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."

Sunday, November 19, 2017

Another Test For The Department of Health’s Tin Ear. Will It Listen To The Experts This Time?

I don’t know about you but I have found it very hard ever to remember having the Department of Health conduct a consultation and not have the final consultation report say exactly the same things as were said by them before they began. (Think PCEHR Legislation, Opt-Out and the list goes on.)
Well the consultation on the Secondary Use of myHR Data has just closed following many Submissions.
You can download those published up to Sunday 19/11/2017 from this link:
Here is the list of commentators so far.
While I have not read all of them in detail there are some clearly some respondents who have similar views to those expressed in my previously published submission, which has now been placed on the HealthConsult site.
Here is the direct link to mine on the blog:
I think it is reasonable to suggest that most respondents are keen for useful information to be used but want transparency and openness as to how it is used as well as genuine public disclosure of just who is using the data and what they are finding. The need for genuinely ethical usage of the information recurs as does a rejection of using the data for purely commercial and marketing purposes.
At least a few respondents suggested an independent entity to manage access and usage and at least a couple pointed out that the data quality of what is in the myHR now is pretty dreadful.
All we have to do now is wait and see how close the final Framework is to what is being suggested.
Place your bets with your favourite bookmaker!
David.

AusHealthIT Poll Number 397 – Results – 19th November, 2017.

Here are the results of the poll.

Does Firm Bipartisan Political Support And Near Unlimited Funding Mean The myHR Will Ultimately Be A Success Despite Its Flaws?

Yes 4% (5)

No 95% (117)

I Have No Idea 1% (1)

Total votes: 123

It seems the vast majority do not think the myHR can overcome its fundamental flaws despite the Government enthusiasm and lots of money.

Any insights welcome as a comment, as usual, especially regarding what might be done to have the present system changed, updated or whatever and have something more useful brought forward and implemented.

A great turnout of votes!

Again we note a sole respondent who is clueless!

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

David.

Note: If you want to suggest another option on the Standards Poll this week please comment here!

D.

Saturday, November 18, 2017

Weekly Overseas Health IT Links – 18th November, 2017.

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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Digital halves basic administrative work for London’s child health records

Claire Read

3 November 2017
Time spent on basic administration of child health records in London has halved following the introduction of a new digital setup, one of the project’s leaders has reported.
Kenny Gibson – head of public health commissioning for NHS England London region – said one Child Information Services hub had seen a 50% reduction in basic data entry since the launch of a single electronic record across the capital.
Gibson, who was speaking on the second day of EHI Live 2017 at Birmingham’s NEC, explained that Child Information Services (CHIS) staff were now being freed up to do more sophisticated data work.
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EHR Alerts: Physicians Still Override Most, Study Says

November 06, 2017
The medical profession has been alerted to this problem for almost 2 decades, and yet it persists, which makes a new study of this subject almost tiring to read.
Yep — the subject is alert fatigue in electronic prescribing.
It's a subject brimming with irony. Electronic prescribing, a standard feature of electronic health record (EHR) systems, is supposed to be safer than the handwritten approach in part because the software warns prescribers about hazards such as drug-drug interactions or patient allergies before they hit the "complete" button. However, physicians complain that they receive too many alerts, and too many insignificant ones at that, and they override most, according to research published as far back as the early 2000s. In the process, they override many alerts they should heed, which becomes a safety issue.
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HIT Think Why artificial intelligence will be crucial in value-based care

Published November 10 2017, 2:56pm EST
Automation has been relieving the strain on human hands, backs and knees for generations. But until recently, those whose jobs required high-level cognitive skills have been able to rest assured that no machine or program could possibly replace their ability to make nuanced decisions based on the evaluation of complicated, sometimes conflicting, data.
That was before artificial intelligence (AI) rose to the fore. It appears possible—if not probable—that advanced algorithms will one day replace “mid-level” brainpower as well. It begs the question many have already asked: could robots someday replace highly deductive roles such as doctors and nurses?
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ONC working on information blocking rule mandated by Cures Act

Published November 10 2017, 7:20am EST
Under the 21st Century Cures Act, the Office of the National Coordinator for Health IT has been tasked with developing a rule that will address the definition of information blocking, and that final product could have dire consequences—including financial penalties—for providers and vendors found to be guilty of the practice.
Speaking this week at the annual symposium of the American Medical Informatics Association in Washington, National Coordinator for HIT Donald Rucker, MD, said that ONC is currently drafting the rule, although he provided no specific details on a release date or a timeline for public comment.
The agency’s rule will be used by the Department of Health and Human Services’ Office of the Inspector General to guide its investigations and enforcement activities related to provider and vendor misconduct.
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Hospitals plan to boost investments in clinical analytics by 17%

New research projects that healthcare organizations will continue buying more and more analytics technologies every year.
November 08, 2017 03:24 PM
Whether you’re talking about predictive, prescriptive or just plain old analytics, the healthcare industry is gearing up to become more information-driven. The ability to better understand care delivery, payment models and reimbursement, even operations hold considerable promise to drive cost out of the system.
But getting there will also require big investments in analytics software systems. Exactly how much hospitals have to spend to remain competitive, however, is a looming question.
New findings from BCC Research suggest that hospitals spent $6.2 billion on analytics in 2016 and will increase that to $7.2 billion by the end of 2017, according to a report overview
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Health IT salaries fell 20% in 2017 even as executive compensation surged

Nov 8, 2017 8:40pm
Informatics and technology might be a huge pain point for hospitals, but most health IT professionals aren’t getting paid as much as they used to, according to a new survey.
On average, health IT professionals made just over $73,000 in 2017, a 20% decline from the previous year, according to survey data published by Health eCareers. The company, which connects healthcare employers with job seekers, surveyed nearly 20,000 professionals in the healthcare provider industry ranging from clinical staff to executives.
Informatics professionals were the hardest hit. Out of 724 survey respondents that identified themselves as health IT professionals, more than half indicated they worked specifically in healthcare informatics and data where the median salary was $46,000 annually, nearly $30,000 less than last year.

ONC Patient Matching Algorithm Challenge Selects 3 Winners

Vynca, PICSURE, and Information Softworks are winners of the ONC Patient Matching Algorithm Challenge were.

November 08, 2017 - ONC today announced the three winners of the Patient Matching Algorithm Challenge.
Winning submissions were selected from a pool of over 140 competing teams and nearly 7,000 algorithm submissions using an ONC-provided dataset. Algorithms were designed to identify and match data about a patient held by one healthcare provider with data about the same patient contained within the same system or other systems.
“Many experts across the healthcare system have long identified the ability to match patients efficiently, accurately, and to scale as a critical interoperability need for the nation’s growing health IT infrastructure,” stated National Coordinator for Health IT Don Rucker, MD in a list serv. “This challenge was an important step towards better understanding the current landscape.”
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Researchers Question Previous Health Data Breach Study

Vanderbilt University researchers are calling for improved health data breach statistics after an earlier study claimed larger facilities were at greater breach risk.

November 08, 2017 - Claiming that larger healthcare facilities have a higher risk of experiencing a health data breach “neglects inherent biases in data collection and reporting practices,” according to a letter published in the Journal of the American Medical Association (JAMA). 
Vanderbilt University researchers Daniel Fabbri, PhD, Mark E. Frisse, MD, and Bradley Malin, PhD, wrote a letter to the editor in response to a study published earlier in 2017. That previous study used reported breach data from HHS and claimed that having greater access to healthcare data (common in larger hospitals and teaching-focused facilities) could lead to greater breach risk.
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NIH launches ‘Data Commons’ program to aid researchers

Published November 08 2017, 7:25am EST
The National Institutes of Health is launching a four-year $9 million pilot program through which 13 organizations will receive funding to develop a shared cloud-based platform that will enable scientists to work with the “digital objects” of biomedical research.
A digital object is anything that could exist on a computer or the Internet, such as data, software, apps and analytics tools, according to NIH. In total, more than 30 entities--organizations and institutions—will share the funding.
The goal of the NIH Data Commons pilot is to accelerate biomedical discoveries by making research findable, accessible, interoperable and reusable.
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KLAS picks EHR leaders in ambulatory, acute, home, long-term care and more

While Epic and Cerner lead in ambulatory, Thornberry, Homecare Homebase, MatrixCare and Practice Velocity come out on top in their respective categories.
November 07, 2017 02:26 PM
A new report from KLAS rating EHRs vendors from across the entire continuum of care is shining a light on some of the niche vendors catering to the ambulatory care, acute care, home care, long-term care, behavioral health and urgent care markets.
The report, “Continuum of Care: A Comprehensive Look at EMRs in a Connected Continuum,” looked at both enterprise and single-setting EHR vendors to determine which platforms best positioned to help customers successfully adapt in each care setting.
In the home care arena, KLAS points to Thornberry and Homecare Homebase as leaders.
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So your hospital has been breached; Here's what you must do now

Don’t panic, but don’t delay in finding out what has been breached and deciding on a course of action.
November 07, 2017 01:39 PM
Cybercriminals have been very successful in the healthcare industry, and as a result, they’re not going to stop attacking. Data breaches are inevitable. As good as healthcare CISOs get in protecting health data, hackers can be even craftier to break through the latest in cybersecurity technology and practices.
So how should hospital infosec teams react when there is a breach? What steps should they follow to ensure a breach is under control? Cybersecurity experts who have seen their share of incidents and events have a variety of tips about how to put a lid on breaches and respond appropriately.
First of all, don’t panic, said Stacy Scott, managing director at Kroll, an investigations and risk mitigation firm.
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How The Rise Of Medical Technology Is Worsening Death

10.1377/hblog20171101.612681
Our aging population is at risk from a most benign-appearing source—the medical technologies we trust to keep us healthy.
When they were first widely used in the 1930s and 1940s, breathing machines did what humans could never have imagined a generation earlier: They kept young polio victims alive until their bodies cleared the virus that had temporarily weakened their respiratory system. Thanks to these miraculous machines, tens of thousands of these patients recovered and went home to live out the rest of their lives. This bold new use of medical technology riveted the world and set the stage for a new era in medicine, in which an overriding faith in the curative powers of technology prevailed. Over the next several decades, doctors assumed that everyone wanted and deserved access to these treatments. The breathing machine, or mechanical ventilator, was the first of many life-prolonging technologies to come. Now, there are machines to substitute for a wide range of physiological functions, including the pumping of the heart and the oxygenation of the blood.
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Takeaways from digital health progress report include wider adoption by pharma, healthcare

Nov 7, 2017 at 7:59 AM
A digital health progress report by IQVIA Institute for Human Data Science, formerly known as the QuintilesIMS Institute, shows a maturation of the sector. The number of digital health apps has doubled in recent years to 318,000. Increased clinical validation has led to wider adoption by pharma companies and healthcare systems to remotely monitor patients and quantify medication adherence for clinical trials. It also notes that the digital health tools are being used to monitor disease progression but wider adoption requires overcoming significant barriers such as malpractice liability and
Here’s a roundup of the most interesting findings from the report:
“We are seeing an increase in the number and sophistication of sensors to see how patients are responding to medications,” said Murray Aitken, IQVIA Institute for Human Data Science Executive Director in a conference call with reporters Friday. He pointed to the adoption of smart inhalers to track asthma and COPD medication adherence. There has been widespread collaboration between device developers such as Propeller Health, Adherium Health and Qualcomm Life with big pharma companies such as Novartis, Boehringer Ingelheim, AstraZeneca, and GlaxoSmithKline.
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5 Steps Healthcare CIOs Can Take to Get Ready for Blockchain

Stumped on how to make blockchain happen for your organization? Don Tapscott, co-founder of the Blockchain Research Institute, has advice on where to start.
Juliet is the senior web editor for StateTech and HealthTech magazines. In her six years as a journalist she has covered everything from aerospace to indie music reviews — but she is unfailingly partial to covering technology.
Blockchain could be the conduit to a more secure, transparent and interoperable future for healthcare, says Don Tapscott, co-founder of the Blockchain Research Institute. Tapscott, who spoke at the College of Healthcare Information Management Executives (CHIME) 2017 Fall CIO Forum on Nov. 3 in San Antonio, Texas, argued that as pushes for advancements in health IT bump up against the barriers of cost and legacy systems, blockchain can help rebuild the health system from the ground up.
“Tinkering is not going to be sufficient, we need to actually reinvent healthcare. Fortunately, there’s a new technology in healthcare emerging that can help us do that,” said Tapscott, speaking about blockchain, the ledger technology that underlies bitcoin.
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FDA Calls for Continuous Collaboration in Medical Device Security

There must be a balance between utilizing innovative technologies and monitoring patient safety when it comes to medical device security measures.

November 07, 2017 - Healthcare is becoming increasingly reliant on connected devices, which is why medical device security must remain a top priority. Cybersecurity threats are a constant worry but the FDA aims to help healthcare organizations remain innovative while still ensuring patient safety.
There must be a total product lifecycle approach, according to Suzanne B. Schwartz, M.D., M.B.A., who serves as FDA Associate Director for Science and Strategic Partnerships at the Center for Devices and Radiological Health.
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The Promise, Growth, and Reality of Mobile Health — Another Data-free Zone

Amira Roess, Ph.D., M.P.H.
November 8, 2017DOI: 10.1056/NEJMp1713180
The use of mobile communication technologies to improve the health of individuals and populations — dubbed “mobile health,” or “mHealth” — has grown dramatically since 2008, when the term mHealth became widely used. The excitement over the use of mHealth technology especially in low- and middle-income countries (LMICs) stems from the recognition that mobile phones have penetrated the market like no other technology. There are more than 5 billion wireless communication subscribers, and more than 70% of them are in LMICs1 (though the subscription rate in low-income countries is 60% overall, and much lower in rural areas). Moreover, commercial wireless signals reach 85% or more of the world’s population, extending much farther than the electrical grid.1
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As mHealth nears the decade mark, questions about its effect on patient outcomes persist

Nov 9, 2017 11:15am
There are thousands of mHealth apps, tools and technologies. But do they actually work?
It’s been about 10 years since the word “mHealth” became part of the healthcare lexicon. And since then, the number of mobile technologies, tools and apps has exploded. But has the trend had any impact on outcomes?
Well, it’s hard to say.
“The evidence to support their rapid and widespread use is limited,” writes Amira Roess, Ph.D., in a recent New England Journal of Medicine “Perspectives” piece. Most programs aren’t evaluated in any meaningful way, she adds, noting the scientific literature is dominated by case studies or small-scale pilot studies with “almost no effectiveness studies.”
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AMIA, OpenNotes partner on patient engagement

Informatics group aims to make patients' online access to physicians' clinical notes the standard of care.
November 06, 2017 03:15 PM
The American Medical Informatics Association and OpenNotes will collaborate to expand the access and control that patients and families have over their own health data. 
OpenNotes, which co-director Tom Delbanco, MD, described as a movement rather than a software program, started in 2010 at Beth Israel Deaconess Medical Center in Boston, Geisinger Health System in Pennsylvania and Harborview Medical Center in Seattle. The movement has since expanded to more than 20 hospitals and enabled nearly 20 million patients to see what their doctors wrote about them in the EHR. 
AMIA and OpenNotes described the partnership, announced at AMIA's 2017 Annual Symposium, as a collaboration that seeks to enlist more hospitals and doctors to empower even greater numbers of patients with “access to, and control of, their personal health information.” 
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Healthcare innovation lessons from around the world

Nov 7, 2017 12:53pm
The U.S. health system could learn from programs that have been successful overseas.
The U.S. healthcare system can learn plenty from successes in other countries, according to a new study. 
The Institute of Global Health Innovation at Imperial College London and the Global Health Innovation Center at Duke University examined five case studies from around the world that offer "frugal innovations" that the U.S. could learn from or replicate, according to research published in Health Affairs. In some cases, the American healthcare system has already begun to adopt or adapt the programs. 
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How medical-device CEOs can navigate digital disruption in healthcare

By Siddhartha Chadha, Sastry Chilukuri, and Steve Van Kuiken
How medical-device CEOs can navigate digital disruption in healthcare
Medical-device companies will need to reinvent themselves to stay competitive. Now’s the time to craft a strategy and scale a transformation.
Digital has already disrupted major sectors of the economy, and a revolution is under way in healthcare. As in other industries, battlegrounds are emerging, and there will be clear winners and losers. Medical-device players, facing unique opportunities and headwinds, will need to reinvent themselves as digital health companies to remain relevant and win in this fast-evolving market. Recognizing the urgency, almost all of the industry’s CEOs have declared digital health a top priority.
An earlier article, “Four keys to successful digital transformations in healthcare,” discussed broad trends and emerging battlegrounds—building direct relationships with consumers, finding new sources of value, collaborating for complementary capabilities, and contributing to burgeoning industry standards. Building on that work, this piece outlines how medical-device companies can define a winning strategy and design an at-scale digital transformation.
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Digital divide also affects how some providers use EHRs

Published November 07 2017, 7:30am EST
While hospitals have widely adopted electronic health records systems in the years since the enactment of the HITECH Act, a digital divide has emerged in how those records systems are used, particularly by those healthcare organizations with fewer resources.
In fact, critical access hospitals are less likely to utilize advanced EHR functions for performance measurement and patient engagement—both of which are critical to improving the quality of care.
That’s the conclusion of new research presented on Monday at the 2017 American Medical Informatics Association Annual Symposium in Washington.
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Innovative Digital Health Tools Offer 'Seamless' Patient Experience

Alexandra Wilson Pecci, November 7, 2017

The Nemours App for Asthma is the first product from Nemours's Center for Health Delivery Innovation, released as part of a new digital health strategy that provides all digital assets on a single platform for users.

Older patients might get a huge chunk of the country's healthcare dollars, but when it comes to the future of digital health, it's young people who will undoubtedly drive the trends. That's especially true for children's healthcare, where the patients and families are young. 
"Families are comparing us to Amazon and Google and their banking app," says PJ Gorenc, operating officer of the Nemours Center for Health Delivery Innovation. "They are on the younger end of the spectrum and many of them are digital natives who don't know a world without convenient access to any of the organizations they interact with."
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ECRI's top 10 tech hazards for 2018, security gaps, dirty scopes make the list

ECRI Institute weighed factors like severity, likelihood that the hazard could cause serious injury or death, frequency, overall likelihood and preventability.
November 07, 2017 01:08 PM
The ECRI Institute has unveiled its Top 10 Health Technology Hazards for 2018, which highlights what the Institute feels are the greatest potential sources of danger involving medical devices and other health technologies for the upcoming year. 
To compose the list, ECRI Institute engineers, scientists, clinicians, and other patient safety analysts nominated topics for consideration and also considered the thousands of health-technology-related problem reports the Institute has received through its Problem Reporting Network and through data shared with our patient safety organization, ECRI Institute PSO. They also weighed factors like severity, likelihood that the hazard could cause serious injury or death, frequency, overall likelihood and the likelihood of the spread to affect a great number of people, either within one facility or across many facilities, insidiousness, and preventability among other factors.
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New technology puts the AI in aid for US veterans

Posted Nov 2, 2017 by Ryan Hemphill
Ryan Hemphill is an attorney and private equity and venture capital executive based in New York City. Ryan also is the founder and CEO of The Open Road Foundation, a nonprofit corporation serving wounded U.S. veterans and their families with employment and education services through partnerships in the automotive sector.
As part of their latest endeavor to improve care for our country’s combat vets, the Department of Veterans Affairs has invested in a rapidly advancing form of intelligence: the artificial kind. AI has been hailed by most forecasters as a revolutionary force in all manner of fields, from transportation to predicting the weather, and this exciting wave of possibility promises to transform the healthcare sphere, as well. The opportunity to use this growing tech to improve veteran healthcare has rightfully attracted positive attention to some intriguing new initiatives.
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A data breach cost $3.6M on average in 2017: 6 things to know

Written by Julie Spitzer | November 03, 2017 | Print | Email
The average cost to recover from a data breach was $3.6 million in 2017, according to AT&T's cybersecurity insights report.
AT&T surveyed 700 people in IT management roles from around the world for its report, "Mind the Gap: Cybersecurity's Big Disconnect."
Here are six things to know.
1. Respondents ranked malware, worms and viruses (60 percent) as the No. 1 threat to their organization in the year ahead, followed by unauthorized access to corporate data (49 percent) and ransomware (46 percent).
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HIT Think Why healthcare wants to crack the ‘black box’ surrounding AI

Published November 06 2017, 4:47pm EST
How can end users of artificial intelligence applications trust the results they receive when they have no idea how the AI reached its conclusions? This black-box paradox haunts proponents of AI in every industry, but it’s particularly problematic in healthcare, where the method used to reach a conclusion is vitally important.
Yet the problem seems almost insurmountable—the most effective machine learning models are notoriously opaque, offering few clues as to how they arrive at their conclusions.
In healthcare, physicians are especially reluctant to trust technologies they can’t explain. Trained as they are in the scientific method, with responsibility for making life and death decisions, physicians are understandably unwilling to entrust those decisions to a black box.
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UPMC set to invest $2B in digitally based specialty facilities

Published November 06 2017, 5:06pm EST
UPMC is making plans to build three digitally based specialty hospitals, looking to support their care with information technology that supports both treatment and coordination of care.
The Pittsburgh-based healthcare organization says it will invest $2 billion in the facilities, which will treat cancer, heart and transplant cases, and vision and rehabilitation care.
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Enjoy!
David.