Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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Review says Babylon’s AI claims lack ‘convincing evidence’
Researchers have concluded that Babylon Health has not offered ‘convincing evidence’ that its AI-powered diagnostic and triage system can perform better than doctors.
Hanna Crouch, 7th November, 2018
In July 2018, Babylon Health claimed a study had demonstrated its artificial intelligence (AI) system had diagnostic ability that is ‘on-par with human doctors’.
But in a letter to medical journal The Lancet, Hamish Fraser, Enrico Coiera and David Wong explained their review – ‘Safety of patient-facing digital symptom checkers’ – shows there ‘is a possibility that it [Babylon’s service] might perform significantly worse’.
Fraser, Coiera and Wong – respectively a qualified doctor and associate professor of medical science; professor in medical informatics; and lecturer in health informatics – argue that Babylon’s claims have been ‘met with scepticism because of methodological concerns’.
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Hawaii’s HIE Leveraging Technology to Improve Patient Identification
November 8, 2018
by Heather Landi, Associate Editor
Hawaii Health Information Exchange (HHIE), Hawaii’s state-designated HIE, is taking action to improve patient identification and the accuracy of provider data for enhanced care coordination across the state.
HHIE is working with Pasadena, Calif.-based NextGate to implement an enterprise cloud-based master patient index and provider registry software to create a sustainable statewide system of accurate patient and provider data by resolving duplicate and incomplete records.
HHIE was established in 2006 to improve statewide healthcare delivery through seamless, safe and effective health information exchange. The HIE covers more than 1.2 million patients and has more than 450 participants including Castle Medical Center, Hawaii Pacific Health, The Queen's Medical Center, and the state’s largest insurance provider, HMSA.
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Predictive Analytics, EHR Big Data Reduce Sepsis Mortality by 18%
North Oaks Health System has created a predictive analytics tool that uses EHR big data to speed antibiotic treatment and reduce sepsis mortality.
By Jessica Kent
November 09, 2018 - At North Oaks Health System in Hammond, Louisiana, researchers have used big data from the Epic electronic health record (EHR) to develop a predictive analytics tool that has reduced sepsis mortality by 18 percent.
According to the CDC, sepsis leads to death for a quarter of a million Americans each year and causes two percent of all hospital admissions nationwide.
North Oaks developed a tool called a Clinical Care Advisory (CCA), which helps notify providers of patients at high risk for sepsis based on the information in their medical records. CCA runs on a predictive model in the patient’s EHR to look for signs and symptoms of the condition.
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Start Improving Clinical Outcomes With AI: 3 Steps
By Christopher Cheney | November 07, 2018
A Florida-based community hospital is using AI tools to examine patient data and formulate new treatment protocols for deadly illnesses such as sepsis.
KEY TAKEAWAYS
Community hospitals can launch and maintain sophisticated AI initiatives.
AI initiatives can focus in on patient data at health systems and hospitals to target patient cohorts for data analysis.
Using AI to develop new care pathways can improve patient outcomes and reduce total cost of care.
Artificial intelligence (AI) is sometimes seen more as hope and hype than as a solution for healthcare that can improve patient outcomes and reduce costs.
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Two urology practices select Integra Connect to replace EHRs
Published November 09 2018, 7:36am EST
Here is Health Data Management’s weekly roundup of health IT contract wins and go-lives:
The Urology Group, with 15 sites serving parts of Ohio and Kentucky, and the Michigan Institute Urology, with 22 sites in southeast Michigan, both are replacing legacy electronic health record systems and selecting the same vendor—Integra Connect.
Some 39 physicians at The Urology Group recently went live on the EHR as the organization prepares for the shift to value-based care. “We have long seen the need for a new wave of innovation among urology EHRs to better equip practices like ours for the changes in our specialty in general and with the shift to value-based care in particular,” says Gary Kirsh, MD, the group’s president.
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https://www.healthdatamanagement.com/opinion/why-incident-response-planning-is-growing-in-importance
HIT Think Why incident response planning is growing in importance
By John Nye
Published November 09 2018, 5:11pm EST
Incident response is rising in importance—2018 seems to be “the year of IR.” Every major security vendor and service provider have been creating webinars and white papers about IR, and almost every organization is talking about it from the boardroom to the breakroom.
Why has IR become such a hot button topic in 2018? Just a few years ago, many of the organizations shoring up their IR today would not have been willing to spend the time and money to develop a useful plan, let alone test and improve it regularly.
Fortunately, or perhaps unfortunately, the last couple of years have played a large role in bringing boards and executives around to the importance of a solid and dependable IR plan. For better or worse, healthcare has become a target of criminal attacks and the irrefutable evidence can no longer be ignored by those in the ivory tower, and now it’s time to strike while the iron is hot. This means there is no better time to approach the board and executives to impart the criticality of a well-crafted IR and disaster recovery (DR) plan.
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https://www.hardocp.com/news/2018/11/09/healthcaregov_system_hack_much_worse_than_initially_thought/
Friday November 09, 2018
HealthCare.gov System Hack Is Much Worse Than Initially Thought
It seems that the HealthCare.gov hack that we reported on earlier this month is more concerning that initially thought. A letter is being mailed out to citizens who have been affected by the hack.
Name, date of birth, address, sex, and the last four digits of the Social Security number (SSN), if SSN was provided on the application. Other information provided on the application, including expected income, tax filing status, family relationships, whether the applicant is a citizen or an immigrant, immigration document types and numbers, employer name, whether the applicant was pregnant, and whether the applicant already had health insurance. Information provided by other federal agencies and data sources to confirm the information provided on the application, and whether the Marketplace asked the applicant for documents or explanations. The results of the application, including whether the applicant was eligible to enroll in a qualified health plan (QHP), and if eligible, the tax credit amount. And if the applicant enrolled, the name of the insurance plan, the premium, and dates of coverage. The information that was accessible did not include bank account numbers, credit card numbers, or diagnosis or treatment information.
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Report on informatics systems in NHS Wales raises "alarming findings"
November 08, 2018 11:01 AM
An inquiry found that there had been 21 outages of national IT systems across the NHS in Wales in the first six months of 2018.
The Welsh Assembly Public Accounts Committee (PAC) has questioned the “competence, capability and capacity" across the system to digitise healthcare services in Wales after an inquiry uncovered a “raft of problems”, from delays in the delivery of digital projects to “unclear” lines of accountability.
The committee found that there had been 21 outages of national systems from January to July this year. A letter from the Cardiff and Vale University Health Board indicated that a national data centre failure that occurred between 3 to 5 August affected “all of Wales”.
The PAC said it was “deeply concerned about the slow pace of delivery of modern informatics systems”, asking the Welsh Government to set out a “clear timetable” to put the infrastructure on a “stable footing”.
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Precision medicine is too complex for EHRs, KLAS says
By Tom Sullivan
November 08, 2018 01:06 PM
Respondents to new research indicated that major EHR vendors are not capable of precision medicine work.
KLAS on Thursday published a report that found healthcare providers are skeptical about the role electronic health records will play within precision medicine initiatives.
WHY IT MATTERS
The idea that EHRs will not be the platform of choice for precision medicine is not new.
The idea that EHRs will not be the platform of choice for precision medicine is not new.
Beth Israel Deaconess Medical Center CIO Dr. John Halamka said as much back in October of last year at the HIMSS Big Data and Healthcare Analytics Forum in Boston.
"Do I really believe that the next precision medicine breakthrough is coming within an EHR? No," Halamka said at the time. "It will come from third-parties … twenty-six-year-olds working in their garage to link innovations to EHRs using FHIR APIs."
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Making a persuasive business case for bigger AI investment
By Mike Miliard
November 08, 2018 09:58 AM
IT leaders should show the value of specific AI use cases, while also ensuring the C-suite understands the potentially slow or hard-to-define ROI.
The genre of "Convincing the C-suite to Invest in X" stories is well-trod ground here at Healthcare IT News. In just the past two years we've written articles describing how hospitals can persuade their bosses to pay more attention to – and pay more money for – data-driven quality improvement, information governance, cybersecurity and smarter analytics for value-based care.
Sometimes it's hard to get those who hold the purse strings to do the right thing – to convince them that it's in the health system's best interest to try a test deployment of a new or perhaps overhyped technology, or that there may be substantial ROI in a project whose value may seem intangible at first.
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https://ehrintelligence.com/news/new-fda-app-streamlines-ehr-patient-data-collection-for-researchers
New FDA App Streamlines EHR Patient Data Collection for Researchers
A new FDA app helps researchers collect EHR patient data from a variety of sources for use in clinical trials and observational studies.
By Kate Monica
FDA recently launched a new app designed to allow researchers to easily collect real-world evidence in the form of EHR patient data, claims and billing information, and patient-generated health data through patients’ mobile devices.
The app—called MyStudies—enables researchers to gather real-world evidence from a variety of sources and use this data in clinical trials and studies. These clinical trials and observational studies may help to inform regulatory decisions in the future as researchers gain a more comprehensive understanding of how new drugs and medical products affect patients.
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1 in 3 ransomware attacks target healthcare companies, report suggests
Healthcare breaches made up 37 percent of all ransomware incidents in the third quarter, according to a Beazley report.
For the report, Beazley — a London-based cybersecurity insurance company with offices in Asia, Australia, South America, the Middle East and the United States — analyzed data breaches that affected its clients during the third quarter of 2018 across several industries including healthcare, financial services and higher education.
Here are the top five causes of data breaches in healthcare, according to Beazley's third-quarter data:
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Report links top corporate growth, profits to digital maturity
By Bob Violino
Published November 08 2018, 7:32am EST
Digitally mature organizations have higher revenue growth and net profits, regardless of their industry, according to a report by business and technology consultancy West Monroe Partners.
Four digital characteristics in particular—a clear vision and dedicated leadership; engaged employees who are intrinsically motivated; an ability to leverage data for insights; and digital interactions that are convenient and effortless—showed a high correlation with the best financial performance, which the report defined as annual growth rates above 10 percent.
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AI system predicts billions of potential side effects from drug combinations
Published November 08 2018, 7:32am EST
An artificial intelligence system developed by researchers at Stanford University could ultimately help physicians make more informed decisions about which medications to safely prescribe.
The AI system, called Decagon, is able to predict billions of potential side effects from drug combinations—no small feat given that there are nearly 125 billion possible side effects between all possible pairs of drugs, most of which have never been prescribed together or systematically studied.
Researchers contend that the predictions generated by the deep learning approach, once provided to doctors in a more user-friendly format, would significantly improve the current capability available to clinicians—namely, mere chance.
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HIT Think Why employees’ lapses in protecting data can sting organizations
Published November 08 2018, 5:37pm EST
Healthcare organizations are learning difficult lessons about the fact that the actions of employees can come back with serious consequences to the organization.
When it comes to maintaining the privacy and security of patient data, no action comes without a consequence. While some actions are completely uncontrollable, that does not necessarily mean that liability cannot potentially flow to the employer. Additionally, HIPAA may only tell part of that story in that regard, as state law will play a significant role in determining potential liability.
The impetus for the focus on potential employer liability is a recent decision from the Supreme Court of Virginia. The high-level summary is that the employer healthcare organization (Carilion) may be liable for the snooping of two employees into the record of a patient and the subsequent spreading around of information learned.
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Getting Rid of Stupid Stuff
- Melinda Ashton, M.D.
Many health care organizations are searching for ways to engage employees and protect against burnout, and involvement in meaningful work has been reported to serve both functions. According to Bailey and Madden, it is easy to damage employees’ sense of meaningfulness by presenting them with pointless tasks that lead them to wonder, “Why am I bothering to do this?”1 An increase in administrative tasks has resulted in less time for the activity that clinicians find most important: interacting with patients. Some commentators have recently suggested that it may not be the electronic health record (EHR) per se that leads to burnout, but rather the approach to documentation that has been adopted in the United States.2
Although my health system, like most in the United States, cannot magically eliminate the documentation required for billing and regulatory compliance, my colleagues and I had reason to believe that there might be some documentation tasks that could be eliminated. Our EHR was adopted more than 10 years ago, and since then we have made a number of additions and changes to meet various identified needs. We decided to see whether we could reduce some of the unintended burden imposed by our EHR and launched a program called “Getting Rid of Stupid Stuff.” Starting in October 2017, we asked all employees to look at their daily documentation experience and nominate anything in the EHR that they thought was poorly designed, unnecessary, or just plain stupid. The first thought we shared as we kicked off this effort was, “Stupid is in the eye of the beholder. Everything that we might now call stupid was thought to be a good idea at some point.”
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Health IT takeaways from the midterm elections
By Tom Sullivan
November 07, 2018 01:23 PM
What the 116th Congress might mean for the fate of the ACA and healthcare technology.
Democrats regained the U.S. House of Representatives in Tuesday's midterm elections, while Republicans maintained control of the Senate – a rebalancing of power likely to bring both certainty and opportunities for healthcare.
"Healthcare was a voting issue for this election," said Samantha Burch, senior director of congressional affairs at HIMSS.
PwC surveyed 1,500 people, for instance, and found that 59 percent cited healthcare as a very important issue.
Let's take a look at what Tuesday night's results mean for healthcare policy and technology.
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Infrastructure, committee changes are health IT focal points as congressional power dynamics shift
by Evan Sweeney
Nov 7, 2018 2:42pm
You won’t see candidates running on a heavy health IT platform, but the industry could benefit from a congressional shift in power that creates an opportunity to focus on infrastructure and new entrants looking for bipartisan wins.
Infrastructure is a key area that health IT groups plan to focus on following Tuesday’s midterm elections in which Democrats took control of the House and Republicans strengthened their grasp on the Senate. While both the Trump administration and Democrats have long advocated for comprehensive infrastructure reform, there hasn’t been much momentum. But the issue could resurface with more strength over the next two years as both parties search for bipartisan wins in a split Congress.
For health IT advocates, a new infrastructure package means a focus on things like broadband and public health surveillance that directly impact telehealth and data collection—smaller issues that could fit into broader legislation.
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Digital collaboration can improve palliative care
Greer Myers | Nov 6, 2018
Digitally driven palliative care utilizing predictive analytics and artificial intelligence for appropriate patient identification can train and deploy networks of palliative care professionals of primarily nurses and social workers to engage with patients in the community.
Feeling lonely and isolated from friends, family and familiar places is more than simply an emotional quagmire for millions of Americans. Many contend that these issues may represent a greater public health hazard than obesity or smoking. While this is a challenge that transcends all age groups, it is particularly troublesome for seniors, particularly those who are experiencing a serious or advanced illness, where the physical challenges of mobility make the effort required to socialize with friends and family overwhelming.
Some experts think the problem is getting worse, driven by an aging population, changes in family structure, reliance on technology in place of face-to-face discourse and other forces. Thankfully, both public and private sectors are starting to pay more attention. An AARP loneliness study published in 2010 and now being updated reported that approximately 42.6 million U.S. adults ages 45 and older were suffering from loneliness.
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Physicians dismissing patients' knowledge linked to diagnostic errors, study finds
Researchers analyzed instances of diagnostic errors submitted by patients and their families and found 224 cases of problematic physician behavior, according to study published in Health Affairs.
Here are three things to know:
1. For the study, researchers read adverse event reports submitted by patients and patient families from January 2010 to February 2016. Researchers analyzed about 184 different narratives detailing diagnostic errors and found problems relating to how physicians interacted with patients.
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4.4M Records Exposed in 117 Health Data Breaches in Q3 2018
A total of 4.4 million patient records were compromised in 117 health data breaches in the third quarter of 2018, according to the latest Protenus Breach Barometer.
By Fred Donovan
November 06, 2018 - A total of 4.4 million patient records were compromised in 117 health data breaches in the third quarter of 2018, according to the latest Protenus Breach Barometer.
These figures compare with 3.15 million records compromised in 142 health data breaches in the second quarter, and 1.13 million patient records compromised in 110 breaches in the first quarter, according to the quarterly report prepared by security firm Protenus and DataBreaches.net.
“It’s important to note that the number of affected patient records has continued to climb each quarter in 2018,” explained the report.
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Winona Health to offer $40 teleconsultations to its patients
Published November 07 2018, 7:32am EST
Winona Health in Minnesota is launching a telemedicine program that will let consumers have remote consultations with Winona doctors.
The rural health provider is working toward adoption of value-based contracts as it focuses on community wellness, says Rachelle Schulz, CEO at Winona. The organization includes a 49-bed hospital, 110-bed nursing home and more than 90 other providers.
“We are committed to improving access to high-quality care that is also convenient and affordable,” she explains. “Between busy schedules and high-deductible insurance, convenience and affordability are increasingly important to people.”
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HIT Think Five takeaways from the midterm election results
By Yulan Egan
Published November 07 2018, 5:20pm EST
With the results of the mid-term election now being firmed up, Advisory Board put its experts to work assessing the impact of the new Congress on healthcare policy.
Five significant impacts are on the horizon.
Healthcare reform
A split Congress will keep healthcare reform squarely in the spotlight, while limiting the possibility of drastic legislative action in the next two years. With Democrats regaining the House majority, Republicans will be unable to make another attempt to repeal-and-replace the ACA (even if they wanted to, which is far from clear). And without control of the Senate, Democrats will be unable to send any sweeping legislation such as Medicare for All, or even a restoration of the individual mandate, to President Trump’s desk for veto.
A split Congress will keep healthcare reform squarely in the spotlight, while limiting the possibility of drastic legislative action in the next two years. With Democrats regaining the House majority, Republicans will be unable to make another attempt to repeal-and-replace the ACA (even if they wanted to, which is far from clear). And without control of the Senate, Democrats will be unable to send any sweeping legislation such as Medicare for All, or even a restoration of the individual mandate, to President Trump’s desk for veto.
Nonetheless, healthcare is likely to remain a key issue of debate in Congress, particularly if House Democrats follow through on campaign promises to use oversight and investigation power to scrutinize the administration’s actions toward the ACA. And the role that healthcare played in securing Democrats’ House victory has important implication for future elections, as the party’s stance on reducing out-of-pocket expenses and maintaining protections for pre-existing conditions helped secure victory in several battleground House districts and governorships.
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Can AI Address Health Care’s Red-Tape Problem?
November 05, 2018
Productivity in the United States’ health care industry is declining — and has been ever since World War II. As the cost of treating patients continues to rise, life expectancy in America is beginning to fall. But there is mounting evidence that artificial intelligence (AI) can reverse the downward spiral in productivity by automating the system’s labyrinth of labor-intensive, inefficient administrative tasks, many of which have little to do with treating patients.
Administrative and operational inefficiencies account for nearly one third of the U.S. health care system’s $3 trillion in annual costs. Labor is the industry’s single largest operating expense, with six out of every 10 people who work in health care never interacting with patients. Even those who do can spend as little as 27% of their time working directly with patients. The rest is spent in front of computers, performing administrative tasks.
Using AI-powered tools capable of processing vast amounts of data and making real-time recommendations, some hospitals and insurers are discovering that they can reduce administrative hours, especially in the areas of regulatory documentation and fraudulent claims. This allows health care employees to devote more of their time to patients and focus on meeting their needs more efficiently.
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EHR Medication Lists Inaccurate, Incomplete, Blood Tests Show
Researchers who checked patients' blood samples for medication concentration found that more than half were taking prescription and/or over-the-counter drugs not listed in their electronic health record (EHR), indicating potential threats to patient safety.
Additionally, more than half of the drugs that triggered drug–drug interaction alerts in the study involved medications not listed in EHRs.
Jeffrey J. Sutherland, PhD, of Precera Bioscience in Franklin, Tennessee, and colleagues published the results of their study online November 2 in JAMA Network Open.
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Epic, Cerner and others moving into expanding global EHR market, says KLAS
By Mike Miliard
November 06, 2018 03:54 PM
With IT deployments broadening and deepening worldwide, a new report assesses unique preferences in Canada, Europe, Latin America, Middle East and AsiaPac countries.
The global market for electronic health records is as diverse and far-flung as the countries and cultures served by the technology. Different regions are at different levels in their IT maturity, have different historical preferences for certain vendors, and have different healthcare imperatives they're trying to solve.
The new Global EMR Performance 2018 report from KLAS arrives just as the EMR market is burgeoning in a big way around the world, and aims to address vendor performance by specific regions to offer accurate picture of how regional and multiregional companies are delivering for their provider customers in each area.
WHY IT MATTERS
KLAS notes that the size and scale of IT deployments have generally grown significantly worldwide in recent years, "rapidly changing the global EMR landscape."
KLAS notes that the size and scale of IT deployments have generally grown significantly worldwide in recent years, "rapidly changing the global EMR landscape."
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One Third of Pediatric Drug Errors Tied to EHR Usability
Usability of electronic health records (EHRs) contributed to more than a third of medication errors noted in 9000 pediatric patient safety event reports, according to an article published in the November issue of Health Affairs.
Although EHRs eliminate some limitations of paper medical records, such as illegible handwriting, they often introduce other problems, write Raj M. Ratwani, PhD, director of the National Center for Human Factors in Healthcare, MedStar Health, and an assistant professor of emergency medicine at Georgetown University School of Medicine, Washington, DC, and colleagues.
One limitation is "usability," which the researchers define as "the extent to which the technology can be used efficiently, effectively, and satisfactorily" based on system design and customization to specific workflows.
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Study: It's still too easy to make mistakes in pediatric electronic health records
by Tina Reed
Nov 5, 2018 5:00pm
When it comes to giving kids the right dose of medication or properly timing their care, it's still too easy for doctors and nurses to make mistakes because of the usability of their electronic health record systems, according to a new study.
In an examination of 9,000 pediatric safety event reports studied by MedStar Health's National Center for Human Factors in Healthcare, researchers found that more than a third had an EHR usability issue that affected the medication process and in about 19%—609 cases—the error reached the patient.
The study, which involved reports from MedStar, Children's Hospital of Philadelphia and Children's Hospital of Wisconsin, was published today in the November issue of Health Affairs.
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OIG: FDA must address postmarket cybersecurity risk to medical devices
Published November 06 2018, 7:02am EST
The Food and Drug Administration’s policies and procedures are not sufficient for effectively dealing with postmarket medical device cybersecurity events, an emerging risk to public health and the FDA's mission.
That’s the finding of an audit by the Department of Health and Human Services’ Office of Inspector General.
The FDA regulates medical devices in two phases: premarket and postmarket. In the postmarket phase, after clearing or approving a medical device, the agency conducts oversight activities such as monitoring and investigating a medical device’s safety and effectiveness, and alerting the public when there are problems.
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AI tools based on one organization’s data may need more ‘education’
By Fred Bazzoli
Published November 06 2018, 2:28pm EST
A study suggests that artificial intelligence tools used to diagnose images may need a wider range of images to train on than previously thought.
The research, conducted at the Icahn School of Medicine at the Mount Sinai Health System, found that AI tools trained on only one organization’s images may suffer declines in performance and accuracy when tested on data from other healthcare organizations.
Such a finding may throw a curve in the push to use AI more broadly in radiology and other medical disciplines, suggesting that a wider knowledge base might be needed to ensure tools are sufficiently trained to work on data from a range of organizations.
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https://www.healthdatamanagement.com/opinion/4-top-challenges-the-cloud-poses-to-database-management
HIT Think Beating the 4 top challenges of database management in the cloud
By Oren Eini
Published November 06 2018, 3:58pm EST
According to a recent survey from KeyBanc Capital Markets, 32 percent of CIOs say they plan to use multiple vendors to create internal private cloud systems, while 27 percent planned hybrid cloud arrangements.
It’s no secret why. When making the leap to the cloud, organizations have two goals in mind—achieving economies of scale not typically available to smaller organizations and obtaining greater access to resources that free up their own.
However, attaining these highly sought-after benefits isn’t always easy. As is the case with any innovation, a move to the cloud presents a new set of challenges. For database managers, dealing with complex data integrations spanning multiple environments presents a messy and complicated scenario.
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The best apps for exercise, health and fitness
From sleep to running: our experts pick the best apps to keep track of your health and fitness on your phone
Peta Bee | Phil Robinson | Lee Bell
Freeletics
A library of almost 1,000 five-to-thirty-minute workouts, none of them requiring equipment, that can be filtered by duration, body part and goals. The emphasis is on body-weight exercises (think squats, push-ups and burpees), although running is an option. Even with the free version the choice is huge and the video tutorials are among the best I’ve seen. Peta Bee
freeletics.com. Free — you can upgrade to Freeletics Coach, a digital “personal trainer”, £54.99 for six months
A library of almost 1,000 five-to-thirty-minute workouts, none of them requiring equipment, that can be filtered by duration, body part and goals. The emphasis is on body-weight exercises (think squats, push-ups and burpees), although running is an option. Even with the free version the choice is huge and the video tutorials are among the best I’ve seen. Peta Bee
freeletics.com. Free — you can upgrade to Freeletics Coach, a digital “personal trainer”, £54.99 for six months
Myfitnesspal
Using this app is like letting your company’s finance department audit your diet. You key in your weight, log what you eat and how much exercise you do and Myfitnesspal will tell you when you’ve reached your calorie limit for the day. There are no cutesy Californian motivational epithets. You begin to type what you are eating into a diary and the app presents you with likely options from its vast database. Define the portion size and it breaks your meal down into protein, fats and carbs. Mess up and the graphs at the end of the week are like a personal presentation titled: “THIS IS WHY YOU ARE FAT.” It’s brutal, but once you hit on an exercise/eating plan that works you can look back through the app and replicate that week again and again. Phil Robinson
myfitnesspal.com. Free — optional premium subscription £39.99 a year
Using this app is like letting your company’s finance department audit your diet. You key in your weight, log what you eat and how much exercise you do and Myfitnesspal will tell you when you’ve reached your calorie limit for the day. There are no cutesy Californian motivational epithets. You begin to type what you are eating into a diary and the app presents you with likely options from its vast database. Define the portion size and it breaks your meal down into protein, fats and carbs. Mess up and the graphs at the end of the week are like a personal presentation titled: “THIS IS WHY YOU ARE FAT.” It’s brutal, but once you hit on an exercise/eating plan that works you can look back through the app and replicate that week again and again. Phil Robinson
myfitnesspal.com. Free — optional premium subscription £39.99 a year
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Use your words! Sorting through the confusing terminology of artificial intelligence
By Mike Miliard
November 05, 2018 12:00 AM
AI, machine learning, cognitive computing, neural networks? Supervised, unsupervised, semi-supervised? Object recognition, natural language processing? What does it all mean?
In Orlando on Feb. 11, HIMSS will be hosting its second annual Machine Learning & AI for Healthcare event. That ampersand is important, because there is a distinction between artificial intelligence and machine learning, even if they're often confused or conflated.
Think of it this way: All machine learning is AI, but not all AI is machine learning.
To make it even more interesting, however, there's a healthy handful of other, equally confusing terms associated with AI that even the most tech-savvy healthcare professionals would be forgiven for scratching their heads over. There's cognitive computing and deep learning and neural networks and many others.
What does it all mean? What is legitimate technological terminology and what is just marketing jargon? (In healthcare AI, as you no doubt have noticed, there's no shortage of marketing.)
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UK to boost life expectancy through increased focus on "predictive prevention"
November 05, 2018 07:05 AM
UK government aims to improve healthy life expectancy by at least five extra years before 2035 through the use of digital technology and data.
Public Health England will bring together a group of experts to scale up the agency's work on "predictive prevention", enabling people to take greater control of their health and care through personalised advice and interventions, according to a new policy paper released this week.
“We are testing new ways of providing people with preventative advice, using cutting edge technology often called 'predictive prevention'," the government said. "Innovations like these provide exciting opportunities for the future of health and social care - offering earlier diagnosis and more targeted treatments, supporting self-management of conditions, making health and social care more convenient, and joining up data across services securely to deliver better and more personalised care."
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Only 29% of Healthcare Entities Have Full Cybersecurity Program
Only 29 percent of healthcare organizations report having a comprehensive cybersecurity program in place, according to the 2018 CHIME HealthCare’s Most Wired survey released this week.
By Fred Donovan
November 02, 2018 - Only 29 percent of healthcare organizations report having a comprehensive cybersecurity program in place, according to the 2018 CHIME HealthCare’s Most Wired survey released this week.
Among those organizations that don’t have a comprehensive program, 31 percent are either not meeting with their executive committee or are meeting less than once a year to provide security updates. For the survey, 618 healthcare organizations were polled.
The CHIME report described six core components of a comprehensive cybersecurity program and the percentage of respondents who have that component: security deficiencies reported to the board (95%), security progress reported to board (94%), dedicated CISO (90%), dedicated cybersecurity committee (79%), annual security updates to the board (76%), and board-level committee providing security program oversight (34%).
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99% of Healthcare Organizations Fully Access EHR System Remotely
Nearly all surveyed clinicians can access their EHR system from outside the hospital network, according to CHIME’s 2018 Most Wired report.
By Kate Monica
November 01, 2018 - Ninety-nine percent of surveyed clinicians can fully access their EHR systems remotely, according to CHIME’s Most Wired National Trends 2018 report.
CHIME surveyed 618 healthcare organizations to gain insight into each organization’s strategies for approaching health IT adoption, development, and optimization.
While past Most Wired research has focused primarily on measuring health IT adoption to showcase organizations with advanced health IT infrastructure, this year’s survey was designed to help healthcare organizations identify potential gaps in health IT adoption and use.
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Health IT Roundup—Apple Heart Study enrolls more than 400,000; Teladoc cuts net losses to $23M
by Evan Sweeney
Nov 5, 2018 2:56pm
Apple-Stanford heart study enrolls 400,000
Stanford Medicine and Apple have enrolled more than 400,000 participants in a study to see if the Apple Watch can predict a patient's risk of heart attack or stroke.
The Silicon Valley duo has closed enrollment in a study launched late last year that uses the Apple Watch to track heart rates. Researchers want to determine if the wearable can be used to identify atrial fibrillation earlier.
Researchers said the study has entered the final phase of data collection and will be completed early next year.
“We hope this study will help us better understand how wearable technologies can inform precision health,” said Lloyd Minor, M.D., dean of the Stanford School of Medicine. “These new tools, which have the potential to predict, prevent and manage disease, are finally within our reach.” (Release)
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The Rise of APIs and App Stores In Healthcare
Two years ago, we published a report on the promise of open APIs in healthcare. In APIs for a Healthcare App Economy: Paths to Market Success (available as a free download), provider organizations told us that developing and using APIs was low on their list of priorities. Modern REST-style APIs were still not on the radar for most providers and payers.
Back then, HCOs large and small said they expected their EHR vendor to build an API infrastructure for them. Two years ago, only Allscripts and athenahealth offered an app store along with a comprehensive developer support program. At that time, the other EHR vendors were slow-walking FHIR support and had vague plans for app stores and developer support programs. We found that:
- Small HCOs were completely dependent on their EHR vendor.
- EHR data was the most valuable data resource in healthcare.
- Large IT vendors had varied beliefs about the role and contribution of third-party developers.
- Large and small IT vendors had strong faith in open APIs.
- Small and independent IT vendors were thinking way beyond the EHR.
- Physician dissatisfaction with EHRs was an unsolved problem.
Since then, market conditions have continued to change. EHR vendors are now more vocally rolling out the API infrastructures that will bring healthcare into the mainstream of 21st century computing. Every major EHR vendor has delivered a variety of proprietary, HL7, FHIR, and SMART APIs along with the ability to leverage REST to improve their products.
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EHR, PHR or something in between? UnitedHealth’s tech venture prompts skepticism and intrigue
by Evan Sweeney
Nov 5, 2018 2:42pm
With plenty of cash on hand and a backlog of health IT acquisitions, the country’s largest health insurer is carving out its own space in the health IT sector with a new medical records platform.
But experts said it's not clear whether UnitedHealth can break through in an industry where companies have historically struggled with consumer engagement and interoperability.
Its plans are still shrouded in ambiguity, but UnitedHealth is poised to launch its own version of an electronic medical record. During its third-quarter earnings call last month, CEO David Wichmann said the company plans to release a “fully integrated and fully portable individual health record that delivers personalized next best health actions to people and their caregivers," indicating the solution would have some kind of baked-in analytics.
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ResMed buys post-acute care EHR MatrixCare for $750M
by Evan Sweeney
Nov 5, 2018 3:17pm
A company that specializes in connected devices and remote monitoring for sleep apnea and respiratory illnesses has agreed to buy the post-acute care EHR MatrixCare for $750 million.
San Diego-based ResMed announced the purchase on Monday morning, noting that MatrixCare's focus on skilled nursing facilities and long-term care providers is “complementary” to the company’s current offerings software offerings for medical equipment, home health and hospice.
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HIT Think How smarter data—not more data—can reduce physician burnout
Published November 05 2018, 4:55pm EST
Doctors have become collateral damage in healthcare reform.
By most measures, the last decade of healthcare transformation—with its focus on evidence-based guidelines, electronic health records and value-based payment models—has driven improvement in the quality of care individuals can expect from their healthcare providers. The frequency of hospital-acquired conditions is declining, hospitals are starting to realize cost-savings through bundled payment models, and 30-day readmission rates are declining nationwide.
Meanwhile, physicians are leaving the profession in droves. The problem has gotten so severe that the Association of American Medical Colleges now projects a U.S. shortage of 42,600 to 121,300 physicians by 2030. In many places globally, the physician shortage is even more staggering.
Increasingly, the evidence points to physician burnout as the driver of this phenomenon. A new study published recently in JAMA finds that nearly half of new residents experience symptoms of burnout at least once a week. This comes on top of a 2016 study authored by doctors from the Mayo Clinic and American Medical Association that found that the prevalence of physician burnout has increased from 45.5 percent to 54.4 percent over the last three years.
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Like Clockwork: How Daylight Saving Time Stumps Hospital Record Keeping
Hospitals often avoid the glitches by turning the software off and switching to paper charts. But that's less than ideal since hospitals have evolved to become increasingly reliant on electronic systems.
Modern technology has helped medical professionals do robot-assisted surgeries and sequence whole genomes, but hospital software still can't handle daylight saving time.
One of the most popular electronic health records software systems used by hospitals, Epic Systems, can delete records or require cumbersome workarounds when clocks are set back for an hour, prompting many hospitals to opt for paper records for part of the night shift.
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Why Doctors Hate Their Computers
Digitization promises to make medical care easier and more efficient. But are screens coming between doctors and patients?
By Atul Gawande
Digitization promises to make medical care easier and more efficient; instead, doctors feel trapped behind their screens.
On a sunny afternoon in May, 2015, I joined a dozen other surgeons at a downtown Boston office building to begin sixteen hours of mandatory computer training. We sat in three rows, each of us parked behind a desktop computer. In one month, our daily routines would come to depend upon mastery of Epic, the new medical software system on the screens in front of us. The upgrade from our home-built software would cost the hospital system where we worked, Partners HealthCare, a staggering $1.6 billion, but it aimed to keep us technologically up to date.
More than ninety per cent of American hospitals have been computerized during the past decade, and more than half of Americans have their health information in the Epic system. Seventy thousand employees of Partners HealthCare—spread across twelve hospitals and hundreds of clinics in New England—were going to have to adopt the new software. I was in the first wave of implementation, along with eighteen thousand other doctors, nurses, pharmacists, lab techs, administrators, and the like.
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Enjoy!
David.
