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, April 27, 2019

Weekly Overseas Health IT Links – 27th April, 2019.

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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Royal College of Physicians recruiting for digital healthcare lead

The Royal College of Physicians (RCP) is recruiting for a senior clinical to lead the development of its digital healthcare programme. 
Hanna Crouch 12 April, 2019
The professional body is looking for someone who has experience of implementing new technologies or evaluating digital healthcare solutions and driving improvements that benefit patients.
The job adverts adds: “We are seeking a leader who can work effectively as part of a team, whilst initiating and maintaining operational and strategic relationships with external colleagues and stakeholders, including patients and carers.
“We will appoint a Clinical Director with strong communication and lobbying skills; a translator, someone who is equally comfortable with clinical informaticians and non-experts working in clinical practice.”
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IBM Watson Health cuts back Drug Discovery 'artificial intelligence' after lackluster sales

And seemingly uses machine learning to explain why it's kinda not but kinda is

By Katyanna Quach 18 Apr 2019 at 23:07
IBM Watson Health is tapering off its Drug Discovery program, which uses "AI" software to help companies develop new pharmaceuticals, blaming poor sales.
The service isn’t completely shutting down, however. IBM spokesperson Ed Barbini told The Register: “We are not discontinuing our Watson for Drug Discovery offering, and we remain committed to its continued success for our clients currently using the technology. We are focusing our resources within Watson Health to double down on the adjacent field of clinical development where we see an even greater market need for our data and AI capabilities.”
In other words, it appears the product won’t be sold to any new customers, however, organizations that want to continue using the system will still be supported. When we pressed Big Blue's spinners to clarify this, they tried to downplay the situation using these presumably Watson neural-network-generated words:
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Patent filings hint at Apple's potential move into managing healthcare records


Apple has already made notable inroads into healthcare with new health features on its Apple Watch and its continued expansion of its Health Records on iPhone feature.
But digital health leaders and analysts see the potential for Apple to become an even bigger player in consumer health, specifically with electronic health records, similar to how the company built an online music sales experience with iTunes.
Recently published patent filings support the idea that the company has ambitions to be the Mint.com of health records by aggregating all consumers’ health data in one place on their mobile devices, Dave Levin, M.D., chief medical officer of Sansoro Health and former CMIO for the Cleveland Clinic, told FierceHealthcare. 
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Most Hospitals Use EHR Data to Support Quality Improvement Efforts

An ONC data brief shows hospitals most often use EHR data to support quality improvement, monitor patient safety, and measure performance.
April 17, 2019 - Eighty-two percent of hospitals used EHR data to support quality improvement from 2015 to 2017, according to a newly-released ONC data brief.
ONC used data from AHA’s Information Technology survey to assess trends in EHR data use among non-federal acute care hospitals. According to data from AHA, 81 percent of hospitals use EHR data to monitor patient safety, while 77 percent use it to measure organization performance.
Sixty-eight percent of hospitals used EHR data to identify high risk patients, while 67 percent used data to create individual provider profiles.

Friday, April 26, 2019

The Eight Pillars Of The Digital Health Revolution – Bianca Phillips

This article, and last of a series of five and reproduced with permission.

The eight pillars of the digital health revolution

Authored by  Bianca Phillips
This article is the final in a series on the making of the digital health revolution. It provides an overview of what has been discussed to date as well as some additional thoughts.
Personalised medicine
In the article Digital health success hinges on four principles, co-authored with Dr Bernard Robertson-Dunn, we provided an overview of personalised medicine and an overview of pharmacogenomics, epigenomics, exposomics, transcriptomics, proteomics, phenomics, microbiomics and metabolomics.
We proposed the idea that the shift to a personalised medicine model of care would require the application of four principles:
  • the acquisition of more and better data from the patient at the time and point of care;
  • diagnostic tools and models that understand and interpret these data;
  • treatment that addresses the cause of the problem; and
  • a health care system that efficiently uses this radically different approach to clinical medicine.
Telemedicine for diabetes and heart failure
In the article Telemedicine for diabetes and heart failure: an evidence review, co-authored with Dr Denise O’Connor and Professor Leonard Gray, we observed that the “evidence from systematic reviews and overviews indicates that telemedicine can improve blood glucose control in people with diabetes and provide similar health outcomes in the management of heart failure as to face to face or telephone delivery of care.”
We also noted that the Cochrane telemedicine review findings will be updated later this year and may be of interest to practitioners looking to implement telemedicine into their practices, and recommended the Royal Australian College of General Practitioners telehealth guidelines.
My Health Record challenges
In the article My Health Record: legal challenges, co-authored with David Vaile, we discussed the concerns put forth by the Parliamentary Joint Committee on Human Rights, and the Human Rights Commission in relation to the My Health Record opt-out model.
Additionally, we discussed the language used in section 67 of the My Health Records Act 2012, which states that a patient can use information included in their My Health Record “for any purpose”. We considered the provision from the lens of practitioner privacy, which is often overlooked as an area of importance.
Control and ownership of health records were also noted as a legal challenge. We stated that:
“We need to debate whether patient control is a good idea from a clinical, legal, ethical and social perspective, and also the degree to which the current claims about patient control reflect the design and operation of a system by a third party with the power to change the rules at any time, and to interpret which third party claims to accept.”
It will be interesting to follow the debate on data ownership taking form in the United States, and it is hoped that these matters will be more openly discussed in Australia moving forward.
The eight pillars of digital health law making
Having observed the My Health Record system as a case study of law making, there appear to me to be eight pillars of law making. The eight pillars I suggest are as follows:
  • accountability of law makers for the reasons for their decisions;
  • human rights;
  • clinical benefit;
  • societal benefit;
  • harm reduction;
  • risk reduction;
  • business case; and
  • public consultation.
These principles were considered as part of the law-making process for My Health Record, but there are questions surrounding the extent to which they were considered and whether the law-making process could be improved.  I am of the opinion that these eight pillars could be applied to the field of digital health more generally, being utilised in a structured manner as component of decision-making. At the very least, they could be utilised as a law-making quality review checklist, just like AMSTAR is used as a checklist for the quality of systematic review.
Some of these pillars are easier to define than others. For example, notions of clinical benefit are easier to define than societal benefit, which is laden with complex societal, ethical and philosophical questions. The task of further elaborating these pillars is a component of my research; however, I note that there are some benefits in retaining a framework in its abstract form, as often reaching a consensus on broad considerations is a necessary starting point.
Conclusion
The digital health movement has precipitated in the past 5 years, and it is expected that the field will continue to grow as technology companies turn their focus to the consumerisation of health care. It is clear that the approach to date has been one of “move fast and break things”. However, as Paul Yock has stated:
“In this environment, tech’s ‘move fast and break things’ model can become ‘move too quickly and break your company’ … [a] better approach for healthcare is need-driven innovation. Rather than leaping to invent a technology (like a sleep monitor) and then searching for a challenge it can be used to address (promoting more restful sleep), one starts by deeply understanding an important problem in healthcare and then designs a technology that is uniquely suited to solve it.”
As such, the success of digital health requires immense input from the medical community in order to achieve its intended objectives.
Digital health is more likely to accord with principles of evidence-based medicine, and to account for the needs of patients and practitioners in the clinical setting, if practitioners themselves are the driving force for change.
It is my view that attempts by technologists and governments to present new tools as a fait accompli will simply not succeed.
Thank you for following the series, and I hope it has been interesting and has presented some new ideas for your consideration. I would like to thank all of the co-authors for their insightful contributions along the way; it was wonderful to co-author with leaders in the field of digital health from the disciplines of law, engineering and medicine.
Bianca Phillips is a Victorian academic lawyer conducting medical law research. Bianca will be presenting her ideas on the future of digital health and the law at a summit at Harvard Medical School later in the year. If you would like to get involved in her research initiatives, feel free to connect on her website www.e-healthconsultants.com. She can also be found on Twitter @biancarphillips and LinkedIn.
Here is the link:
I am sure comment are welcome!
David.

I Know The Recent Comments App Has Stopped Working!

It has done this before and recovered in a day or so. Nothing has been changed at this end.

Sorry for the service interruption!

David.