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."

Saturday, July 09, 2016

Weekly Overseas Health IT Links – 9th July, 2016.

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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‘Medicalized’ smartphones to put health data in hands of patients

Published July 01 2016, 6:42am EDT
The world is on the verge of a fourth industrial revolution, characterized by artificial intelligence, robots, big data, and deep learning and analytics, but medicine is still stuck at the beginning of the third industrial revolution, which has already brought digital capabilities to billions of people worldwide.
That’s the contention of Eric Topol, MD, director of the Scripps Translational Science Institute and chief academic officer of Scripps Health in La Jolla, Calif., who says that the digital revolution has been occurring since the middle of the last century. Even so, the healthcare industry continues to only minimally leverage information technology.
However, Topol, a practicing cardiologist at Scripps Health and author of The Patient Will See You Now: The Future of Medicine is in Your Hands, sees mobile devices as the technological enabler for the “democratization” of medicine by giving patients control of their own health data, which has historically been the exclusive domain of doctors.
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Mobile ransomware jumps, blocking access to phones

Kaspersky Lab has detected a spike among its own Android users

IDG News Service | Jun 29, 2016 1:48 PM PT
The number of users infected with mobile ransomware is skyrocketing, as hackers try to expand the number of potential victims they can target.
Compared with a year ago, almost four times as many users are being attacked by mobile ransomware, security firm Kaspersky Lab said on Wednesday.
Enterprise mobile management suites are adding app- and content-management features to the roster of
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HIT Think Why interoperability is essential for population health success

Published June 29 2016, 4:07pm EDT
Delivering high-quality healthcare and improving overall outcomes, while simultaneously containing the rising costs of doing so, is a major challenge of the U.S. healthcare system.
Electronic medical records (EMR), health information exchanges (HIE) and patient portals provide valuable methodologies to providers; however, the problems and challenges of those systems have been widely reported. As the value-based model of healthcare continues to gain acceptance among providers and payers, population health management is becoming the future of healthcare delivery.
Population health management provides the methodologies for providers and payers to contain and lower their costs, which increases operational efficiencies. With a system that spends almost 50 percent more on healthcare than the next highest-income country, yet has some of the worst health outcomes than any other developed nation, providers must be able to streamline care and improve treatment outcomes. In order to successfully transition to this broader, holistic approach, the integration of interoperability is crucial.
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eRedbook linked up to screening data

Ben Heather
28 June 2016
Parents in London are being invited to register to use the eRedbook personal child health record.
In an update on its website, Sitekit, the Scottish company that developed the digital alternative to the familiar ‘Redbook’, said Central London Community Healthcare has become the first in the capital to invite parents to register.
Parents in Barnet, Hammersmith and Fulham, Kensington and Chelsea, and Westminster who want to use the record have to record some key details on the site, sign up for a Microsoft HealthVault account, and then confirm their details with a health visitor to gain access.
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Brexit: What it could mean for digital health

Ben Heather
24 June 2016
The people have voted and it’s unlikely to be good news for either the NHS’s finance or efforts to give it a digital makeover.
Even before the United Kingdom voted to leave Europe on Thursday, the financial clouds were gathering for the NHS and, consequentially, Health IT projects around the country.
Quentin Cole, health industries lead partner at PwC, was among the first out of the block predicting added pain for the NHS.
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3 tips for defending patient information from hacker attacks

by Matt Kuhrt |
Jun 30, 2016 10:50am
Physicians typically have access to sensitive personal information on large numbers of patients, which makes their devices prime targets for hackers looking to steal that information, writes Paul Cerrato in Medscape.
News that a hacker acquired personal information on nearly 10 million patients and put it up for sale online indicates a worrisome shift from ransomware attacks on hospitals targeting access to personal information, as our sister publication, FierceHealthIT, recently reported. Doctors with lax information security practices expose themselves to Health Insurance Portability and Accountability Act violations and large fines, in addition to putting their patients’ information at risk, Cerrato says.
Doctors can protect sensitive patient information, as well as their own reputations, by sticking to some common-sense guidelines.
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Editor's Corner: Physician EHRs are stuck in a time warp

Jun 30, 2016 10:07am
Last week, I lamented that there’s little progress when it comes to government rulemaking--that the government appears stuck, proposing many of the same requirements for the electronic clinical quality measures (eCQMs) in the new Inpatient Prospective Payment System that it proposed for the Meaningful Use program, even though some of them didn’t work and in some cases changed.
But it’s not only the government stuck in neutral. The private sector seems just as stuck on its own merry-go-round when it comes to electronic health records.
First, there’s a new study about EHR workarounds, which found them to be “common.” Physicians are still resorting paper crutches, such as sticky notes and faxes, in order to help them in their practices, even though they run the risk of inaccuracies and creating barriers to tracking information. For example, doctors are using paper memory aids because they can’t go back and find test result information in the EHR once it’s been reviewed; the massive number of intrusive alerts still creates an inefficient overload.
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Lessons from the MedStar Health ransomware attack

Jun 30, 2016 10:09am
The ransomware attack that paralyzed MedStar Health computer systems in March taught some painful lessons, according to Craig DeAtley, the organization's director of emergency management.
In a recent interview, DeAtley explains to The Exchange--the newsletter from the Assistant Secretary for Preparedness and Response (ASPR) and the Healthcare Emergency Preparedness Information Gateway (TRACIE)--that the Columbia, Maryland-based health system was caught off guard by the speed in which most of its systems were compromised and locked down.
“We were practiced at individual workarounds, but we had never really rehearsed losing everything, much less all at once,” he says.
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Why a new defense strategy is needed to stop ransomware

Published June 30 2016, 3:52pm EDT
In February, the nation witnessed one of the most high-profile ransomware attacks in history, which led a major U.S. hospital to pay a $17,000 ransom to the hackers who seized control of the hospital’s computer system.
This wasn’t an isolated incident. Many more hospitals were infected by ransomware throughout the first half of the year, and even more are likely to be hit in the next six months.
Unlike most forms of malware, ransomware almost immediately encrypts all of the victim’s files as soon as it gains access to a system. Even the smallest vulnerability can result in total encryption and loss. This drastic effectiveness, paired with the low cost to entry for criminals to adopt ransomware-based attacks, means that unless an organization changes its approach to security, it’s only a matter of time until all its files are rendered inaccessible.
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IBM’s Watson to work with VA on Vice President Biden's Cancer Moonshot

The effort will help doctors boost access to precision medicine for 10,000 VA veterans with cancer.
June 29, 2016 09:14 AM
The Department of Veterans Affairs and IBM Watson Health today launched a public-private partnership to provide veterans with cancer a better shot at recovery.
IBM announced the initiative at Vice President Joe Biden’s National Cancer Moonshot Summit today,
IBM Watson Health will help doctors expand access to precision medicine over the next two years for 10,000 American veterans.
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Clinical IT not ready for precision medicine

Jeff Rowe
Jun 27, 2016
Precision medicine has been a frequent topic of conversation among healthcare stakeholders and policymakers for quite some time, but the underlying reality is that, from the standpoint of IT infrastructure, healthcare organizations still aren’t up to the challenge.
That’s according to Nephi Walton, biomedical informaticist and genetics fellow at Washington University School of Medicine, who spoke recently at the HIMSS Big Data and Healthcare Analytics Forum in San Francisco. "We're really not in near as good a position as we should be to take advantage of the data that's here right now," he said. “Our technology to produce data from genetic medicine is far more advanced than our ability to use it in a clinical environment. Our IT infrastructure is grossly inadequate to meet the demands of precision medicine today.”
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Data drives historic fraud takedown

Jun 28, 2016 9:30am
For years, authorities had been chasing Aleksandr Pikus, who was charged with orchestrating a kickback scheme in New York involving more than $86 million in false claims submitted to Medicare, according to Marketplace. But over the last several years, investigators were able to build a better case against Pikus using real-time billing data.
“In the past, when we didn’t have the kind of computing capability that we do now. Trying to determine a national scope, could take weeks, months, sometimes even years,” Ann Maxwell, assistant inspector general at the Department of Health and Human Services (HHS) Office of Inspector General (OIG) told Marketplace. “Now we are talking about a couple of hours.”
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David Blumenthal: Data ownership at the heart of healthcare evolution

Jun 29, 2016 12:00pm
Freeing patients’ data to move with them remains one of the biggest obstacles in the healthcare information revolution, writes Commonwealth Fund President David Blumenthal in an article in The Wall Street Journal.
Doctors and hospitals have legitimate reasons to be unwilling to share data, writes Blumenthal, the former National Coordinator for Health IT. After all, if a patient’s records can go elsewhere, the patient’s business can, too.
But questions remain about who actually owns that data. One solution, he says, would be to put patients in charge of their own data so they can decide who has access to it and when. Patients could designate particular doctors or facilities that should have access, as well as certain family members or caretakers. They could decide whether to provide it to researchers or public health authorities.
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Healthcare hacks continue to evolve

by Dan Bowman |
Jun 29, 2016 1:48pm
News Tuesday that a hacker is selling 9.3 million patient records on the dark web illustrates an evolution in the modus operandi of data thieves and other cybercriminals.
In 2015, nearly 100 million records from four health insurers--Anthem, Excellus BlueCross BlueShield, Premera Blue Cross and CareFirst BlueCross BlueShield--were stolen by hackers.
Then came a shift. 
This year, ransom for control of IT systems took center stage. Several hospitals have been hit, including California-based Hollywood Presbyterian Medical Center, Chino Valley Medical center and Desert Valley Hospital, MedStar Health in Maryland and Titus Regional Medical Center in Texas.
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Most organizations unprepared for data theft by employees

Published June 27 2016, 3:26pm EDT
As organizations spend billions of dollars a year trying to protect their data from hacking, they face another threat closer to home—data theft by their own employees.
That’s one of the findings in a survey published by management consultant Accenture and HfS Research on Monday.
Of 208 organizations surveyed, 69 percent “experienced an attempted or realized data theft or corruption by corporate insiders” over the past 12 months, the survey found, compared with 57 percent that experienced similar risks from external sources. Media and technology firms, and enterprises in the Asia-Pacific region reported the highest rates—77 percent and 80 percent, respectively.
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AMDIS Award-winner on Data Security and MACRA

Scott Mace, June 28, 2016

Medstar Health's Peter Basch, MD, says the March data breach that crippled its systems and sparked an FBI investigation, "helped us as an organization to be more prepared for the next time."

Each year, the Association of Medical Directors of Information Systems (AMDIS) recognizes outstanding achievements in the field of applied medical informatics.
This year's individual winner, announced last week at AMDIS' 25th Annual Physician-Computer Connection Symposium, is Peter Basch, MD, senior director for IT quality and safety, research and national health IT policy at Medstar Health in Washington D.C.
In an interview, Basch discussed MACRA, EHRs, and life in the data breach era. The transcript below has been lightly edited.
HealthLeaders: With all the changes in medicine and technology, are you optimistic or pessimistic right now? It's a crunch year.
Basch: Part of being a doctor, and I am a practicing doctor, is to bring cautious optimism into everything we do, whether it's for the patient who is fearful, or whether it's with a patient who might have a serious illness.
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Low-cost technology may improve rehab for stroke victims

Published June 24 2016, 6:38am EDT
New technology being developed at the Tandon School of Engineering at New York University is designed to help stroke victims more quickly regain lost motor skills compared with conventional therapies.
The technology, projected to cost $1,000 for each unit, can be placed in patient homes, negating the need for frequent trips to a hospital or clinic for rehabilitation.
The project uses “mechatronic devices,” which is a marriage of mechanical and electrical engineering disciplines to make smart products with embedded intelligence, says Vikram Kapila, a professor of mechanical and aerospace engineering at NYU’s Tandon School of Engineering. An example of such devices is airbags in a car, he explains. Sensors detect a crash, and the bags deploy.
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IBM Watson, X Prize team up to offer a $5 million artificial intelligence challenge

X Prize CEO Marcus Shingles said the idea is to use AI to solve the world’s hardest challenges, including those in healthcare.  
June 24, 2016 03:06 PM
IBM Watson joined forces with the X Prize Foundation to launch an open $5 million challenge to build an artificial intelligence app for healthcare that could also be used in other industries, including education, energy, the environment, global development or even exploration.
“In the coming decade, as X Prize strives to achieve its impact mission through incentive competitions and crowd-sourcing, we see tremendous opportunity in this emerging generation of problem solvers to use AI to solve humanity’s grandest challenges," X Prize CEO Marcus Shingles said in a statement. "The IBM Watson AI X Prize is intended to promote and progress the notion of ‘AI for impact’ among the global bold innovator crowd, both the established community of practitioners, as well as encourage newcomers to experiment and ultimately demonstrate how AI can be used as a tool for good.”
Unlike previous X Prizes, including the Tricorder X Prize, in which companies are vying to develop a handheld medical scanner, and the original Ansari X Prize for suborbital flight, this contest allows the participants to define their own goals and to focus on solving different problems.
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Paper workarounds still 'common' for EHR users

Jun 27, 2016 10:33am
Physicians using electronic health records still resort to the paper workarounds, according to a study published recently in Applied Clinical Informatics.
EHRs can improve patient care, but they still suffer from design problems causing physicians to compensate by using workarounds, which can cause inaccuracies and make it much harder to track information. The researchers examined data from 2,554 primary care physicians in the Department of Veterans Affairs system and reviewed workarounds in test results management.
They found that 43 percent of the respondents used workarounds to follow up on test results. Of those, 70 percent used paper-based workarounds such as sticky notes, faxes and paper lists. More than 22 percent used a combination of paper and electronic methods, such as e-calendars, to follow up.
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Healthcare workers choose efficiency over password security

Jun 27, 2016 10:58am
In an era of increased anxiety over the security of healthcare data, hospitals don’t guard passwords nearly as closely as they should, according to a new study from the University of Pennsylvania.
Despite the sensitive information housed in hospital systems, researchers, led by Ross Koppel, found that hospital employees often write passwords on sticky notes and keypad-protected doors, share passwords, and use computers without logging out to make things more convenient for whoever uses them next. Not only do such workarounds typically go unpunished, they’re rarely acknowledged at all, according to the report.
While hospital workers understand the importance of data security, it often isn’t practical to go through the full security process in a setting where time may make the difference between life and death. However, some also believe that lack of data security adversely affects innovation within healthcare.
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How to Prevent a Heart Attack: Text Patients on Healthy Habits

Study finds messages from care providers help patients improve their health and change routines

By Lisa Ward
June 26, 2016 10:01 p.m. ET
A recent study has found evidence suggesting text messages could reduce one’s odds of a second heart attack.
A six-month clinical trial in Australia found that patients recovering from a heart attack were more likely to maintain lower blood pressure, less body fat and lower cholesterol levels than a control group when the patients received text messages asking and giving suggestions about their health routines. Patients receiving the texts also were more likely to be active and to quit smoking than the patients in the control group, who didn't receive such texts.
Repeat heart attacks make up more than a quarter of all heart attacks in the U.S., according to the Centers for Disease Control and Prevention. Many of these attacks could be prevented by lifestyle changes. But while health systems have gotten very good at treating heart attacks, they struggle to connect with patients recovering from heart attacks after they return home.
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HIT Think Why the EHR documentation burden needs to be solved

Published June 27 2016, 3:19pm EDT
It wasn’t so long ago that patient records consisted of paper documents created from hand-scribbled notes made by the doctor. Transcriptionists deciphered the details, compiled them, and stuffed them into manila folders tabbed with the first few letters of a patient’s last name. It was inefficient and time consuming, but it worked.
Then came dictation in the 1980s, giving doctors the option of speaking their notes into a voice recorder, from which the transcriptionist interpreted the encounter details and entered data into the patient file. Then came voice recognition software, which ended the bulk of word-for-word typing by transcriptionists. Now, paper files have given way to electronic medical records—digitized information now resides in vast databases accessible at the touch of a button.
Common sense would say advanced technology makes a doctor’s job of capturing and reporting information about daily patient encounters easier. Reality says something quite different. Documenting encounter information into the EMR costs physicians time they could be spending with patients.
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Electronic Tools Fan the Flames of Physician Burnout

HealthLeaders Media News, June 27, 2016

Physicians who use EHRs and CPOEs are not just less satisfied with their clerical burdens, but also at higher risk for professional burnout, according to a national study.

Tait Shanafelt
Add electronic health records systems to the list of factors that contribute to physician burnout.
So far, EHRs and computerized physician order entry systems aren't making good on their promise to make physicians' lives easier.
To the contrary, physicians who use EHRs and particularly CPOEs within their electronic practice environments are not just less satisfied with their clerical burden, but also at higher risk for professional burnout, according to a national study of physicians led by Mayo Clinic.
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Docs using EHRs, CPOE less satisfied, more likely to burn out

Jun 28, 2016 2:35pm
Use of electronic health records and computerized physician order entry (CPOE) reduces physician satisfaction and contributes to higher rates of burnout, according to a new study from the Mayo Clinic published in Mayo Clinical Proceedings.
The researchers surveyed 6,560 physicians in active clinical practice nationwide between August and October 2014. Most (84.5 percent) indicated that they used EHRs; 82.5 percent used CPOE. However, the number of physicians unhappy with the systems outweighed those who were happy with them.
Of those who used EHRs, only 36 percent were satisfied or very satisfied with them; 43.7 percent were dissatisfied or very dissatisfied. Of those who used CPOE, 38 percent were satisfied or very satisfied; 41.9 percent were dissatisfied or very dissatisfied.
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How Telemedicine Is Transforming Health Care

The revolution is finally here—raising a host of questions for regulators, providers, insurers and patients

By Melinda Beck
June 26, 2016 10:10 p.m. ET
After years of big promises, telemedicine is finally living up to its potential.
Driven by faster internet connections, ubiquitous smartphones and changing insurance standards, more health providers are turning to electronic communications to do their jobs—and it’s upending the delivery of health care.
Doctors are linking up with patients by phone, email and webcam. They’re also consulting with each other electronically—sometimes to make split-second decisions on heart attacks and strokes. Patients, meanwhile, are using new devices to relay their blood pressure, heart rate and other vital signs to their doctors so they can manage chronic conditions at home.
Telemedicine also allows for better care in places where medical expertise is hard to come by.
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Enjoy!
David.

Friday, July 08, 2016

This Is A Problem That The New ePIP Regulations Will Just Add To. E-Health Fatigue And Burnout!

This appeared last week.
27 June, 2016

E-health linked to doctor burnout

Posted by ruby
While it is supposed to improve healthcare for both doctors and patients, shifting from a paper to an electronic practice may actually make doctors less happy and more burnt out, a new study suggests.
In particular, use of electronic health records and computerised physician order entry were the two factors linked to the most professional dissatisfaction and the highest rates of burnout, Mayo Clinic researchers have found.
“Although electronic health records, electronic prescribing and computerised physician order entry have been touted as ways to improve quality of care, these tools also create clerical burden, cognitive burden, frequent interruptions and distraction – all of which can contribute to physician burnout,” said lead author Dr Tait Shanafelt, a Mayo Clinic physician.
“Burnout has been shown to erode quality of care, increase risk of medical errors, and lead physicians to reduce clinical work hours, suggesting that the net effect of these electronic tools on quality of care for the US health care system is less clear,” the authors wrote.
Their survey on a national sample of 6560 doctors from the American Medical Association database used a validated questionnaire to assess burnout, and is one of number of studies published by the researchers on physician welfare.
Out of all the specialties, GPs were the least happy with the amount of time they spent on tasks unrelated to patient care, barring urologists.
And behind urologists, family medicine doctors were the most burnt-out of the group.
Professional burnout normally manifested as emotional exhaustion, loss of meaning in work, and feelings of ineffectiveness, the authors said.
The underlying problem was the ways doctors were supposed to record information did not align very well with the existing clinical workflow, Dr Nathan Pinskier, chair of the RACGP’s Expert Committee eHealth and Practice Systems.
“The reality is that what we’ve done so far in terms of electronic health records is essentially just converting pen and paper records into an electronic form,” he said.
“We haven’t done anything more sophisticated, and yet we’ve upped the ante in terms of demanding clinicians to become clerks. They’re now required to add more information to more and more documents.”
On top of that, doctors were working in an environment that was more highly regulated and with more compliance demands than they were 50 years ago, Dr Pinskier said.
These were likely to be contributing factors to increasing fatigue and less job satisfaction, he said.
More here:
With the clunkiness of the present myHR and its rather poor implementation it seems that things in Australia are just going to get more involved and complicated.
Dr Pinskier’s point on the rising demands of compliance is well made!

Here is another link covering the same problem:

http://time.com/4383979/doctor-burnout-electronic-health-records/
 
David.