthcare Consumers
A new
survey shows that most consumers want health systems to provide them with
timely access to their medical records, but nearly three-fifths lack immediate
patient data access.
January 19,
2023 - Providing patients with easy access to their
health information can improve patient engagement. Yet, recent
findings revealed that 60 percent of consumers don’t have adequate patient data
access, according to a survey conducted by Propeller Insights on behalf of
Carta Healthcare, which was obtained via email.
The survey of
a little more than 1,000 United States patients showed that patients have a
strong interest in their own medical records and prioritize providers that
offer greater patient data access.
HC3 Warns Healthcare of AI’s Use in Malware Development
In its
latest brief, HC3 details how artificial intelligence (AI) can be used by
threat actors to aid in malware development, forming a serious threat to
healthcare cybersecurity.
January 19,
2023 - Artificial intelligence (AI) tools play an increasingly important
role in cybersecurity. AI models can be leveraged to defend the healthcare
sector against cyber threats. On the other hand, AI’s capabilities could also
be used for malware development to harm the healthcare sector, a Health
Sector Cybersecurity Coordination Center’s (HC3) analyst note suggested.
“Artificial
Intelligence (AI) has most notably been applied to the defensive side of
cybersecurity. It has been used to detect threats, vulnerabilities, and active
attacks and to automate security tasks,” the analyst note stated.
“However,
because of its known defensive use and because threat actors in cyberspace are
known to be highly creative and well-resourced, concerns have been raised in
the cybersecurity community about the potential for artificial intelligence to
be used for the development of malware.
AI works 24
hours per day, seven days per week. The constant monitoring means that the
tools can quickly process large quantities of data and detect threats, making
it an ideal cybersecurity measure for healthcare facilities.
Regenstrief develops framework to assess patient matching accuracy
Patient
identity is a great weakness in healthcare infrastructure, according
the physician informaticist who led the algorithm research, which is aimed at
boosting interoperability and patient safety.
Regenstrief
Institute announced this week that some of its researchers have developed an
eight-point framework designed to assess the validity and accuracy of
algorithms to match patient medical records.
WHY IT
MATTERS
Accurate patient matching across the care continuum is essential for quality
and safety. It's also key to driving down healthcare costs by reducing the
ordering of duplicative medical tests. But without a national patient
identifier – the United States, Regenstrief points out, is the only developed
nation not to use one – that goal has been elusive for years.
Given
the lack of a national patient ID, in the U.S., linking patient records is
often dependent on algorithms designed by technology vendors or healthcare
researchers.
Regenstrief
vice president for data and analytics Dr. Shaun Grannis led a team of
research scientists to create an eight-point framework for evaluating the performance of
those patient-matching algorithms.
4 Tips to Improve Data Loss Prevention in Healthcare
Here’s how
healthcare organizations can improve their approach to managing critical data.
Mike
Chapple is associate teaching professor of IT, analytics and operations at the
University of Notre Dame.
Healthcare
providers store, handle and transmit some of the most sensitive information a
person can possess, from personal health data to Social Security and credit card
numbers.
Meanwhile,
data loss incidents are on the rise, and they happen 38 times more frequently
than leaders estimate, according to a 2021 Tessian report. Remote
work is also affecting data security, according to that
report: Half of all employees reported that they feel “less secure” when
working outside of the office, and 42 percent said that they are “less likely
to follow safe data practices when working remotely.”
Data
loss prevention (DLP) solutions help IT leaders get better control over
their data by identifying and stopping potential data leaks before they occur.
1. Strengthen DLP System Visibility
DLP
technology only works when it can see the data it needs to protect. In an ideal
environment, this means combining endpoint DLP agents with network-based DLP sensors
and cloud-focused DLP
enforcement points. The greater visibility that DLP has into your enterprise IT
environment, the more likely it will be to spot and stop a potential leak.
Websites Selling Abortion Pills Are Sharing Sensitive Data With Google
Some sites
selling abortion pills use technology that shares information with third
parties like Google. Law enforcement can potentially use this data to prosecute
people who end their pregnancies with medication.
Online
pharmacies that sell abortion pills are sharing sensitive data with Google and
other third parties, which may allow law enforcement to prosecute those who use
the medications to end
their pregnancies, a ProPublica analysis has found.
These
third-party trackers, including a Google Analytics tool and advertising
technologies, collect a host of details about users and feed them to tech
behemoth Google, its parent company, Alphabet, and other third parties, such as
the online chat provider LiveChat. Those details include the web addresses the
users visited, what they clicked on, the search terms they used to find a
website, the previous site they visited, their general location and information
about the devices they used, such as whether they were on a computer or phone.
This information helps websites function and helps tech companies personalize
ads.
But
the nine sites are also sending data to Google that can potentially identify
users, ProPublica’s analysis found, including a random number that is unique to
a user’s browser, which can then be linked to other collected data.
Teladoc to cut 300 jobs or about 6% of its workforce in restructuring
Published: Jan.
18, 2023 at 7:24 a.m. ET
ByCiara Linnane
Teladoc
Health Inc. TDOCsaid Wednesday it is planning a restructuring that will
eliminate about 300 jobs, or about 6% of the telehealth company’s overall
workforce. In a regulatory filing, the company said it expects to book pretax
charge of about $4.4 million in the fourth quarter of 2022 and pretax charges
of about $17 million in 2023. Those are split between about $9 million related
to employee transition, severance payments and other benefits, and about 8
million of exit costs related to office space reductions that are expected to
occur by the second quarter. Chief Executive Jason Gorevic said the move was
necessary to allow the merged organization to operate as one Teladoc Health.
“Second, as we’ve discussed over the past several months and seen across our
industry, businesses like ours must transition to more balanced growth of
revenue and profitability. At this stage in both our evolution as an
enterprise and given the challenged economic environment, we believe that
balanced growth is the right step for us as a well-run company,” he said in a
letter to employees released with the filing. The stock was up 1% premarket but
has fallen 63% in the last 12 months, while the S&P 500 SPXhas fallen 13%.
Ransomware stakes are life-or-death, says Ponemon report
The institute
examined the continued impact of ransomware attacks on patient care and asked
healthcare IT professionals to evaluate their use of benchmarking in making
their cybersecurity program decisions.
Nearly
half of healthcare provider respondents (45%) said ransomware attacks increased
complications from medical procedures, according to a new study from the
Ponemon Institute. That's up from 36% in 2021.
WHY IT
MATTERS
For
the report, "The impact of ransomware on patient safety and the value of
cybersecurity benchmarking," which was sponsored by Censinet,
Ponemon researchers surveyed 579 healthcare IT professionals at
healthcare-delivery organizations in the fourth quarter of 2022 in order to
understand how ransomware continues to impact patient care, and to determine
the value of cybersecurity benchmarking in reducing impacts.
Like
the first study, "The impact of ransomware on healthcare
during COVID-19 and beyond," Ponemon found that more than one in five
respondents indicated that ransomware attacks had an adverse impact on patient
mortality rates.
The
most prevalent impact identified was an increase in patients transferred or
diverted to other facilities, reported by 70% of those surveyed, up from 65% in
the previous study.
More
organizations experienced ransomware attacks, with an increasing number caused
by poor cybersecurity controls and third-party technology vulnerabilities – and
more of these organizations are paying the ransom.
Remote
healthcare certainly has gained traction via the pandemic. As a result, some
healthcare information security experts contend a unified endpoint management
system has become a top priority for provider organizations conducting
telehealth.
Remote
healthcare facilities can be a breeding ground for security breaches, which can
pose a tremendous threat – especially if sensitive patient information is
exposed. Additionally, with healthcare taking a digital shift, tablets and
smartphones have become accessories to enable better and faster patient care.
This
means an increased dependence on technology and a resulting IT overload, said
Apu Pavithran, CEO and founder of Hexnode, vendor of a unified endpoint
management (UEM) platform housed by Mitsogo.
Healthcare
IT News sat down with Pavithran to discuss the digital shift in
healthcare and what that means for security, why CISOs and CIOs should
prioritize endpoint management, what a UEM strategy looks like and why CISOs
and CIOs should consider one, and more.
One
of the biggest pieces of legislation to hit healthcare IT since the HITECH Act
is the 21st Century Cures Act. While it doesn’t have the same stimulus
money as the HITECH Act, it’s possible that it will have even more impact on
healthcare organizations and patients. This is particularly true when it
comes to sharing health information between healthcare organizations and with
patients.
To
better understand everything that’s happening with the 21st Century Cures Act
and how it will impact healthcare organizations, I sat down with Micky
Tripathi, National Coordinator for Health IT at HHS. I start off by
asking Tripathi to share how he sees the state of electronic health information
sharing and interoperability today. Then, I ask him where he sees the
21st Century Cures Act making an impact for good on patients and clinicians and
what other things they can expect to impact them as the regulation takes
effect.
I
also ask Tripathi what he thinks is the most misunderstood part of the 21st
Century Cures Act. Plus, he highlights what areas of the Cures Act are
going to be the hardest for healthcare organizations to implement.
I
couldn’t resist asking him about TEFCA and QHINs as well which seem to be the
hottest healthcare interoperability topic right now. Needless to say, he
sees a lot of promise and potential with what’s happening with these two
important efforts. Finally, I ask him to share his overarching vision for
ONC.
Recalls of
home-based medical devices and defective single-use devices are the top two
concerns on the Pennsylvania-based non-profit's top 10 technology hazards for
2023.
KEY TAKEAWAYS
·For 16 years, ECRI has listed the top 10 technology
hazards in the healthcare space, highlighting issues that can affect care
delivery and even harm patients.
·This year's list highlights the growth of
home-based and patient-centered healthcare, with recalls of home-based devices
and a large number of defective single-use products coming in first and second.
·The organization is urging healthcare
organizations to be diligent in emphasizing safety protocols and asking
the medical device to do a better job with device manufacture and safety
requirements.
The growing
popularity of smart home technology and home-based healthcare, including remote
patient monitoring programs, means there are more medical devices in the home
to oversee, either by the care team or the patent. That could lead to problems
if the devices aren't working.
The challenge
of identifying recalls for at-home medical devices tops the Top 10 Technology Hazards for 2023, an annual report issued
by ECRI, a
Pennsylvania-based non-profit focused on safety, quality, and
cost-effectiveness in healthcare. Now in its 16th year, the report highlights
the problems associated with healthcare technology, and spots trends in care
delivery that might be catching both providers and patients by surprise.
With at-home
medical devices, ECRI notes that patients using those devices at home might be
the last to hear of a recall, and they might not understand what the recall
means or how the address one.
January 18,
2023 - DirectTrust, a non-profit healthcare industry alliance created to
support secure, identity-verified electronic exchanges of protected health
information, has released
the TNAP version 2.0 criteria for TEFCA participants.
The
TNAP-Participant program version 2.0 criteria is available for public comment
through March 20, 2023. The Trusted Network Accreditation Program (TNAP)
provides third-party accreditation for healthcare exchange entities such as
qualified health information networks (QHINs), participants, health
information exchanges (HIEs), accountable care organizations, and data
registries.
The
Electronic Healthcare Network Accreditation Commission (EHNAC) governs
DirectTrust's accreditation and certification programs.
Stakeholders
revised the TNAP-Participant accreditation program to address the
Trusted Exchange Framework and Common Agreement (TEFCA) Recognized
Coordinating Entity (RCE) requirements that Participants and Subparticipants
must meet to participate with a QHIN. TEFCA aims to establish a floor of
universal interoperability across the country through a network of QHINs.
AI Education Needed to Prepare Medical Students for Clinical Practice
Researchers
argue that artificial intelligence must be taught “as a fundamental toolset of
medicine” for medical students to be successful when they begin to practice.
January 18,
2023 - In a recent commentary
published in Cell Reports Medicine, University of Michigan researchers argued
that the lack of education on healthcare artificial intelligence (AI) in
medical school leaves students underprepared for future clinical practice.
The
researchers stated that AI is transforming the practice of medicine and
becoming ubiquitous in clinical care with the advent of AI-based systems
assessing chest radiographs, pathology slides, and early warning systems
embedded in EHRs. However, they noted that medical students have minimal
exposure to these technologies and the concepts needed to effectively evaluate
them.
This leaves
students underprepared for future clinical practice in a world where healthcare
AI is becoming increasingly common. The authors argued that remedying this
requires educators to bolster undergraduate medical education (UME) on the
topic of AI.
Specifically,
the authors proposed that medical educators should treat AI as a critical
component of medical practice to be introduced early and integrated with the
other core components of medical school curricula. By equipping graduating
medical students with this knowledge, educators will help ensure that students
possess the skills to solve challenges at the intersection of AI and medicine,
they stated.
How Healthcare Cybersecurity Benchmarking Can Help Sector Enhance Security
Efforts
Healthcare
cybersecurity benchmarking can help health IT experts establish cybersecurity
program goals and improve decision-making, a new survey from Censinet and
Ponemon Institute suggests.
January 18,
2023 - Healthcare cybersecurity benchmarking data can help health IT
experts make data-driven decisions, evaluate program effectiveness, and improve
their organization’s overall security posture, a new report
commissioned by Censinet and conducted by Ponemon Institute suggested.
Ponemon
Institute surveyed 579 IT and IT security professionals at healthcare
organizations, asking them a series of questions about the value of
cybersecurity benchmarking and their experiences with ransomware attacks.
As ransomware
increasingly becomes recognized as a patient safety issue, healthcare
organizations need to make informed, risk-based security decisions more than
ever. The report suggests that peer benchmarking is a key step toward helping
the sector mitigate risk effectively.
Ransomware
is a Patient Safety Issue
Nearly half
of respondents reported experiencing a ransomware attack in the past two years.
The survey results supported existing data that show an increase
in third-party data breaches and ransomware attacks, as well as a hike in
ransomware payment demands.
January 2023 takes a deep dive into federal health and IT policy and
features insights from National Coordinator Micky Tripathi, a recap on the
evolution of the ONC, and a look into the future of interoperability.
Jan 17 2023
From the
Editor:
For nearly
two decades, the Office of the National Coordinator for Health Information
Technology has been moving the health industry to digitize health records and
demonstrate a baseline of capabilities with information systems.
Now, the
federal agency is embarking on new initiatives that seek to help the industry
achieve benefits from information technology, facilitate the exchange of health
information to improve patient care, and support health-related initiatives of
other federal agencies.
This series
of articles, based in part on an in-depth interview with Micky Tripathi and
Steve Posnack of ONC, aims to give the industry insight into ONC’s current and
future role, and can help organizations better understand the arc of emerging
federal policy.
Key Takeaways
As
you dive into this COVERstory, we hope you find it becomes a reference helping
you:
1. Gain a historical perspective of how the
ONC is responding to the current state of federal regulations and its
growing authority.
2. Understand the coming attractions driving
the ONC to become more proactive and aligned with the industry and other
federal agencies.
3. Place within historical context the
reasoning behind federal incentives and how this ties into the current
state of interoperability and the new TEFCA initiative.
4. Connect the dots between the many acronyms
and acts that have been created over the last decade. 21st Century Cures,
TEFCA, MU/Promoting Interoperability, FHIR, USCDI, and many more.
5. Understand how key leaders perceive the
current alignment between the ONC and the industry.
6. Learn some approaches that will help your
organization better anticipate and respond to the ever-evolving landscape
of federal regulations.
The
41st annual J. P. Morgan Healthcare Conference came to a close Thursday in San
Francisco, the first in-person event after three years.
It
was a week packed with rainstorms, meetings, presentations and long lines for
elevators and coffee.
On
the healthcare side, the biggest news might have been the weather,
with intense downpours, hail and lightning.
Many
executives attending JPM last week noted it was relatively quiet, from a news
perspective, with the exception of CVS Health. The retail drugstore giant
backed three funding rounds: Carbon Health's $100 million series D, $25 million
for Array Behavioral Care and Monogram Health's hefty $375 million round. And
there were rumors about a potential $10 billion deal to buy Medicare-focused
primary care player Oak Street Health.
What
you didn't hear at JPM was the typical buzz around new fundraising (except
Carbon Health) and big M&A deals. The relative quiet reflects the current
down market, many JPM attendees told Fierce Healthcare, as venture capital
dollars are harder to come by and many startups are taking a back-to-basics
approach.
Ali
Parsa, CEO and founder of Babylon,
an AI and digital health platform, says discharge planning doesn’t require
“massive amounts of technology” or “rocket science”; just good planning from
the beginning of the stay. Indeed, one research study
(suggested to me by Dr. Geoffrey Rutledge, Chief Medical Officer and co-founder
of HealthTap) achieved a significant
time saving through low-tech measures such as checklists.
Other
respondents, however, reported that their solutions were making a difference in
discharges.
Weaknesses
of Current Technology
With
modern databases, it’s ridiculous for many care managers to be checking the
availability and services of nursing facilities manually. They should be able
to draw up a list of suitable facilities quickly and transfer data from the
patient’s electronic record to a corresponding record at the chosen facility.
And why can’t patients and caregivers have instant access to pictures, CMS
ratings, and other information about the facility they’re considering?
Using
smartphones as diagnostic tools is a work in progress.
KEY
TAKEAWAYS
·Although doctors and their patients have found
some real-world success in deploying the phone as a medical device, the overall
potential remains unfulfilled and uncertain.
·Smartphones can help assess people for
concussions, watch for afib, and conduct mental health wellness checks, to name
the uses of a few nascent applications.
·Companies are tapping into modern phones'
built-in cameras and light sensors; microphones; accelerometers, which detect
body movements; gyroscopes; and even speakers.
·The apps use AI software to analyze the collected
sights and sounds to create an easy connection between patients and physicians.
·Earning potential and marketability are
evidenced by the more than 350,000 digital health products available in app
stores.
By Hannah
Norman
The same
devices used to take selfies and type out tweets are being repurposed and
commercialized for quick access to information needed for monitoring a
patient's health. A fingertip pressed against a phone's camera lens can measure
a heart rate. The microphone, kept by the bedside, can screen for sleep apnea.
Even the speaker is being tapped, to monitor breathing using sonar technology.
In the best
of this new world, the data is conveyed remotely to a medical professional for
the convenience and comfort of the patient or, in some cases, to support a
clinician without the need for costly hardware.
COVID-19 Sparks Health IT Market Growth in Telehealth EHR Integrations
Telehealth
EHR integrations were twice as likely to contain specialized capabilities for
COVID-19 response compared to all apps listed in EHR app galleries.
January 17,
2023 - The health IT market experienced a rapid increase in telehealth EHR
integrations following the onset of the COVID-19 pandemic in March 2020,
according to a study
published in AJMC.
Researchers
collected data from Boston Children’s Hospital’s SMART (or Substitutable
Medical Apps and Reusable Technologies) and four EHR vendors’ public app
galleries: Allscripts, Athenahealth, Cerner Corporation, and
Epic Systems Corporation.
The number of
telehealth-related apps doubled from pre-pandemic levels to 87 apps by June
2021. Compared with all apps listed in the EHR
app galleries, these apps were two times more likely to contain specialized
capabilities for COVID-19 response, such as secure messaging, vaccine
administration, and laboratory testing.
HHS
temporarily issued several measures to make it easier for patients to receive
care through telehealth during the COVID-19 public health emergency. For
instance, HHS gave healthcare providers and patients the flexibility to use
video communication apps that did not comply with Health Insurance Portability and
Accountability Act (HIPAA) regulations for telehealth purposes.
January 17,
2023 - ONC has released
the Draft United States Core Data for Interoperability (USCDI) Version 4, which
proposes to add 20 data elements across a new data class and eight existing
data classes.
The new data
class is “Facility Information,” which includes the data elements facility
identifier, facility type, and facility name.
If finalized,
USCDI
v4 would have 112 data elements organized in 19 data classes.
The v4
submission cycle ended on September 30, 2022. ONC received approximately 150
submissions for new data elements and almost 350 comments on previously
submitted data elements. ONC applied prioritization criteria discussed in
Standards Bulletin 2022-2 to develop the final list of proposed new data
elements for Draft USCDI v4.
CISA Reflects on Past Year, Upcoming Critical Infrastructure Security
Priorities
CISA’s
2022 Year in Review outlines the four-year-old agency’s top accomplishments of
the past year and hints at upcoming critical infrastructure security
priorities.
January 17,
2023 - The Cybersecurity and Infrastructure Security Agency (CISA) released its 2022 Year in
Review, in which the agency reflected on what it accomplished in 2022 and what
it hopes to achieve in 2023.
The
four-year-old agency was established to lead the United States’ efforts to
protect its 16 critical infrastructure sectors from relentless cyber threats
through public-private partnerships as well as the creation of useful cyber
resources and tools.
“Protecting
our nation’s critical infrastructure is foundational to our national security.
That critical infrastructure includes everything from healthcare, water, and
education to chemical, transportation systems, telecommunications, energy, and
much more,” the Year in Review document stated.
KOLOA,
Hawaii — Specialists are responsible for protecting their practices from cyber
attacks and should not rely solely on standard cyber security measures,
according to a presentation at Hawaiian Eye 2023.
To
help practice owners become more prepared for potential cyber security issues, Renee
Bovelle, MD, debunked myths surrounding how practices should approach protecting themselves, which
included combatting an overreliance on cybersecurity insurance as well as the
incorrect assumption that third party electronic health record vendors are
responsible for making their products compliant with HIPAA privacy and security
rules.
“You
may say, ‘I have a cybersecurity policy, so I don't have to worry if anything
happens.’ Well, that is not the case,” she said.
Cyber
security companies want their clients to have methods in place to prevent any
breaches in cybersecurity; if practice owners cannot show evidence that they
have met their cyber insurance company’s policies, their claims may be
rejected, according to Bovelle.
Dr.
David Shulkin has had a decades-long career in healthcare, from working at
the higher echelons of the private healthcare sector to being appointed by
President Barack Obama as undersecretary for health at the U.S. Department of
Veterans Affairs in 2015. Two years later, Shulkin was confirmed as the ninth
secretary of the Department of Veterans Affairs under President Donald
Trump.
Shulkin
spoke with MobiHealthNews
about how the healthcare industry has changed throughout his career and how
he's using lessons from his time in public service to develop his chronic pain
management startup Override.
MobiHealthNews:
What kind of changes have you seen within the healthcare industry over the
course of your career?
Dr.
David Shulkin: Wow. Well, that's a big question. Mostly what
I've seen is a transition from when there was complete professional autonomy,
where the provider used to be the one that would control what was happening.
That meant the provider would determine the price, the provider would give the
advice and expect people to follow it, and the provider really was able to
determine the course of treatment.
Anyone
who has had the misfortune to land in the hospital, or care for a relative in
one, knows the following frustrating experience: The doctor comes during
morning rounds and says the patient is good to go…and hours later, you’re still
waiting for the paperwork to get done.
I
decided to unpack this experience. During conversations with about 20 experts,
I learned about the complex plans that go into the simple act of getting a
patient out of the hospital. This article discusses some organizational and
workflow measures that hospitals are taking to shorten discharge times, saving
money along the way. A subsequent article will chime in with some technologies
that help.
Factors
Delaying Discharges
Where
to begin? So many hospital activities were cited by respondents to my question
that I can hope at best to summarize the most salient of them. I’ll run through
the observations quickly in order to get to solutions, which boil down to
“Think about what you’re doing.”
First,
according to Donna Pritchard and Joy Avery of CipherHealth,
a company with a communications platform for healthcare, discharge may take
time because a lot of important procedures lie between the doctor’s
proclamation and the actual discharge. The patient might need some physical
therapy, more tests to prove they are free of disease, a dose of antibiotics,
etc. Lisa Weber, Director, Healthcare Industry Practice at UiPath—a company that automates elements of
the workflow in healthcare and other industries—offers a partial list of people
who participate in discharging the patient: the patient themselves, patient
caregivers, charge nurse, doctor, therapists, and care manager.
Electronic
Health Records (EHRs) are the central technology pillar for healthcare
organizations. EHRs are vital to both clinical and administrative operations.
Because of that, we wanted to dedicate an entire article to where EHRs are
headed in 2023.
What is your prediction for the
EHR market in 2023?
Here
are their responses.
MEDITECH – Leah Farina, Vice
President of Client Services and Carol Labadini, Vice President of
Meditech-as-a-Service
In
2023 our MEDITECH acute care users can expect more focus on EHR optimization.
As organizations continue to deal with workforce challenges, they are looking
to their technology partners to help ease the burden on staff. This means
optimizing the EHR so that it fits more seamlessly into their daily routines
and helping customers take advantage of underutilized technologies like
surveillance-based toolkits as well as patient portals.
Our
ambulatory users can expect more functionality for specialty clinics, like
infusion clinics, dialysis, and pain management in 2023. We are also planning
to continue enhance our Expanse Now mobile physician app which allows
clinicians to practice more efficiently.
The two
are joining forces to create analytical technology that would help digital
health studies attract a more diverse and representative patient population.
KEY
TAKEAWAYS
·Racial and ethinc minorities account for 28% of
the US population but only 6% of clinical trial participants.
·Digital health programs are often developed to
improve access to care for underserved populations, but they struggle to
overcome social determinants of health and other non-clinical factors that
hinder access to care.
·Duke University's BIG IDEAs Lab and Evidation
will develop technology that would allow these programs to identify and track
study participation, adherence, and retention across racial and demographic
lines.
Duke
University is joining forces with a California-based digital health firm to
develop technology to measure health equity in clinical studies.
The North
Carolina university's BIG IDEAs Lab is partnering with Evidation to create
"an analytic structure to better predict study participation, adherence,
and retention across racial and demographic lines," according to a press release.
While the
COVID-19 pandemic saw a huge increase in the use of telehealth and digital
health to boost access to care for underserved populations, it also trained the
spotlight on social determinants of health and other barriers to care
experienced by those groups.
Increasing
the number of telehealth visits for cancer patients could reduce the financial
toxicity of oncology services.
KEY
TAKEAWAYS
·Based on two cost models for telehealth visits,
the mean total saving in indirect costs ranged from $147.4 to $186.1 per visit.
·For more than 11,000 cancer patients in the
study, about 3,790,000 roundtrip miles were avoided, which generated more than
75,000 hours of savings in total driving time.
·The mean driving cost savings per telehealth
visit ranged from $83.2 at $0.56 per mile of travel to $122.0 at $0.82 per mile
of travel.
Telehealth
visits generate significant cost savings for adult cancer patients younger than
65, according to a new research article.
Cancer is
among the most expensive medical conditions to treat in the United States,
according to the National Cancer Institute (NCI). Direct costs include
multiple types of treatments such as surgery, chemotherapy, and radiation
therapy. Indirect costs include travel expenses and lost employment
productivity for clinical visits.
The new
research article, which was published by JAMA Network Open, examines indirect
cost savings for more than 11,000 patients with more than 25,000 telehealth
visits at Moffitt Cancer Center, the only NCI-designated Comprehensive Cancer
Center in Florida. The telehealth visits were conducted from April 1, 2020, to
June 30, 2021.
Senior HSE exec says he was ‘absolutely horrified’ by hospital
overcrowding as he resigns
Professor
Martin Curley said the HSE is not fit for purpose
Eoghan
Moloney
January 16
2023 04:41 PM
The
HSE’s head of digital transformation, Professor Martin Curley, has resigned,
saying that administrators being so resistant to change, that would have
reduced hospitalisations and improved patient outcomes, was a “big part” of his
decision to leave.
Prof
Curley said he was “horrified” by the overcrowding seen in Irish hospitals in
recent weeks and said technologies are available to ease this, but there must
be a “concerted effort to scale them” across the health service.
Asked
on RTÉ’s Drivetime programme whether the HSE is fit for purpose, Martin said:
“I’ll be very honest, no it’s not”.
He
said that working with the HSE has been “difficult and the system has been very
slow to respond”.
“The
HSE is not the solution, the HSE is the problem. There are a lot of things
going right in Ireland...but we’re really challenged in our healthcare system.”
Reduction in EHR Inbox Notifications Not Enough to Cut Clinician Burnout
Collaboration
between health system leaders and primary care providers is necessary to
address clinician burnout brought on by EHR inbox notifications.
January 16,
2023 - Reducing EHR inbox notifications in the primary care setting did
not have a measurable effect on clinician burnout, according to a study
published in AJMC.
In 2017, the
Veterans Health Administration (VHA) led an initiative to reduce low-value EHR
inbox notifications. Each facility formatted its EHR to include a mandatory set
of notifications based on VHA and facility priorities and trained PCPs in EHR
customization of optional notifications.
Researchers
estimated the share of PCPs experiencing clinician burnout using VHA All
Employee Survey responses before and after the initiative in 2016 and 2018. The
study aggregated survey responses from 6,459 PCPs at 138 VHA facilities.
The VHA
initiative resulted in increases and decreases in notification volumes for
PCPs. In both instances, there was not a measurable impact
on clinician burnout.
Ransomware Operators Continue to Aggressively Target US Healthcare Sector
HC3’s
latest brief highlights the tactics and capabilities of Royal ransomware and
BlackCat ransomware, two groups that are known to target the healthcare sector.
January 16,
2023 - The Health Sector Cybersecurity Coordination Center’s (HC3) latest brief
outlines the tactics and exploitation techniques used by Royal ransomware and
BlackCat ransomware, two threats that ransomware operators have been using to
aggressively target the US healthcare sector.
HC3 has
previously warned the sector about both Royal
and BlackCat
in previous briefs and analyst notes, but its latest brief dives into more
detail regarding their past activity and impact on the healthcare sector.
ROYAL
RANSOMWARE
HC3 described
Royal ransomware as a “relatively new, but highly capable” threat to the
healthcare sector. First observed in 2022, Royal is the ransomware of choice
for some experienced operators, including those who previously took part in
Conti ransomware operations.
oyal is
written in C++ and targets Windows systems. Notable attacks for the group
include an attack against Silverstone Circuit, a popular racing circuit in the
UK, and one against an unnamed US telecom organization in December 2022. The
December attack resulted in compromised employee passports and driver’s
licenses.
Artificial intelligence interprets your medical record
The system will automatically propose condition codes for patients'
discharge summaries.
HasseBerntsenCommunications
AdviserPresentedby:Norwegian centre for E-health
research
monday 16. January 2023 - 04:30
Healthcare
professionals have to deal with an international system with over 30,000 codes
for various diseases. It is easy to make mistakes. Researchers are now
developing a computer program so that practitioners can be assisted by
artificial intelligence.
Because in
the healthcare system, a lot of manual and time-consuming work takes place to
document a patient's care.
After each
patient contact, the practitioner must write a discharge summary and record one
or more condition codes that describe the type of examination or treatment the
patient has received.
A discharge
summary is a written summary of the examination or treatment of a patient,
based on medical records.
This is the second time in 12 months that protestors unsuccessfully raised
conflict-of-interest allegations against Booz Allen over a large Veterans
Affairs win.
The
Government Accountability Office’s decision on Tuesday to deny a pair of
protests has cleared the way for Booz Allen Hamilton to continue its role
supporting the Veterans Affairs’ electronic health record modernization
project.
In
September 2022, Booz Allen won the $860 million task order that extends
its work for another five years as program manager for the VA’s massive
program to implement Cerner's electronic health record. The company first won
that role in 2017 through a $750 million task order awarded in 2017.
The
VA competed both orders through its Transformation Twenty-One Technology
Next Generation vehicle known as T4NG.
