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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The NHS is not ready for the next generation of doctors
Whether you like it or not, technology is here to stay and is ingrained in most people’s everyday lives though some believe healthcare is lagging behind. Dr Lydia Yarlott, NHS Paediatrician and co-founder of messaging app, Forward Health, delves into why she believes a lack of technology might be pushing young doctors away.
DHI Team News
24 October, 2019
It was announced recently that an extra 5,000 trainee medics will be needed each year to make up the current shortfall in the NHS workforce, and that’s before we consider the impact Brexit will have.
The number of psychiatrist vacancies has doubled in six years. GPs, the first line of defence for our under-pressure health service, are in desperately short supply.
Astonishingly, the number of junior doctors leaving the profession after just two years in practise is now greater than those who stay. Recently we heard that clinicians are being encouraged to ‘ration’ referrals to specialists in order to minimise strain on services.
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‘Unacceptable delays’ see Microtest lose NHS Wales GP contract
NHS Wales has cancelled its contract with Microtest following “unacceptable delays” in getting its clinical software out to GPs.
Owen Hughes
25 October, 2019.
Microtest had been contracted to deliver its clinical systems to Welsh GPs over a four-year period after being awarded onto Wales’s primary care IT framework in 2018.
NHS Wales Informatics Service (NWIS) has now announced that this contract has been aborted “by mutual agreement”, after Microtest was unable to “deliver the hosted clinical software and meet the integration requirements of NHS Wales within the timescales that would allow GP practices to transition from the previous contractual arrangements.”
An NWIS spokesperson said: “The decision to end the contract was not arrived at lightly, with several factors contributing, including the impact that the delays were having on practices in planning for their migration to a new system.
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Electronic Prescription Service to be rolled out nationally next month
All prescriptions in England are set to be digitised following the roll-out of the final stage of the Electronic Prescription Service (EPS) next month.
Andrea Downey
21 October, 2019.
The service will create a faster and more secure process for clinicians to prescribe and dispense medication, the Department of Health and Social Care said.
Following successful trials in 60 GP practices and thousands of pharmacies, it’s estimated the service will save the NHS £300 million a year by 2021 through reducing paper processing and prescribing errors.
The pilot saw some 329,000 prescriptions dispensed by more than 3,100 community pharmacies. Roll-out is due to begin on 18 November.
Jo Churchill, primary care minister, said: “Digitising the entire prescription service is a key part of keeping up the drive to make the NHS fit for the 21st century.
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A biased algorithm is delaying healthcare for black people in the US
Technology 24 October 2019
A medical algorithm used in the US is prioritising the treatment of healthier white people over sicker black people
Joe Raedle/Getty Images
Black people in the US may be missing out on healthcare because a widely used algorithm is racially biased. The proportion of black people referred for extra care would more than double if the bias were removed, according to new research.
Algorithms are fast becoming a key part of healthcare. Such technologies are used to screen somewhere between 100 and 200 million people in the US, says Ziad Obermeyer at the University of California, Berkeley.
One example is an algorithm that is used to predict the future health of individuals based on their past health records. Once the algorithm is fed data about a person’s diagnoses, prescriptions and procedures, it spits out a number that predicts the cost of the person’s future healthcare.
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Can Using the Computer During a Visit Improve Patient Relations?
Yes, says David Nash, MD, MBA -- if the patient does it alongside you
David Nash, MD, MBA
25 October, 2019
Ever since the dawn of electronic medical records (EMRs) in the 1970s, the physician community has registered concern about being forced to spend more time interacting with computers than patients.
Admittedly, this is a valid argument; however, spending more time with a computer does not necessarily preclude spending time with patients. In fact, the computer creates opportunities for physicians to connect with patients on a whole new level.
For example, a recent article by Zuzanna Czernik, MD, and colleagues recounted the case of a patient admitted to the hospital with pleuritic pain who, on the basis of general rudeness and unwillingness to follow physician orders, had been labeled as "difficult." The patient's demeanor changed dramatically when the physician brought a computer to the bedside and showed him the area of concern on the computed tomography scan of his lung.
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ONC: One-third of hospitals use EHR to access PDMP data
October 24, 2019, 11:14 p.m. EDT
Nearly one in three hospitals are using their electronic health record systems to access state-run databases that track prescriptions written for controlled substances.
Prescription drug monitoring programs, which are seen as vital to reducing opioid prescribing, are not typically well integrated with the EHRs that clinicians use.
However, the Office of the National Coordinator for Health IT contends that it has the “first evidence of how hospitals are accessing PDMP data” within their EHRs.
An ONC analysis of 2017 AHA Annual Survey Information Technology Supplement Data shows that EHR-PDMP integration is providing hospitals with patient-specific prescription information at the point of care to help reduce opioid misuse.
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Physicians want to pressure vendors to improve EHRs
October 24, 2019, 11:06 p.m. EDT
Many doctors are profoundly unhappy with the capabilities of their electronic health records systems, and calls are growing for vendors to do better.
That’s one of the major findings from an annual survey by Medical Economics of how physicians feel about the capabilities of their EHR systems. More than 1,000 physicians responded to the survey, with nearly half saying their EHR has harmed the quality of care within the practice, rather than improving it.
Complaints about EHR systems include:
- Lack of user-friendliness because the records are not organized the way clinicians have been taught to organize patient notes, and they have to click too many times to find information, and problem lists are designed to only get ICD-10 codes correct.
- Exchanging information remains difficult because ambulatory and hospital EHRs don’t share information easily, so physicians often can’t use their own EHR in the hospital.
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HIT Think
Engineering the frictionless user experience through password-free identity
October 25, 2019, 3:30 a.m. EDT
Passwords are stuck in the past.
It recently took me several minutes to check a balance on my bank’s mobile website. I’m not the only one finding it difficult to navigate mobile apps, password vaults and resets, security questions and other everyday elements of the login process.
I’d like to check my balance from a smart watch, inquire about an insurance claim through a voice-activated home assistant and receive important portfolio alerts sent directly to my smart television — all without having to enter a password.
A related issue, more important for new customers, is being able to open an account without waiting for days or weeks. Gen Z and millennial clients are accustomed to instant response from digital services, and they expect similar convenience from financial services providers. (For a deeper dive on the forces reshaping the financial services industry, I suggest a six-minute read, “Five actions to achieve adaptive risk management.”)
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HIT Think
How hackers increasingly can target the data of homebound patients
October 25, 2019, 2:16 p.m. EDT
With the rising number of homebound healthcare patients using technology to communicate with caregivers, family and others, comes new data threats from hackers targeting patient data.
In a new blog post, I’ve assessed the data security threat of hackers obtaining sensitive data through popular home smart assistant technologies such as Alexa and Google Home, from which hackers can launch attacks.
Here is what patients, families and caregivers need to know in order to not become a conduit for a hacker.
- Although Amazon and Google respond to reports of vulnerabilities in popular home smart assistants, hackers continually work hard to exploit any vulnerabilities in order to listen to users’ every word to obtain sensitive information that can be used in future attacks.
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The NHS trust leading the digital revolution
Data experts at a Kent NHS trust at the heart of the NHS digital revolution have signed up at least 30 NHS trusts for their award-winning solutions to improve patient care.
October 25, 2019 03:14 AM
The East Kent Hospitals University NHS Foundation trust stands to make a significant contribution to the gargantuan task of digitising the NHS.
THE LARGER TREND
NHSX Chief Exec Matthew Gould has previously likened this task, to “eating an elephant” on account of the vast number of systems and the byzantine maze of data trails within the NHS. Luckily these data experts have an appetite for a challenge.
THE LARGER TREND
They have created a dedicated information and analytics team, headed by demographics’ expert Dr Marc Farr, which is described as “one of the most mature data frameworks of any trust”. They have even developed their own brand called Beautiful Information. Farr, previously with Doctor Foster Intelligence, arrived at the trust with a clear agenda.
ON THE RECORD
Farr said: “My mission was to separate informatics from IT, raise the profile of information and develop a strategy which would build a central team delivering actionable, real-time data. My ambition was to create the most transparent trust in the country.”
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National Academy of Medicine Tackles Healthcare Worker Burnout 'Crisis'
By Christopher Cheney | October 25, 2019
A new clinician burnout report from the National Academy of Medicine includes six recommendations to address the problem.
KEY TAKEAWAYS
· About half of physicians nationwide are experiencing burnout symptoms.
· Physician rates of depression or suicidal ideation are as high as 40%.
· Burnout is also impacting trainees, with 45% to 60% of medical students and residents experiencing symptoms.
The National Academy of Medicine has released an extensive report on how the country can respond to burnout in the medical professions, with the president of the organization calling burnout an epidemic in need of urgent action.
Research indicates that about half of physicians nationwide are experiencing burnout symptoms, and a study published in October 2018 found burnout increases the odds of physician involvement in patient safety incidents, unprofessionalism, and lower patient satisfaction. Burnout has also been linked to negative financial effects at physician practices and other healthcare organizations.
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The National Academy of Medicine says healthcare must make transformative changes to address burnout
Oct 24, 2019 7:35am
Twenty years ago, it issued a landmark report on medical errors that fueled a nationwide patient safety movement. Yesterday, the National Academy of Medicine said the healthcare system must make the same kind of transformative changes to address clinician burnout.
With between one-third and one-half of U.S. clinicians experiencing burnout, the National Academy of Medicine called the problem an epidemic that requires systemic changes by healthcare organizations, educational institutions and all levels of government. In a new report, the academy outlined six goals—from creating positive work environments to improving the usability of information technology—stakeholders should aim at to prevent and mitigate burnout among physicians, nurses, medical students and other health professionals.
The academy, known then as the Institute of Medicine, authored the report "To Err is Human" and shocked the country with the revelation that nearly 100,000 people a year lost their lives to preventable medical errors, which fostered the drive to improve quality in the healthcare industry. Academy President Victor Dzau said the organization hopes it latest report will have a similar effect as burnout has been linked to increased medical errors, reduced quality of care and high turnover rates.
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October 24, 2019 / 10:14 AM / a day ago
Amazon buys healthcare start-up Health Navigator
(Reuters) - Amazon.com Inc said on Wednesday it bought healthcare start-up Health Navigator, its second purchase in the healthcare services industry.
The deal comes after the company acquired online pharmacy PillPack last year, pitting itself against drugstore chains, drug distributors and pharmacy benefit managers. (reut.rs/31DSU8k)
The company said the acquisition is a part of its new employee offering, Amazon Care, where employees of the e-commerce giant will be able to receive fast-paced access to healthcare facilities without having to make appointments.
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Cleveland Clinic looks to tech to help double number of patients
October 24, 2019, 1:57 a.m. EDT
Last year, the Cleveland Clinic cared for more than 2 million patients—an unprecedented number. However, president and CEO Tom Mihaljevic, MD, says it’s a small fraction compared with what the health system can and should be doing.
“The care that we deliver today is of paramount importance to those in need,” Mihaljevic told an audience this week at the Cleveland Clinic’s 2019 Medical Innovation Summit. “What we strive to do is to touch as many people as possible with the highest quality care.”
Mihaljevic said the Cleveland Clinic has an “ethical mandate to grow” and a moral obligation to relieve human suffering. However, he acknowledged that the provider organization “touches far fewer lives than what our brand recognition, our reputation would suggest.”
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Ambient clinical intelligence push aims to aid docs, ease EHR burdens
October 24, 2019, 2:48 p.m. EDT
A recently announced collaboration between Nuance Communications and Microsoft is part of a growing movement to use information technology to assist—and not burden—doctors.
The use of ambient clinical intelligence holds the promise of bringing IT alongside clinicians to support them and give them the ability to focus their attention on patients, without having technology get in the way, contends Eric Topol, MD.
The effort by Nuance and Microsoft was announced last week, with the bold aim of “transforming healthcare delivery for a more sustainable future,” primarily by speeding the use of ambient clinical intelligence (ACI) technologies.
In this scenario, clinicians would interact with patients verbally, and the technology would enable the compilation of clinical notes by automatically extracting relevant information for clinical records invisibly, in the background, without clinician intervention during the patient encounter.
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Topol: AI in early stages, but has potential to revolutionize healthcare
October 24, 2019, 1:37 a.m. EDT
Emerging technology has the potential to add efficiency and effectiveness to healthcare, according to Eric Topol, MD.
Capabilities such as artificial intelligence, polygenic risk scores and digital health technology can equip physicians to improve and reduce the cost of care, while enabling them to better connect with patients, said Topol, the founder and director of The Scripps Research Institute.
Much of care today is not based on provable facts, Topol noted at Liberation 2019, the annual meeting of Medecision, in Frisco, Texas. He cited an article by Hannah Fry, MD, published last month in The New Yorker, which detailed research that found that, of every 1,000 people taking statins for heart conditions over five years, only 18 will avoid a major heart attack or stroke.
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Jefferson Health combines genomics, population health to enhance employee wellness
More than 30% of the health system’s employees have signed up for a precision medicine program that helps get predictive genomics data straight to frontline caregivers.
By Bill Siwicki
October 24, 2019 11:38 AM
Health system Jefferson Health is deeply committed to doing the right thing for the health of its employees. And the health system knows that precision medicine, based on a personal risk analysis thanks to genomics, can help individuals predict risk, but also can help physicians develop the right care plans.
THE PROBLEM
“We knew we had to offer that to the 32,000 people who work with us,” said Dr. Stephen K. Klasko, CEO of Jefferson Health and president of Thomas Jefferson University.
In addition, the health system hosts an NCI-designated cancer center – the Sidney Kimmel Cancer Center at Jefferson. Sidney Kimmel has been a leader in cancer genomics and in genetic counseling to diagnose and predict outcomes. Most recently, Sidney Kimmel created a genomic screening center for men.
“That counseling is critical: Once the results come in, we had to provide immediate help to employees who would ask, ‘What does this mean?’“ Klasko said.
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How a hospital sought to reduce strain on staff and improve outcomes using new enterprise imaging technology
Healthcare IT News went to Princess Alexandra Hospital in England earlier this month to speak to staff about the impact of the new system.
October 24, 2019 03:57 AM
The need to address the NHS' shortage of radiologists is widely recognised in England, where unmanageable workloads are said to be adding more strain on a workforce already spread too thin.
One organisation that has experienced increasing demand on services is Princess Alexandra Hospital NHS Trust (PAHT), located in the south-east, where the radiology department has seen a 10% year-on-year increase in imaging referrals.
The trust, established in 1965, looks after a local population of over 350,000 people, operating across three sites, the Princess Alexandra Hospital, St Margaret’s Hospital and Herts and Essex Hospital.
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Google, care.ai working together to develop autonomous monitoring platform
The edge computing technology's neural network algorithms can help drive workflow efficiency, detect gaps in care and deliver real-time intelligent notifications to staff, the AI developers say.
By Mike Miliard
October 24, 2019 02:52 PM
As it works to develop what it's calling a "Self Aware Room" for hospitals, artificial intelligence company care.ai is collaborating with Google, using its Coral Edge tensor processing unit to drive faster edge-deployed neural networks for autonomous patient monitoring.
WHY IT MATTERS
The technology, says care.ai, will be able to more effectively and efficiently keep tabs on hospital patients' conditions, sending tailored notifications to staff to keep them apprised of what's happening in a room at any given time.
The technology, says care.ai, will be able to more effectively and efficiently keep tabs on hospital patients' conditions, sending tailored notifications to staff to keep them apprised of what's happening in a room at any given time.
This could help with the management of preventable falls, pressure ulcers, infectious disease, and other patient safety issues, the company said, replacing reactive responses with more forward looking AI-powered predictive monitoring.
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IT DevOps Solutions to Improve the Physician and Patient Experience
October 24, 2019
We all know that Physician Burnout is a big problem in healthcare. Not only is it impacting physicians, but that has a trickle down effect on patient experience as well. That’s why we see so much focus on how to improve the physician experience. While I’ve seen a lot of great efforts, I’m quickly realizing that there’s a kind of hidden world of IT DevOps that could play a much bigger role in improving the physician experience than most people realize.
For those not familiar with IT DevOps, it’s basically creating a beautiful synergy between the development of the software you use and the operations that’s required to support that software. Turns out that you can develop the best EHR software in the world, but if the IT DevOps is poor, then the EHR software could run really poorly.
This disconnect is why I’ve known EHR companies that have wanted to control the full IT stack in a medical practice from desktop to network to server and everything in between. It was the only way they could ensure that the customer had a great experience with their EHR software. It’s also why Epic is so restrictive and controlling in how and where you can use their software. They understand that how you host their EHR is going to make a huge impact on the experience you have with their EHR. So, they require a certain IT DevOps infrastructure to ensure you’re getting the best experience possible.
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Cerner Revenue Hits $1.4B in Q3
By Jack O'Brien | October 24, 2019
The Kansas City-based health information technology company saw revenue rise 7% year-over-year.
Cerner Corp. reported $1.4 billion in Q3 revenue, according to its latest earnings report released Thursday afternoon.
The Kansas City-based health information technology company grew its revenue 7% year-over-year and recorded GAAP net earnings of $169.4 million.
Additionally, Cerner reported an operating cash flow of $351.4 million with a free cash flow of $174.4 million.
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House panel approves measures to establish Philippine eHealth System
Emphasis and priority should be given to assist Filipinos in record keeping and making medical history available.
The proposed measure creating the country’s electronic health system has passed the first hurdle in the House of Representatives.
According to a recent press release, the technical working group (TWG) of the House committee on health recently convened, even while Congress is on a month-long recess, to approve proposals that seek to establish the Philippine eHealth System and Services.
The TWG Head and Committee Vice-Chair explained that they consolidated the proposed measures to a substitute bill and harmonised it with the recently signed implementing rules and regulations (IRR) of Republic Act (RA) 11223 or the Universal Health Care (UHC) Act.
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The 5 biggest risks ambulatory care needs to address, according to ECRI Institute analysis
Oct 23, 2019 3:11pm
Errors in diagnostic tests and medication safety events pose the biggest risk to patients in ambulatory care settings, according to a new analysis.
Those two errors are the most frequent safety risks in ambulatory care, a report (PDF) from the ECRI Institute, an independent nonprofit organization, found.
The analysis was based on 4,355 adverse events reported to the institute by physician practices, ambulatory care centers and community health centers between December 2017 and November 2018. Nearly half of the events involved diagnostic testing errors; a quarter involved medication safety, and the rest involved falls, security and safety and privacy-related risks, the institute reported.
Approximately half of all events reported occurred in physician practices.
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Industry Voices—Returning the control of health data to the consumer
Oct 23, 2019 10:35am
The vast amount of data available in today’s technology-driven and hyperconnected society is astounding. We create data everywhere we go with our smartphones, tablets and laptops, and the increasing prevalence of the internet of things means that even more of the devices we interact with on a daily basis are gathering and sharing information.
The application of this information through the creation and interpretation of large data sets, i.e. big data, is becoming an increasingly valuable economic force. Organizations in both the public and the private sectors are leveraging big data across industries, including healthcare, to develop more effective practices, inspire innovative breakthroughs and better serve consumer needs.
The growing role of data in our lives and the data trading markets that have arisen raise important questions about data access and ownership. Who rightfully owns data, the individual creating it or the organization collecting it? Who has the right to access all of this information, and what are they allowed to do with it? Who ultimately has more control when it comes to data use, the individual or the organization?
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How Real-World Data Could Advance Clinical Trials, Precision Medicine
Real-world data has the potential to enhance clinical trials and precision medicine, but researchers will need to ensure data is accurate and valid to truly impact patient care.
By Jessica Kent
October 22, 2019 - In a society where nearly everything can be done digitally, customization is almost always expected. Whether it’s including special instructions in a takeout order or curating the perfect playlist, personalization is a major part of any industry – and it makes sense that patients would demand the same of healthcare.
With new sources of data and innovative technologies setting the stage for individualized care and precision medicine, providers can increasingly develop treatments that fulfill patients’ specific needs.
In this emerging, data-driven environment, physicians will have the option of tailoring therapies for every type of patient, including medically complex individuals and those suffering from multiple chronic diseases.
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9 Takeaways From The Physicians Foundation 2019 Survey
By HealthLeaders Media Staff | October 22, 2019
Two of three respondents say rising healthcare costs are due to cost of prescription drugs, and 49% point to hospital costs.
KEY TAKEAWAYS
· 84% of Americans are concerned about how much healthcare costs will affect them in the future.
· 86% say cost and 72% say waiting for insurance pre-approvals negatively impact care.
· 22% don't know what single payer healthcare means at all, and 77% cannot agree on one definition.
55% are more likely to vote for a presidential candidate who advocates for expanding private insurance reforms.
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Mount Sinai Launches Data Program for Social Determinants of Health
The initiative will use data and technology to close healthcare gaps and address individuals’ social determinants of health.
By Jessica Kent
October 22, 2019 - The Icahn School of Medicine at Mount Sinai has launched a new Diversity and Inclusion Hub (DIH), a program that will leverage innovative technology and data to address healthcare gaps and the social determinants of health.
The DIH represents a first-of-its-kind effort among medical institutions to diversify the pipeline as a career path while using data and technology to reduce disparities in surrounding communities.
“As medical and research institutions around the country look to solve inequities and mitigate disparities in health care, we hope this project will become a model for others nationwide. To close long-standing gaps, we all need to innovate – and we need to engage local stakeholders in the process,” said Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai.
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https://www.healthdatamanagement.com/news/how-providers-can-manage-payer-request-for-ehr-data-access
How providers can manage payer request for EHR data access
October 23, 2019, 1:10 p.m. EDT
Payers increasingly are seeking direct access to providers’ systems for automated medical record collection and aggregation, but providers may be wary.
In a recent posting from the American Health Information Management Association, Rita Bowen and Greg Ford examine how organizations should handle health insurers that ask for access to a provider’s electronic health records system.
Rita Bowen is vice president of privacy, compliance and HIM policy at MRO, a health information management firm, and Greg Ford is director of requester relations and receivables administration at MRO.
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Machine learning screens patients for life-threatening genetic disease
October 22, 2019, 11:48 p.m. EDT
Using large healthcare encounter datasets, a machine learning algorithm is able to identify patients with a common genetic disorder that carries a high risk for early heart attacks and strokes.
While individuals with familial hypercholesterolaemia (FH) have 20 times the risk of developing cardiovascular disease than the general population, fewer than 10 percent of the 1.3 million Americans born with the genetic disease are diagnosed.
“People born with familial hypercholesterolemia develop cardiovascular damage by puberty, often culminating in early heart attacks or the need for surgery as young or middle-aged adults," says Katherine Wilemon, founder and CEO of the FH Foundation, a non-profit research and advocacy organization. “Since diagnosis of this deadly but treatable condition has stalled in the American medical system, the FH Foundation harnessed artificial intelligence and big data to accelerate identification of those most likely to have FH.”
In a new study, a machine learning model created by the FH Foundation successfully leveraged healthcare encounter databases to identify individuals with the genetic disorder.
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Autonomous robots bridge elderly healthcare gap
A consortium-led project aims to take the concept of robotic colleagues for healthcare professionals to the next level, helping to address the emerging elderly care crisis in Europe created by staff shortages and an ageing population.
By Piers Ford
October 23, 2019 06:44 AM
SUMMARY
EIT Digital is putting its weight behind the concept of autonomous robot colleagues for hard-pressed professionals in elderly care provision by supporting the development of SARA (Social & Autonomous Robotic health Assistant) as part of its focus on Digital Wellbeing.
SARA is a consortium-led initiative that aims to improve the quality of care in nursing homes and hospitals by introducing robots as social entities – taking on time-consuming tasks and interacting with patients without requiring a human operator. The consortium includes analytics and data science specialist Bright Cape, Forum Virium Helsinki, GIM Robotics, Curamatik and TU Berlin.
The idea is to address the twin challenges of caring for a rapidly ageing population and an acute shortage of healthcare professionals, helping to balance a workload that is under ever-increasing pressure: it is estimated that 13.8% of nurses deal every week with the consequences of heavy work pressure – medication errors, for example – while patients feel the impact on quality of care.
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ONC partners with IHE to advance interoperability standards
They'll create and update new standards, profiles and implementation guides, helping to transition to more modern APIs and emerging standards that make it easier to exchange data securely via smartphone.
By Mike Miliard
October 23, 2019 03:42 PM
The Office of the National Coordinator for Health IT has entered into a cooperative agreement with Integrating the Health Enterprise USA to jointly advance interoperability goals.
WHY IT MATTERS
Together, ONC and IHE – a not for profit interoperability initiative launched in 2010 by HIMSS and RSNA – will work to innovate the technical standards needed for more effective data exchange and to reach the milestones identified in the Nationwide Interoperability Roadmap and the 21st Century Cures Act.
Together, ONC and IHE – a not for profit interoperability initiative launched in 2010 by HIMSS and RSNA – will work to innovate the technical standards needed for more effective data exchange and to reach the milestones identified in the Nationwide Interoperability Roadmap and the 21st Century Cures Act.
The two organizations will lead stakeholders from across the healthcare industry in an effort to create and update new standards, profiles and implementation guides, helping to transition to more modern APIs and emerging standards such as HL7's FHIR protocol that make it easier to exchange data securely via smartphone.
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Implementation best practices: The optimal way to approach security
Three healthcare cybersecurity experts showcase the most effectual strategies CIOs and CISOs can take when erecting defenses against criminals seeking valuable patient information.
By Bill Siwicki
October 23, 2019 12:39 PM
Security technologies and strategies have never been more important in healthcare than they are today. Healthcare provider organizations are one of the top targets of hackers today. The criminals are looking for those treasured electronic patient records, which fetch a hefty price on the dark web.
Healthcare CIOs and CISOs have to erect powerful defenses to keep evildoers at bay. And there are good approaches to take to healthcare cybersecurity technology and less effectual approaches. It’s important for health IT and health security leaders and workers alike to know the best ways to implement security technologies and to think about security in general.
Here, three healthcare cybersecurity experts offer their decades of experience to help CIOs, CISOs and others when it comes to best practices for safeguarding patient data and implementing security technologies.
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Massachusetts Study Uncovers Arbitrary and Ineffective Use of Quality Measures
October 23, 2019
So much in health care depends on the accurate measurement of costs and quality. Doctors are judged by the costs racked up by their patients. Health care providers in some states are required to post the costs of their procedures online. The entire historic shift from fee-for-service to fee-for-value (that is, judging providers by the long-term health of their patients) assumes that we have a foundation for accurate measurements of costs and quality. And yet, as I wrote three years ago, such measurements are elusive. A recent study by the Massachusetts attorney general’s office suggests that the problems persist.
The data at the base of the study is very narrow. The most important data, for the purpose of this article, pertains to efforts at health insurers to institute some kind of quality-based, fee-for-value incentives to health care providers. Massachusetts, a national leader in health care and funding innovations, has a good deal of experience to draw on. For instance, Blue Cross/Blue Shield of Massachusetts instituted rewards for cost control in 2009. The various efforts at tying payments to quality in the state are called “alternative payment arrangements.”
(Of course, many of the techniques used to monitor and control costs are updated, analytics-infused versions of the old managed care paradigm from the 1980s. And Massachusetts continues to suffer from some of the highest health care costs in the country, albeit in support of some of the best care in the country. The governor wants to launch an investigation into these costs
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FHIR-based Pharmacy Care Coordination Platform Goes Live in 50 States
An FHIR-based pharmacy care coordination platform, known as the Pharmacist eCare Plan, is up and running in all 50 states.
By Fred Donovan
October 22, 2019 - An FHIR-based pharmacy care coordination platform, known as the Pharmacist eCare Plan (PeCP), is up and running in all 50 states.
The PeCP platform was selected by the Office of the National Coordinator for Health Information Technology as one of its High Impact Pilot project, related Brett Coughlin, health communication specialist at the Office of the National Coordinator for Health Information Technology, in an October 21 blog post.
The platform provides an interoperable way to “prioritize drug therapy problem lists” and develops a care plan that includes “social determinants of health, an adherence assessment, interventions made by the pharmacy team, clinical goals, and referrals to other members of the healthcare team,” explained Amina Abubakar, PharmD, CEO of Rx Clinic Pharmacy, an early adopter of the PeCP platform.
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Humana, Microsoft partner to use cloud technologies to aid healthcare
October 21, 2019, 11:54 p.m. EDT
Humana and Microsoft are joining together to enlist advanced, cloud-based technologies to build predictive and personalized healthcare solutions.
The seven-year partnership will draw on Microsoft technologies, including its Azure cloud, Azure artificial intelligence and voice technologies.
Humana expects to use the technology to better analyze and distribute relevant information to clinicians in real time, with the goal of improving preventive care and more uniformly addressing factors that influence members’ health, now popularly known as social determinants of health.
Executives of the Louisville, Ky.-based health plan say the company will modernize its technology platforms and aggregate data on Microsoft Azure, with the intent of providing a longitudinal view of members’ health histories.
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NHS in England to fully digitise prescriptions in promise to save £300m in next three years
Primary care minister Jo Churchill said the national rollout of the electronic service would also help free up time for GPs.
October 22, 2019 11:17 AM
All prescriptions in England are to be digitised in the national rollout of an electronic system that will start next month, the department of health and social care announced on Saturday (19 October).
It follows trials including 60 GP practices and hundreds of pharmacies across the country, where almost 70% of prescriptions are already prescribed and dispensed through the electronic prescription service (EPS).
This means that patients will no longer need to pick up repeat prescriptions from their GP. Instead, they will receive a unique prescription barcode that can be scanned at pharmacies in order to retrieve details of their medication.
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Patients increasingly trusting of remote care technology, says new report
More than half of those surveyed says online tools have helped improve their relationship with their primary care provider, with growing appetite for online chat and diagnosis tools.
By Nathan Eddy
October 22, 2019 11:44 AM
Confidence in remote care technology is gaining traction in the United States, with a survey finding 56 percent of Americans currently monitor their health with at least one digital data collection tool.
The study of 3,000 people, conducted by cloud-connected device and health IT software provider ResMed, found six in 10 respondents have diagnosed themselves after browsing symptoms on the internet – that number climbs to just over three-quarters (76 percent) among Millennials.
Perhaps surprisingly, the report indicates that digital tools have in fact deepened people’s connection with their physicians: more than half of those surveyed agreeing that technology has improved their relationship with their primary care provider.
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A CISO’s Perspective on Security Strategy and Governance
October 22, 2019
The following is a guest article by Gerry Blass from ComplyAssistant
Did you know that healthcare organizations thwart thousands of phishing and malware attacks every day? With the increase in the volume of attacks, we’re also seeing an increase in the number of data breaches. In fact, recent data from the Department of Health and Human Services (HHS) Office for Civil Rights (OCR) shows there were 365 breaches in 2018. That’s one per day.
With thousands of threats coming your way daily through firewalls, endpoints and compromised websites, how can you ensure your healthcare organization’s data is protected? Guarding protected health information (PHI) and other types of data is a complex, and potentially overwhelming, undertaking. With the right strategy, however, you can focus and prioritize your efforts… and your budget.
In my role as a former CISO at a large health system, I was responsible for a wide range of tactics designed to improve my organization’s risk profile and protect our patients. For organizations of any size, I recommend focusing on four areas.
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Big Tech: Microsoft. Nuance Plan Tech Which Creates Documentation For Physicians
October 22, 2019
For a while now, since AI applications have begun to hit the mainstream, there’s been talk of the day when such tools might take over patient documentation and free up physicians to actually look at their patients. Now, Microsoft has come out with an announcement which, if characteristically light on details, demonstrates that the company believes that it can solve this problem.
Researchers have been laying out blueprints for AI-driven, hands-free documentation a while. One recent example comes from Stanford Medicine, which touched on similar issues in a paper outlining its vision for the future of EHRs.
The paper predicts that in the future, an automated physician’s assistant would “listen” to interactions between doctor and patient and analyze what was said, then record all relevant information.
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Special Report: VNA and Data Storage
As more and more documents are stored electronically, the need for suitable data storage grows. Jennifer Trueland investigates the growing number of ways in which vendor neutral archives (VNAs) can be used.
When England’s national programme for IT came to an end, many trusts saw the vendor neutral archive (VNA) as a solution for migrating and storing digital images. But as the decade has progressed, the full potential of the VNA as a means of consolidating a much wider array of data is still being realised.
Rather than simply being a repository for radiology studies, the VNA is now bringing in images from other “ologies”, with more coming on all the time.
As the storage and other benefits of cloud, along with the potential of artificial intelligence (AI), come into play, the VNA is only likely to become an even more central part of healthcare delivery.
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Adopting AI in Health Care Will Be Slow and Difficult
October 18, 2019
Artificial intelligence, including machine learning, presents exciting opportunities to transform the health and life sciences spaces. It offers tantalizing prospects for swifter, more accurate clinical decision making and amplified R&D capabilities. However, open issues around regulation and clinical relevance remain, causing both technology developers and potential investors to grapple with how to overcome today’s barriers to adoption, compliance, and implementation.
Here are key obstacles to consider and how to handle them:
Developing regulatory frameworks. Over the past few years, the U.S. Food and Drug Administration (FDA) has been taking incremental steps to update its regulatory framework to keep up with the rapidly advancing digital health market. In 2017, the FDA released its Digital Health Innovation Action Plan to offer clarity about the agency’s role in advancing safe and effective digital health technologies, and addressing key provisions of the 21st Century Cures Act.
The FDA has also been enrolling select software-as-a-medical-device (SaMD) developers in its Digital Health Software Precertification (Pre-Cert) Pilot Program. The goal of the Pre-Cert pilot is to help the FDA determine the key metrics and performance indicators required for product precertification, while also identifying ways to make the approval process easier for developers and help advance healthcare innovation.
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FDA post-market surveillance system enters next phase
October 21, 2019, 12:26 a.m. EDT
A national system that uses electronic healthcare data to monitor the safety of FDA-regulated drugs and medical products is being enhanced to increase its efficiency and responsiveness.
Sentinel, developed and operated by Harvard Pilgrim Health Care Institute since 2009, is the FDA’s flagship active surveillance system and is the world’s largest multisite distributed database dedicated to medical product safety.
“The FDA plans to continue to advance major initiatives introduced in recent years (e.g., signal identification, use of advanced analytics, real-world evidence demonstration projects) over the next five years, with a more concentrated effort on exploring novel ways to extract and structure information from electronic health records in the future,” according to the regulatory agency.
Under a five-year contract worth $220 million, Harvard Pilgrim Health Care Institute will continue to run the Sentinel Operations Center and to create two new coordinating centers—the Sentinel Innovation Center and the Community Building and Outreach Center—to better leverage clinical data for detecting potential safety problems.
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HIT Think
Better understanding the role of human error in data breaches
October 21, 2019, 3:45 p.m. EDT
It seems that every day we are waking up to news about another data breach. This year alone brought major data breaches to organizations as disparate as Capital One, Quest Diagnostics, DoorDash, Fortnite and the City of Baltimore.
With National Cybersecurity Awareness Month in full swing, it’s a reminder that while we are all getting better at recognizing the risks of being connected, we still need to work on changing our behavior to mitigate those risks.
Some contend that no amount of behavioral change can outsmart the hackers, and perhaps there is a sliver of truth to that—after all, technology is constantly evolving, and so are hackers’ methods. But human error—or a lack of behavioral change in light of what we know about cyberattacks—is sometimes still a major cause of data breaches.
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New tool help promote ICD-10 codes for social determinant of health data
eHI's collaborative includes Humana, United HealthCare, American Hospital Association and others who are working to encourage use of existing ICD-10-CM Z codes and develop new ones.
By Mike Miliard
October 21, 2019 04:05 PM
In an effort to help broaden the ways in which social determinants of health can inform clinical decision making, eHealth Initiative & Foundation has recently released some new tools to promote the use of ICD-10-CM codes to capture SDOH data in the electronic health record.
WHY IT MATTERS
Specifically, the tools center around the use of ICD-10-CM Z codes. These are designed to denote certain factors that might influence health status, or explain reasons for medical encounters having to do with circumstances other than a disease or injury classifiable by the rest of the ICD-10-CM code set.
Specifically, the tools center around the use of ICD-10-CM Z codes. These are designed to denote certain factors that might influence health status, or explain reasons for medical encounters having to do with circumstances other than a disease or injury classifiable by the rest of the ICD-10-CM code set.
So, in the context of SDOH, use of Z codes might indicate that a "circumstance or problem is present which influences the person's health status but is not in itself a current illness or injury," as one ICD-10-CM explainer puts it. This could include patients with "potential health hazards related to family and personal history and certain conditions influencing health status."
eHI's collaborative project included payer organizations (Humana, United HealthCare), provider groups (American Hospital Association) and others who worked together to develop a more consistent approach to encouraging the use of existing ICD-10-CM codes for SDOH – and to developing new ones and promoting their adoption and use, once approved, among both providers and coders.
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New report offers insights into phishing scammers' go-to tricks
Email cyber attackers frequently use certain keywords in their subject lines, according to Proofpoint, and tend to send their salvos at certain advantageous times of day.
October 21, 2019 01:54 PM
After reviewing hundreds of millions of malicious emails from the past two years, healthcare security firm Proofpoint has gained some hard-won insights into the tricks and strategies of bad who send phishing emails.
WHY IT MATTERS
While most email users know or have been trained by now not to open attachments sent in suspicious emails, they still click URLs. Proofpoint saw a rise in malware entering systems through URL attacks, suggesting that it's time to revisit training on what to be wary of, both with regard to emails and online communications.
While most email users know or have been trained by now not to open attachments sent in suspicious emails, they still click URLs. Proofpoint saw a rise in malware entering systems through URL attacks, suggesting that it's time to revisit training on what to be wary of, both with regard to emails and online communications.
More than three-quarters (77%) of email attacks on healthcare organizations used malicious URLs, the research shows.
This is especially important as almost all healthcare companies reported emails that spoofed their own domain – meaning that employees seeing a link from an address they assume to be safe are all the more likely to click on it and allow an invader access to the network.
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HIMSS Australia Digital Health Summit to focus on interoperability & connected care
There will be three breakout tracks at the summit: Data, Innovation and Empowering Patients.
By Dean Koh
October 21, 2019 03:53 AM
HIMSS is partnering with the Australia Digital Health Agency (ADHA) to organise the upcoming HIMSS Australia Digital Health Summit (ADHS) from 20-21 November this year, happening in Sydney, Australia. The conference is expected to bring together representatives from ADHA, public and private healthcare leaders from Australia, as well as from the APAC region.
The main theme of the Summit is "Interoperability and Connected Care", which is especially relevant with the implementation of My Health Record (MHR) in the country, an online, electronic summary of one’s key health information. ADHA has been progressively upgrading the MHR, such as partnering with software vendors to be able to share information safely across different software products and improving its clinical workflow capabilities.
Hal Wolf, CEO and President of HIMSS, Tim Kelsey, CEO of ADHA and Professor Mary Foley, Managing Director of Telstra Health will gather for a CXO fireside chat at the Summit on the topic of connected care – what it means in the context of Australia, its recent developments in the healthcare industry and some of the challenges in creating a single view of the patient for better connected care.
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Hospital replaces manual Rx process with e-filling, achieves error rate of just .006%
LIFE St. Mary hospital uses Tabula Rasa HealthCare’s pharmacy platform, which has helped lead to a 16% decrease in ER use and a 27% decrease in total hospitalization.
By Bill Siwicki
October 21, 2019 12:52 PM
LIFE St. Mary, a hospital in the Trinity Health Mid-Atlantic health system, had a manual process to request medication refills and fill pillboxes.
THE PROBLEM
The pharmacy was not integrated with the electronic health record and it did not have full bidirectional electronic prescribing.
Medication lists were not accurate and there was no ability to confirm the last refill date or patient compliance. The health system had medication errors that led to emergency room visits as well as general adherence concerns that were hard to identify.
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Weekly News Recap
- Microsoft and Nuance announce plans to work together to use ambient sensing and conversational AI to help doctors document encounters.
- Google hires former National Coordinator Karen DeSalvo, MD, MPH to the newly created position of chief health officer.
- Change Healthcare is reportedly looking for a private equity buyer for its Connected Analytics unit, which includes the Ansos staff scheduling system, at a potential price in the $300 million range.
- The VA pilots making telemedicine services available at local VFW posts.
- Northwell Health extends its Allscripts Sunrise agreement through 2027.
- A KLAS report finds that customers of acquired health IT vendors are equally split among being less satisfied and more satisfied, with just 20% saying nothing changed.
- Centra (VA) resumes billing and collections following a three-month hiatus that it says was caused by Cerner software problems.
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Sitting comfortably? Let’s discuss femtech
The potential of start-ups focused on women’s health is finally being taken seriously
The venture capitalists used to blush when Tania Boler pitched a silent, wearable breast pump or a workout app that helps women strengthen their pelvic floors.
“It was young men, especially, who didn’t want to think about embarrassing women’s issues. They thought we were weird,” said Boler, 43, who co-founded “femtech” start-up Elvie six years ago with Alexander Asseily, former chief executive of the consumer electronics business Jawbone.
Not all the men were uncomfortable, Boler stressed: many were receptive to her ideas but unwilling to invest in an unproven entrepreneur.
That has all changed. This year, Elvie raised $42m (£33m) from investors including IPGL (the vehicle of Icap billionaire Michael Spencer) and Octopus Ventures, at an undisclosed valuation. Elvie employs 85 staff in Hatton Garden, central London. Boler said it was on track to make sales of £100m next year.
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Enjoy!
David.
