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, October 26, 2019

Weekly Overseas Health IT Links – 26th October, 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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Paramedics to get access to mental health crisis plans

Paramedics will soon be able to access the mental health crisis plans of emergency patients while on the move, following the successful first pilot phase of the National Record Locator.
Owen Hughes – 14 October, 2019
The National Record Locator Service enables paramedics and mental health nurses find out whether the patient they are treating has a mental health crisis plan.
In doing so, medical responders can decide whether the patient should be transported to a more appropriate care setting than A&E, or otherwise direct them to community-based care as indicated in the patient’s crisis plan.
Initial tests of the new National Record Locator service gave ambulance staff in pilot areas the ability to see whether someone they were treating had a mental health crisis plan.
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Can you make AI fairer than a judge? Play our courtroom algorithm game

The US criminal legal system uses predictive algorithms to try to make the judicial process less biased. But there’s a deeper problem.
Oct 17, 2019
As a child, you develop a sense of what “fairness” means. It’s a concept that you learn early on as you come to terms with the world around you. Something either feels fair or it doesn’t.
But increasingly, algorithms have begun to arbitrate fairness for us. They decide who sees housing ads, who gets hired or fired, and even who gets sent to jail. Consequently, the people who create them—software engineers—are being asked to articulate what it means to be fair in their code. This is why regulators around the world are now grappling with a question: How can you mathematically quantify fairness? 
This story attempts to offer an answer. And to do so, we need your help. We’re going to walk through a real algorithm, one used to decide who gets sent to jail, and ask you to tweak its various parameters to make its outcomes more fair. (Don’t worry—this won’t involve looking at code!)
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HIT Think

Why rural residents need better access to care, starting with high-speed Internet

October 18, 2019, 3:49 p.m. EDT
Did you know that “rural America” encompasses 97 percent of the US land mass? And, 60 million people (20 percent of the U.S. population) live in rural America.
This matters when it comes to healthcare. Because of the sheer distances, rural residents are increasingly isolated from reasonable geographic access to physicians, behavioral health professionals, outpatient clinics, and hospitals. This is a dangerous situation that must be addressed.
One way to tackle the issue is to expand telehealth services. But, that requires high-speed internet. And, in 2019 only 63 percent of rural Americans have a broadband internet connection at home. That’s 22.2 million people with no access to high-speed connectivity in their homes. Fortunately, there are several initiatives underway to tackle this problem head-on.
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More consumers look to use tech in their healthcare journey

October 18, 2019, 12:46 a.m. EDT
More Americans are seeking technology as part of their healthcare experience, according to UnitedHealthcare’s annual survey of consumer sentiment.
The survey of 1,008 adults was conducted for United by Engine Insights by phone and supplemental interviews last August, and found that 75 percent of respondents are prepared for this year’s open enrollment season, which runs from November 1 to December.
Some 37 percent of those surveyed in this year’s survey have used the internet or mobile apps to comparison shop for care, up from 14 percent in 2012, according to other United sources.
Millennials (50 percent) were the most likely to use comparison-shopping resources. Among all comparison shoppers, 80 percent described the process as “very helpful” or “somewhat helpful,” including 39 percent saying the shopping process prompted them to change their healthcare provider, facility, or both.
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The key to EHR customization? Listening to the end users, Inspira Health CIO says

Jackie Drees – 17 October, 2019
When it comes to EHR customization, Tom Pacek, vice president of information systems and CIO at Inspira Health in Mullica, N.J., considers end user feedback a critical component to validating how widespread a system issue really is.
Mr. Pacek joined Inspira Health's leadership team in 2008. In addition to leading the health system's IT network and information systems, Mr. Pacek also serves as president of NJSHINE, a public health information exchange in New Jersey.
Here, Mr. Pacek shares his advice for hospitals approaching an EHR customization and when to avoid implementing changes.
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E-Prescribing of Controlled Substances Still Underused

October 18, 2019
In theory, electronic prescribing of controlled substances should be in wide use these days, as there’s never been more pressure of doctors to be very aware of and document carefully such prescriptions.  However, a new blog item from ONC notes that this is not exactly how things stand.
In their recent item, doctors Andrew Gettinger and Thomas Mason note that there are a number of good reasons to use EPCS technology, including that it can support direct integration of opioid prescription information into EHRs and that it can streamline clinician workflow.
However, as Gettinger and Mason note, research from the National Electronic Health Record Survey found that as of 2017, only 32% of physicians used EPCS. The level of EPCS use varied significantly among different specialists, practice sizes and practice ownership structures.
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Survey Shows Growing Level of Interest in Healthcare AI

October 18, 2019
A new survey has found a big year-to-year jump in the number of healthcare executives saying they’d implemented an AI strategy, with administrative solutions getting more attention than clinical AI options.
The second OptumIQ annual survey on AI in healthcare queried 500 leaders from hospitals, health plans, life sciences organizations and employers on how they saw and what their plans were for the technology.
One of its key findings was an 88% increase over 2018 in the number of respondents stating they had an AI strategy in place and had implemented AI technology. The survey also noted a jump in spending on AI, with respondents estimating that their organizations would spend an average of $39.7 million over the next five years on AI, up $7.3 million from last year.
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Microsoft, Nuance developing ambient and AI technology to tackle doctors' documentation headaches

Oct 17, 2019 9:00am
Tech giant Microsoft is teaming up with Nuance Communications to use technology to solve a big pain point for doctors—too much time spent on documenting and administrative tasks.
The two companies are collaborating to use ambient technology combined with artificial intelligence, automation and cloud computing to create an exam room experience where the clinical documentation "writes itself," the companies said in a press release.
Physician burnout continues to be a significant problem in healthcare. A recent study shows that primary care doctors now spend two hours on administrative tasks for every hour they’re involved in direct patient care. Physicians reported one to two hours of after-hours work each night, mostly related to administrative tasks.
Joe Petro, chief technology officer at Nuance, said the two companies saw an opportunity to leverage their respective technical strengths to tackle the problem of physician burnout.
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EHR modifications, data analysis become tools to fight doc burnout

October 17, 2019, 12:41 a.m. EDT
Physician burnout continues to plague healthcare organizations, and at Privia Health, the financial hit can be an estimated $1 million for each physician that leaves and has to be replaced.
That can be a huge hit for the company, a national physician organization that provides services through high-performance physician groups, accountable care organizations and population health management programs, says Joseph DeVeau, MD, who is the virtual health medical director for Privia Medical Group.
DeVeau, who has survived his own case of burnout as a family doctor, knows many of the causes. Electronic health records systems are often cited as one of the causes of physician workloads, serving as a possible prelude to exhaustion and lack of desire to continue in the profession.
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Why there’s reason for cautious optimism with interoperability

October 17, 2019, 3:26 p.m. EDT
Recently, I’ve found myself cautiously optimistic about the progress of data and document exchange among physicians and health systems. Perhaps the cause of optimism is my recent return from two conferences focusing on the future of interoperability.
These conferences, the Strategic Health Information Exchange Collaborative (SHIEC) and the Office of the National Coordinator (ONC) Interoperability Forum, highlighted the state of the union for local and national data exchange.
Perhaps my optimism is an outcome of the actual work happening in the trenches of standards development, network proliferation and patient access. Or maybe it is because the interoperability product I’ve worked on at NextGen recently passed a five-year anniversary.
Regardless of the cause, when it comes to clinical data exchange between disparate electronic health record systems, optimism is rarely validated by the facts. Just in the last five years published research, private studies, and journal articles have found the following.
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How should AI be designed and regulated, and who should it serve?

That was the question Wednesday at the Connected Health Conference, as a panel of experts discussed the right regulatory approach to ensure developers can innovate – while also giving physicians and patients tools that work safely for them.
October 17, 2019 03:11 PM
The U.S. Food and Drug Administration unveiled a new set of draft recommendations on clinical decision support software recently, and in its guidance, the agency said it’s taking a risk-based approach to categorization of these various CDS tools, many of them powered by artificial intelligence, that it hopes will be an “appropriate regulatory framework that takes into account the realities of how technology advances play a crucial role in the efficient development of digital health technologies.”
Given the vast proliferation of AI and machine learning software across healthcare, and the speed at which it’s evolving, that certainly won’t be the last word from the FDA, or other regulatory agencies, on the subject.

A truly global framework

Indeed, said Robert Havasy, managing director of the Personal Connected Health Alliance, when he looks across the U.S. and around the world he sees the beginnings of a “truly global framework emerging, with common principles among the U.S., Europe and other places,” for the safe and effective deployment of AI in healthcare.
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Big Tech: Amazon’s Virtual Care Model Could Have A Big Impact

October 17, 2019
For quite some time, mainstream tech giants like Microsoft, Apple and Google have struggled to find a secure foothold in healthcare.
One of the biggest challenges they’ve faced has been figuring out just how much investment they should make in the brick-and-mortar aspects of patient care, e.g. real-world hospitals and clinics. So far, they’ve largely stayed out of that side of the business.
However, they have plenty of reason to go hard into virtual care which, among other things, requires no long-term investment in fixed assets and can be delivered easily to the consumer base they’ve already cultivated. As a result, the news that e-retail juggernaut Amazon is going into the telehealth business must be landing with a thump in healthcare boardrooms.
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Most Breached Hospital Data Includes Sensitive Information

October 17, 2019
It’s bad enough that hospital data breaches are so common. What’s worse is that the bulk of those breaches apparently disclose sensitive data which could help the thieves steal from the breach’s victims.
According to a new study appearing in the Annals of Internal Medicine, more than 70% off all hospital breaches expose patient demographic or financial information which could potentially be used to commit identity theft or other forms of fraud. The researchers drew this conclusion from an analysis of approximately 1,500 protected health information breaches taking place over the past ten years.
Specifically, they found that each breach studied exposed at least one piece of demographic information such as names or email addresses. Meanwhile, 2 percent of breaches included sensitive medical information, which they determined to have threatened the medical privacy of 2.4 million patients.
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Germany aims to become EU leader in digital health revamp

Berlin to push for overhaul amid concerns over privacy, implementation.
Updated 10/16/19, 5:57 PM CET
The EU’s biggest country is eyeing a digital overhaul of its massive health care system, and it wants to take the bloc along for the ride.
Strong concerns about privacy have long hampered efforts to digitalize health care in Germany. But its health minister, Jens Spahn, has now made doing so one of his top priorities.
This week, the German parliament’s health committee is hashing out with doctors, insurers and health industries’ representatives the draft Digital Supply Law that Spahn proposed earlier this year. One of its measures — a provision that would require German health insurers pay for apps that help diabetes patients manage their sickness, for example — is already facing opposition from the Bavarian State Medical Association. The group contends these apps shouldn’t be used without involving doctors in their prescription, the German Press Agency reported.
The legislation would also encourage doctors offering video consultations to make patients aware of this option, and it would grant a higher reimbursement rate to physicians if they send medical correspondence via email rather than by fax. Under present rules, reimbursement rates are higher for faxed correspondence, the ministry said.
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More on Telehealth

Telehealth eliminates time and distance to save money

In the age of consumerism, virtual visits meet consumers where they are, says Anthem executive.

Susan Morse, Senior Editor
In the argument of whether telehealth increases or decreases utilization, Anthem is squarely on the side of the latter and has been ramping up its efforts to expand virtual services to members.
Employers want it because it saves money and telehealth can keep employees on the job rather than leaving work to see their primary care doctor or go to urgent care or the emergency room, according to Maria Proulx, regional vice president Sales, Anthem Blue Cross Blue Shield of New Hampshire and former VP of Segment Solutions.
"I absolutely tell you, employers love it," Proulx said. "It's the idea of trying to meet members where they're at. They recognize the cost of care savings associated with telemedicine and for employees who can't leave during the day."
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How blockchain can protect telemedicine programs

A blockchain expert explains for healthcare CIOs and CISOs how the distributed ledger technology can defend telehealth systems against hackers.
October 16, 2019 12:20 PM
Despite the convenience of telemedicine, this technology raises enormous potential security concerns. If the virtual connection between a doctor and the patient is unsecure, it is possible that patients’ location, data and other sensitive information could be leaked.
“The privacy risks associated with telemedicine mostly stem from the lack of security controls over the collection, use and sharing of data,” said Blaise Wabo, associate director of A-LIGN, a cybersecurity technology and services vendor.
“For example, home telehealth devices and sensors may collect and transmit information on activities in the household that a patient wishes to keep private, such as substance abuse or their daily routine, including when their home is unoccupied during particular times of the day,” said Wabo.
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Tampa General, OnMed launch telehealth station that can diagnose patients

Oct 16, 2019 5:18am
Busy hospital staff can't always take hours out of their day to visit a doctor about minor problems like a sinus infection or a skin rash.
Staff at Tampa General Hospital (TGH) now have a new way to access instant healthcare services via a self-contained telemedicine station located inside the hospital.
TGH partnered with Clearwater, Florida-based technology company OnMed to be the first to deploy the company's telemedicine station after six years of development. The stations feature advanced technology including thermal imaging, ultraviolet sanitization and facial recognition to operate as self-contained, unstaffed exam rooms, the company said.
TGH is a 1,000-bed hospital with more than 8,000 full-time employees and 1,000 members on its medical staff.
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Oct 15, 2019, 04:40am

Microsoft Announces Important Security Update For All Windows 10 Users

Davey Winder
Microsoft announces new security update for all Windows 10 devices
Microsoft has had something of a rough time of late when it comes to Windows 10 updates, with the blame resting firmly on its doorstep. When these updates impact negatively on security, I'm amongst the first to call the operating system giant out. Ditto, as far as vulnerabilities in software associated with those updates are concerned. All too often Microsoft makes matters worse by introducing confusion rather than clarity to the update process. For once, though, I'm pleased to report that Microsoft has an update that will make Windows 10 devices more secure for all 900 million users. That update comes in the form of "Tamper Protection" that will lock down malicious and unauthorized changes to the security settings of Windows Defender. Changes of the type that the recent Nodersok Windows "Zombie Attack" attempts to make; the disabling of Windows Defender itself.

What is Windows 10 Tamper Protection?

Microsoft has announced, starting with immediate effect, it is to roll out Tamper Protection to all Windows 10 devices across the enterprise and consumer landscapes. First introduced with the May 2019 Windows 1903 update, Microsoft is to now enable the feature on all devices by default. Assuming, that is, your device is running with that Windows 10 1903 update installed; older versions of Windows 10 are likely to get the feature ported across in due course though.

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Docs Give Suggestions to Declutter EHR Inbox, Cut Physician Burnout

A study showed that physicians are unhappy with many features, or lack thereof, in their EHR inboxes.

October 15, 2019 - There is a direct correlation between EHR inbox usability and workflow, and physician burnout, safety, and efficiency, according to a study published in JAMA Network Open.
Researchers found that physicians would like EHR developers and healthcare organizations to reduce message processing complexity, simplify the inbox interface, provide features to reduce the physician cognitive load, facilitate care team communication, and streamline inbox message content.
From 2015 and 2016, researchers conducted walkthroughs using four separate EHR systems with 25 physicians at six separate large healthcare organizations.
Throughout these interviews, the physicians identified 50 barriers and 32 facilitators associated with EHR inbox designs and workflows. They also pointed out 28 other suggestions to improve the system.
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AI and machine learning growing as an industry force, experts say

October 16, 2019, 2:07 p.m. EDT
Through the expansive healthcare system in the U.S., few providers are actively using artificial intelligence technology.
However, more organizations are getting ready to take advantage of the technology, says Michael Muelly, a radiologist and product manager at Google Cloud Healthcare.
By 2005, AI got a boost from rapid advances in computing technology, and that helped usher in more advanced robotics, which led to computers learning from the data itself, Muelly explained during an educational session at the Medical Group Management Association’s 2019 conference in New Orleans.
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HIT Think

Why legal questions surround the use of voice technology in care delivery

October 16, 2019, 2:40 p.m. EDT
Voice recognition technology is on the rise—just ask someone with a smartphone or smart speaker—and, given the opportunities presented by artificial intelligence, the possible healthcare applications seem endless.
Imagine a traditional primary care physician visit during which the physician and patient engage in a direct and productive conversation with one another while an AI-powered voice technology listens in the background, handling the time consuming and distracting tasks associated with “charting.”
Given the popularity and usefulness of AI “assistants,” both healthcare providers and software developers are eager to explore potential use cases and to integrate these solutions into healthcare delivery. Despite the exciting potential for AI in healthcare, it is critical to carefully consider limitations created by an outdated legal framework and accompanying ethical pitfalls.
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Intermountain Reduces Waste With Blockchain, Saves $90M

October 16, 2019
If you’re wondering whether blockchain technologies are worth deploying in healthcare, you’ll probably find the following to be worth a look. According to a Forbes piece, Intermountain Healthcare has been using a mix of blockchain-based technology and AI to find waste within its 22 hospitals, and has generated a boatload of savings as a result.
Intermountain built its new solution with two vendors, BurstIQ and Empiric Health. Empiric, for its part, uses machine learning, artificial intelligence and natural language processing to find variations in patient care. Burst IQ, meanwhile, uses blockchain-based tech to support fine-grained ownership of data and protect privacy while making the data available to a large number of stakeholders, including patients, health systems, insurers, and medical researchers.
Combining Empiric’s analytics and BurstIQ’s blockchain-based capabilities, Intermountain created an approach that saved it more than $90 million in surgical costs over a two-year period.
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AdventHealth Uses AI to Balance Capacity Issues Among 9 Hospitals

By Mandy Roth  |   October 15, 2019

Use of command center AI technology and predictive analytics accelerate patient care and nearly eliminate the need to turn away patients due to capacity issues.

KEY TAKEAWAYS

·         Before AdventHealth's command center, Mission Control, launched in 2018, more than 500 patients were turned away from the health system and others experienced delays in care.
·         While some hospitals had capacity, lack of real-time data visibility across the enterprise made patient transfers difficult.
·         Today, only two patients a month are turned away and the time between receiving orders to admit a patient and finding a bed has dropped from about 90 minutes to 30 minutes
During 2017 nine hospitals in AdventHealth's Central Florida Division collectively turned away 526 patients due to lack of capacity. During the first six months of this year, that number plummeted to just two per month.
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Why Medical Data is 50 Times More Valuable Than a Credit Card

10/15/2019| by Will Maddox
As the healthcare company lurches into embracing cloud-based technology, protecting medical data has become even more essential. While banks and other financial organizations have long been data security experts, the healthcare field has been a bit slower to protect its data, which can often be more valuable than credit cards and bank account numbers.
Experts say the value of a social security number is worth 10 cents on the black market, with credit cards going for 25 cents. Medical identify theft of secure medical records, which often include both of those numbers plus much more information, is even more lucrative.
“Medical information is a lot richer,” says ClearDATA Chief Privacy Officer and Founder Chris Bowen, who says the medical record is 50 times more valuable than a credit card number. “It is not just the credit card. You can build entire human persona around a health record. You can create or seek medical treatment, abuse drugs, or get prescriptions. The life span is so much longer than a credit card.”
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Survey: 17% of health execs unaware of Cures Act rules

October 16, 2019, 12:11 a.m. EDT
Many healthcare providers and payers are in the dark when it comes to the 21st Century Cures Act’s health IT requirements, according to a new survey by Accenture.
The firm surveyed 76 chief information officers, chief technology officers and vice presidents of information technology at U.S. healthcare providers and healthcare payers with more than $1 billion in annual revenue.
What Accenture found was that 17 percent of health executives are “completely unaware” of the 21st Century Cures Act, which requires greater patient access to healthcare records and sharing of such records—with 65 percent only “somewhat” or “vaguely” familiar with the law’s provisions.
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Ancestry’s DNA health screening will require doctor’s order

October 15, 2019, 3:38 p.m. EDT
Ancestry.com is entering the growing field of genetic health screenings with a strategy that’s markedly different from that of its biggest competitor.
Ancestry said Tuesday that its new consumer health tests will require authorization by a physician. Its main competitor, 23andMe, went through the lengthy and expensive process of getting approval from the Food and Drug Administration so it can sell its tests directly to customers without a prescription.
The involvement of doctors in Ancestry’s tests places it in the midst of a debate over whether physician-ordered genetic screening is merely a way for companies to avoid the regulatory scrutiny of the FDA. Several other DNA startups, including Color and Veritas, also require a doctor to order health tests.
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Practices need to vastly improve data accuracy in records, attorney says

October 15, 2019, 3:50 p.m. EDT
The processes of medical recordkeeping continue to change, as regulators more frequently set new requirements, and many healthcare organizations struggle to keep up with the changes.
But the big problem is that too many hospitals and practices still haven’t managed the basics of collecting and reporting data for regulators and attorneys, Isabelle Bebit-Kilinyak, a corporate attorney in the McDonald Hopkins law firm in Cleveland, noted during an educational session at the Medical Group Management Association’s annual conference.
“We still see too many errors in data,” she asserted. “Signatures cannot be read, required information is omitted, and relevant information also is omitted. Who is keeping track of physical signature logs?”
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Drugmaker to Test Machine Learning to Prevent Drug Shortages

Germany-based Merck plans pilot using TraceLink software to sharpen its supply-and-demand forecasts

By  Sara Castellanos
Oct. 14, 2019 3:03 pm ET
Merck KGaA plans to use analytics and machine learning to predict and prevent drug shortages, a move that could also save it money.
Currently, the Germany-based pharmaceuticals company needs to stockpile medications to make sure it has enough on hand, meaning some of them expire before they can be used. Merck said its supply-and-demand forecasts are about 85% accurate today.
To sharpen its predictions, the company’s health-care division plans to start testing a cloud-based software platform later this year. The platform, made by North Reading, Mass.-based TraceLink Inc., can analyze in real time data points from various organizations within Merck’s supply chain, including pharmacies, hospitals and wholesale distributors.
TraceLink is now developing machine-learning algorithms that will be used in the pilot, which will begin with immuno-oncology drugs, designed to boost the body’s immune system to fight cancer. “We want to start it in an area where the product is a lifesaving product,” said Alessandro DeLuca, chief information officer for Merck’s health-care division.
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Will China’s revised cybersecurity rules put foreign firms at risk of losing their secrets?

·         Companies are concerned they may have switch to Chinese service providers and equipment to meet Beijing’s demands on the protection of sensitive data
·         ‘Chinese government is putting in place new tools that make it much more difficult for companies to keep their information private,’ cybersecurity expert says
Updated: 6:23pm, 14 Oct, 2019
As the clock ticks down to the latest update to China’s cybersecurity regulations on December 1, foreign firms are becoming increasingly concerned about how the changes might affect their operations.
Beijing has set its sights on becoming a technology powerhouse and to achieve that knows it must also develop a defensive structure capable of protecting its manufacturers, researchers and developers from cyberattacks.
As such, the new regulations, which operate alongside China’s cybersecurity law enacted in 2017, lay out precise instructions on how public and private sector companies and organisations – both Chinese and foreign – must secure their networks.
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CDS software, labels for staplers and breast implants among FDA 2020 guidance priorities

List comes two days after White House issued an executive order on agency use of the documents
Published Oct. 11, 2019

Dive Brief:

  • Final guidance on a variety of topics including the Safer Technologies Program for medical devices, labeling recommendations for surgical staplers, clinical decision support software and device-specific Safety and Performance Based Pathway implementation are among FDA's priorities for the 2020 fiscal year, the agency announced Friday.
  • A variety of device safety draft guidance initiatives on revising procedures for handling post-approval studies imposed by PMA order, labeling and an informed decision checklist for breast implants, and device cybersecurity management content in premarket submissions, are also top action items for FDA. 
  • The annual publication comes days after the White House issued an executive order aimed at limiting federal agencies' use of the documents by, among other requirements, necessitating Office of Information and Regulatory Affairs review of significant guidance documents before issuance. 

Dive Insight:

The FDA relies heavily on guidance documents to explain its thinking on complex regulation to a healthcare industry hungry for the information. 
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Geisinger CMIO: Innovation is about finding new ways to problem solve, not using new tech 

Jackie Drees – 14 October, 2019
Benjamin Hohmuth, MD, chief medical informatics officer at Danville, Pa.-based Geisinger Health System, sees innovation as new ways to tackle relevant problems rather than an opportunity to deploy new technology.
Dr. Hohmuth has a special interest in clinical informatics and has served as CMIO at Geisinger since 2018. Prior to taking on the role, he was associate CMIO and director of the health system's hospital medicine department.
Here, Dr. Hohmuth discusses how he helps foster innovation among his team members as well as the customization his team applied to improve workflows in Geisinger's EHR.
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Researchers Find 15% of Trials Could be Replicated Using Real World Data

Posted 10 October 2019 | By Michael Mezher 
A study published this week in JAMA Network Open finds that currently available real-world data (RWD) sources can only be used to feasibly replicate 15% of clinical trials.

The aim of the study was to determine whether RWD could be used to power observational studies that answer the same clinical questions as traditional clinical trials.

Randomized controlled trials (RCTs) are considered the gold standard for clinical evidence to support the safety and efficacy medical products due to high levels of internal consistency and reduced bias.
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What Banking Can Teach Health Care About Handling Customer Data

October 14, 2019
Why can we run our entire financial lives with a few smartphone apps, a couple of plastic cards, and an ATM network, while so many of our interactions with the health care system still rely on phone calls, copiers, fax machines, and even the occasional multi-part form? Why is the routine exchange of health care information still so difficult compared with the routine exchange of financial information?
One reason is that banking has solved some foundational interoperability issues that health care still struggles with. As the longtime CIO at Partners HealthCare in Boston and, more recently, as part of my work at Cerner, a major vendor of electronic health records, I’ve watched this struggle up close for decades. The obstacles are numerous, but they include a lack of agreement on standard methods of information sharing, a habit of regarding patient information as a competitive advantage to be jealously guarded, and a fragmented system of reimbursement that doesn’t encourage interoperability.
The widespread adoption of electronic health records should theoretically mean that we don’t have to repeat our medical history for every new doctor, any emergency room (ER) ought to know we’re allergic to penicillin even if we arrive unconscious, and we’ll automatically get a heads-up if we have a diagnosis that qualifies us to participate in a clinical trial.
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Joint task force to simplify merging personal health data into EHRs, drafts FHIR spec

PCHAlliance and Integrating the Healthcare Enterprise seek to enhance continuity of care by working on mobile health apps and personal health monitoring devices.
October 15, 2019 11:33 AM
The Personal Connected Health Alliance (PCHAlliance) and Integrating the Healthcare Enterprise (IHE) have joined forces to simplify the collection and sharing of health data generated by personal health monitoring devices and mobile apps to improve continuity of care.
A joint task force formed earlier this year has drafted a specification that applies the HL7 FHIR standard to report measurements taken by personal healthcare devices and mobile apps outside of healthcare facilities and report those measurements back to the person’s electronic health record.

More work to do

Test tools from both organizations are being integrated to create one process by which IT vendors can demonstrate consensus-based implementation of this specification during IHE Connectathons. Further alignment and integration of implementation guidance and testing are planned over the coming year.
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How blockchain can help improve patient identity matching and consent

During Converge2Xcelerate at the HIMSS Connected Health Conference, a blockchain expert and the CEO of DirectTrust put forth some ideas about how direct ledger technology could help solve a longstanding challenge.
October 15, 2019 01:09 PM
BOSTON - "We have to come up with new paradigms if we are going to succeed in this industry," said Amar Gupta, a professor at MIT's Institute for Medical Engineering and Science, as well as its CSAIL Lab, in a keynote address at Converge2Xcelerate on Monday.
At ConV2X – hosted by Blockchain in Healthcare Today and Telehealth and Medicine Today, and presented as part of the pre-conference events of the HIMSS Connected Health Conference – Gupta (who was recently named editor-in-chief of TMT) made the case that healthcare has been too insular and too hidebound for too long.
"You really need to respect the interdisciplinary work that needs to be done in this area," he said. "If you don't do that, you will not succeed in new innovations."
As if to take Gupta up on his challenge, Scott Stuewe, CEO of DirectTrust, and Vincent Albanese, CEO, of blockchain services company Haven Health Solutions – two different stakeholders who might not have been collaborating as recently as a few years ago – took the stage to describe how distributed ledger technology could help address one of healthcare's most perennial challenges: patient identity matching and consent.
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Healthcare Groups Urge Changes To Proposed ONC Interoperability Rule

October 15, 2019
Several trade groups focused on healthcare issues have come together to publish a letter urging the ONC to rethink aspects of its proposed interoperability rule tackling health data sharing, privacy and information blocking. ONC filed the proposed rule as part of a package of rules being put in place to implement the 21st Century Cures Act.
The groups signing the letter include the AMA, CHIME, AHIMA, AMIA, Federation of American Hospitals, Medical Group Management Association and Premier.
Addressed to the Senate Committee on Health, Education, Labor and Pensions, the letter argues that as it stands, the proposed rule would undercut their members’ ability to move toward a better healthcare system and greater data interoperability.
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Ransomware attacks on hospitals will worsen if security doesn't improve

Ransomware attacks are insidious. Experts urged healthcare CIOs to invest in proactive security measures to combat the growing threat.

By Makenzie Holland,
Published: 11 Oct 2019
Ransomware attacks on hospitals in Alabama forced a healthcare system to turn patients away last week.
The data and systems at three hospitals were held hostage until an undisclosed amount of ransom was paid, according to a press release. The hospitals gave into the demands despite another possible solution: reverting to a complete back-up of their data and systems.
In a press release, the health system said it was using backup files to rebuild certain system components, but received a key from the attacker to unlock the rest of its data. The lack of a complete backup, or the lack of a good data recovery plan for timely system restoration, is a common occurrence for healthcare organizations, often forcing them to pay the ransom, according to Clyde Hewitt, executive advisor for healthcare cybersecurity firm CynergisTek.
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The Data Breach Game: The 9 Worst IT Security Practices

How many of these data security offenses is your organization guilty of, and how can you correct them? Play the Data Breach Game and find out.
  • By Joey D'Antoni
·         10/09/2019
As news of yet another data breach breaks this week, I thought it would be fun to make a game out of the various ways data gets breached.
I even decided to get fancy and made a pretty graphic; you can enlarge it below or print out the .PDF version so you can play at home, since the ransomware your CEO downloaded to his iPad has locked your company out of its office badging system.
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Oct 12, 2019, 09:30am

AI (Artificial Intelligence): What’s The Next Frontier For Healthcare?

Tom Taulli
Perhaps one of the biggest opportunities for AI (Artificial Intelligence) is the healthcare industry. According to ReportLinker, spending on this category is forecasted to jump from $2.1 billion to $36.1 billion by 2025. This is a hefty 50.2% compound annual growth rate (CAGR).
So then what are some of the trends that look most interesting within healthcare AI? Well, to answer this question, I reached out to a variety of experts in the space.
Here’s a look: 
Ori Geva, who is the CEO of Medial EarlySign:
One of the key trends is the use of health AI to spur the transition of medicine from reactive to proactive care. Machine learning-based applications will preempt and prevent disease on a more personal level, rather than merely reacting to symptoms. Providers and payers will be better positioned to care for their patients’ needs with the tools to delay or prevent the onset of life-threatening conditions. Ultimately, patients will benefit from timely and personalized treatment to improve outcomes and potentially increase survival rates.
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Making the Case for National Unique Patient ID

Julie Dooling of AHIMA Offers Arguments in Favor of an Identifier
 Marianne Kolbasuk McGeeHealthInfoSecOctober 11, 2019
Congress is considering whether to allow regulators to fund work on developing a national unique patient identifier - an issue that has long been extremely controversial. In an interview, Julie Dooling of the American Healthcare Information Management Association makes the case for how such an identifier could help match patients to all relevant medical records to improve care and potentially help prevent fraud.
Because matching patients to the right records is so complex, the error rate is high, Dooling says. "Conservatively, there is an 8 percent to 12 percent duplicate record error rate in healthcare" due to multiple records created for the same patients, she says. And a national ID could play a critical role in reducing that error rate, she argues.
AHIMA is among dozens of healthcare industry groups that have been lobbying Congress to lift a longstanding ban against the Department of Health and Human Services funding the development or adoption of a national patient ID.
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Tools help doctors integrate mental health into patient care

October 14, 2019, 3:53 p.m. EDT
Patients who go to the doctor for a routine appointment generally get the care they came for, but the physician doesn't always consider the patient’s mental health status.
With tools at many physicians’ disposal such as artificial intelligence, data analytics and workflow software, a clinician can use analytics to integrate mental wellness into the appointment, says Chris Molaro, CEO at NeuroFlow, which offers a mental health analytics platform that works with the electronic health record of the practice.
NeuroFlow recently teamed with Genomind, which delivers genetic testing tools to help clinicians make more informed treatment decisions and create better outcomes for patients with mental illness.
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Ancestry to offer health tests as it steps up DNA test battle

October 14, 2019, 2:30 a.m. EDT
Ancestry.com, known for its DNA tests that enable customers to explore their family trees, plans to offer genetic screening for health problems.
“We’ve seen adding this capability as a natural evolution, but only if we could do it in a way that was authentic to our core mission,” Chief Executive Officer Margo Georgiadis wrote in an email that landed in customers’ inboxes last week. “That would mean creating a solution that could enable our customers to gain meaningful insights to help them live longer, healthier lives.”
She said AncestryHealth would be available to customers soon, but she did not specify a projected date.
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Q&A: John Halamka on worldwide trends in AI, blockchain, cloud and more

The pioneering CIO and longtime health IT evangelist, now Harvard's globe-trotting International Healthcare Innovation Professor, talks about what's next in emerging trends – and offers travel tips learned from 400,000 air miles each year.
October 14, 2019 03:07 PM
Longtime Beth Israel Deaconess Medical Chief Information Officer Dr. John Halamka left that role six months ago after more than two decades – during which time he also became one of the most vocal health information technology champions and visible thought leaders during a pivotal time of IT uptake.
Halamka has been traveling the world recently – more than 400,000 miles this year, he says –  from Europe to Israel to Africa to China, back to his Sherborn, Massachusetts-based Unity Farm Sanctuary for a quick visit with Dudley, his shaggy Scottish Highland Bull, and then out again to explore the newest global trends in leading-edge digital health.
Halamka will keynote the ConVerge2Xcelerate event in Boston on October 15, hosted by Blockchain in Healthcare Today – where he is editor-in-chief – and co-presented as part of the preconference activities of the Connected Health Conference.
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Black+ Decker Launches Home Robot With Medication Management Capabilities

October 14, 2019
For the most part, robots aren’t on the radar screen when providers look for remote healthcare options. However, at least one manufacturer with a long tradition of manufacturing practical consumer technology hopes to change this.
If you’re like me, you associate Black + Decker with its lines of power tools, lawn care and outdoor equipment and household appliances, and certainly, it’s still in those businesses. Recently, however, it’s launched a new type of tool aimed at addressing consumer health needs.
The company has just launched Pria, an automated medication management and home healthcare assistant device, the first Stanley Healthcare product designed for consumer users. (Stanley Healthcare already sells a range of products designed for senior living facilities and hospitals.)
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Physicians May Be Documenting Care That They Don’t Provide

October 14, 2019
A newly-published study suggests that physicians may not be performing all of the services they document. While the study tracked medical residents rather than physicians who had completed their training, researchers seem to have concluded that their problems with adequate documentation might point to problems affecting all physicians.
To conduct the study, which appeared in JAMA Network Open, a group of 12 observers tracked 9 licensed emergency medicine residents during 180 encounters. These observers were tasked with determining the extent to which the residents documented their review of systems and physician examination taking place during the encounters.
The observations took place at emergency departments in 2 academic medical centers between 2016 and 2018. After observing the encounters, the monitors then reviewed EHR data to determine how accurately the ED residents documented their activities.
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More Than 40% of Consumers Would Switch Providers Over Poor Digital Experience

By Jack O'Brien  |   October 11, 2019

More than half of consumers have used online reviews for choosing a provider, according to a new study.

Forty one percent of consumers said they would switch providers over a poor digital experience, according to a Cedar study released Wednesday.
Difficulties with online bill pay, scheduling appointments and mobile bill delivery were listed as some of the primary challenges facing consumers, with about 20% reporting that they have already switched providers.
Similarly, more than half of consumers have used online review sites to choose a provider, another testament to the pronounced role consumerism has played in healthcare in recent years.
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Weekly News Recap

  • Mednax will sell its MedData business to private equity firm Frasier Healthcare Partners for between $250 million and $300 million.
  • DCH Health System (AL) agrees to pay Russian hackers after an October 1 ransomware attack forced it to divert patients and revert to paper processes.
  • Membership-based primary care company One Medical hires several banks to help it prepare for an IPO.
  • Patient engagement vendor Relatient acquires patient self-scheduling and waitlist software developer Everseat.
  • Cerner reveals details about “Project Apollo,” new cloud-based technology that will leverage the company’s previously announced partnership with AWS.
  • Researchers determine that 25% of healthcare spending – between $760 billion and $935 billion per year – is wasteful.
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Data sharing practices of medicines related apps and the mobile ecosystem: traffic, content, and network analysis

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l920 (Published 20 March 2019) Cite this as: BMJ 2019;364:l920
1.       Quinn Grundy, assistant professor and honorary senior lecturer12,  
2.       Kellia Chiu, PhD candidate2,  
3.       Fabian Held, senior research fellow2,  
4.       Andrea Continella, postdoctoral fellow3,  
5.       Lisa Bero, professor2,  
6.       Ralph Holz, lecturer in networks and security4
·         Accepted 25 February 2019

Abstract

Objectives To investigate whether and how user data are shared by top rated medicines related mobile applications (apps) and to characterise privacy risks to app users, both clinicians and consumers.
Design Traffic, content, and network analysis.
Setting Top rated medicines related apps for the Android mobile platform available in the Medical store category of Google Play in the United Kingdom, United States, Canada, and Australia.
Participants 24 of 821 apps identified by an app store crawling program. Included apps pertained to medicines information, dispensing, administration, prescribing, or use, and were interactive.
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Enjoy!
David.

Friday, October 25, 2019

Here Is The Most Spectacular Information Secrecy Effort Yet Tried By The ADHA.

In a presentation offered to those responding to the RFI on the Future Platform for the myHR the ADHA offered the following slide (RFQ DH2298).

                                   Clinicians sharing information with other clinicians

                                                               Significant Growth


I am sure you will all instantly understand just how rich, comprehensive and quantitative the data they have provided is. Click on graphic to make it bigger.

They really are utterly paranoid about how little the system is actually used by clinicians I reckon. They know they have an information gap but simply refuse to come clean with the public. Note how as a proportion the Shared Summaries are simply hardly used!

Explanations of what this actually tells us welcome! They must take us all for utter fools!

David.