Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Sunday, May 02, 2021

The ADHA Will Leap On Any Opportunity To Try And Justify Pressing On With The #myHealthRecord – Hardly A Pressing Need For Aged Care!

 It seems the ADHA has noticed there might be some leverage, for it, in Aged Care.

ADHA outlines digital health in aged care plans

The Australian Digital Health Agency has developed a three-year program to drive the adoption and use of digital health in residential aged care homes in response to royal commission’s recommendations.

ADHA’s acting chief digital officer Rupert Lee provided an industry forum and update on the agency’s plans for the aged care sector arising from the Royal Commission into Aged Care Quality and Safety’s final report.

He said recommendation 68, which calls for a universal adoption of digital technologies and My Health Record, stood out most to the agency.

That recommendation includes that all providers of clinical or personal care must have a digital care management system with electronic medication management by July 2022.

“Consequently, the agency is initially focusing on residential aged care facilities,” Mr Lee told the ITAC April International Forum on Tuesday.

ADHA is focusing its activity on recommendation 68 as well as 109, which proposes the government invest in ICT architecture and in technology and infrastructure for aged care.

The program will drive the adoption and use of digital health in residential aged care homes to facilitate the sharing of healthcare information when it is needed most, Mr Lee said.

“The purpose of our aged care program is to implement system wide enhancements that will support critical moments in the health care journey of older Australians,” he said.

Three-phase program

The three-year program will focus on the development of specifications and conformance profiles for digital enablement in aged care, Mr Lee said.

The first phase includes My Health Record conformance, viewing capability and the ability to upload advanced care planning information, he said.

“[It includes] My Health Record system enhancements to enable My Health Record to support the transfer of information supporting transitions of care between residential aged care and other healthcare settings, as well as collaboration with the aged care access branch to explore the possibilities between two-way information sharing between My Health Record and My Aged Care,” Mr Lee said.

The second phase includes uploading aged care transfer data, secure messaging functionality and electronic prescribing capabilities.

He said the goal is to have 100 per cent integration and adoption of My Health Record among aged care providers by 30 June 2023.

The program’s third year will assess the next steps for the rest of the sector including home care, Mr Lee said.

He said it was more realistic to prioritise residential aged care given the pressures on the sector and the royal commissioners’ strong focus for significant reform in this part of the sector, he said.

However, the agency is assessing opportunities for home care and recognises that some in this cohort are tech-savvy and especially in virtual care, Mr Lee said.

ADHA eyes primary care, telehealth

The ADHA will also respond to recommendation 56, which proposes a new primary care model to improve access.

“It’s important that the agency also plays a key role in helping to define the role of digital technology and My Health Record in the new primary care model as it directly aligns with the agency’s strategic priority to digitally enable primary care,” Mr Lee said.

In response to recommendation 63, which calls for improved access to specialist telehealth services, he said the ADHA would provide education and solutions on telehealth and virtual care models.

The ITAC April International Forum took place on 27 April.

Here is the link:

https://www.australianageingagenda.com.au/technology/adha-outlines-digital-health-in-aged-care-plans/

There is a review of the recommendations here:

https://www.australianageingagenda.com.au/royal-commission/rc-calls-to-mandate-digital-care-systems/

The contents of recommendation 68 are:

Recommendation 68: Universal adoption by the aged care sector of digital technology and My Health Record

The Australian Government should require that, by 1 July 2022:

a. every approved provider of aged care delivering personal care or clinical care:

i. uses a digital care management system (including an electronic medication management system) meeting a standard set by the Australian Digital Health Agency and interoperable with My Health Record

ii. invites each person receiving aged care from the provider to consent to their care records being made accessible on My Health Record

iii. if the person consents, places that person’s care records (including, at a minimum, the categories of information required to be communicated upon a clinical handover) on My Health Record and keeps them up to date

b. the Australian Digital Health Agency immediately prioritises support for aged care providers to adopt My Health Record.

The evidence cited for all this was Page 323 – Volume 3 of the Final Rreport:

Found here:

https://agedcare.royalcommission.gov.au/publications/final-report-volume-3a

“Aged care providers should be using digital care management systems. Professor Johanna Westbrook, Director of the Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, gave evidence that the aged care sector currently relies heavily on faxing, scanning, emailing and, in some instances, mailing information between external care providers and service providers. She said that this ‘increases the risk of error’ and ‘is resource intensive and inefficient’.198

Electronic medication management systems are particularly important in aged care given the high use of medicines by people receiving aged care. We are encouraged that the Australian Government is trialling an Electronic National Residential Medication Chart in a number of residential aged care facilities.199

My Health Record is an Australian Government online summary of a person’s key health information. It is progressively being adopted across the health care system. The Australian Digital Health Agency has stated, however, that ‘while a number of aged care clinical information systems are conformant and can connect to My Health Record, it is not extensively used across the aged care sector’.200 In October 2019, only 247 out of a possible 1800 aged care residential and home care providers (14%) were registered for My Health Record.201 The Australian Digital Health Agency stated that aged care is ‘a key priority area for future focus’.202

Universal adoption by approved providers of My Health Record should be an immediate focus. Given the high frailty and acuity of older people receiving aged care and their increased need for health care, it is appropriate to expect that all approved providers should be using My Health Record by no later than 1 July 2022. This will ensure that multiple health care and aged care providers can access one central source of health information about people receiving aged care. Any improved information sharing will depend on the person receiving aged care having a My Health Record and giving prior consent to their health records being accessed, used and shared in this way.

System interoperability will support communication and information sharing between the aged care sector and the health care sector.203 For instance, system interoperability between the clinical systems of general practice and approved providers would ‘improve communication and minimise any errors in treatment, particularly when a GP [general practitioner] is required to respond to a clinical situation’.204

Interoperability should be pursued in the short term through My Health Record. The adoption of My Health Record, and systems interoperable with it, will assist with information sharing between care providers and others and hence assist with improved and safe care. Data interoperability, whereby data is captured according to a common set of definitions, is also worthwhile pursuing.

The Australian Government has agreed that all residential aged care services should move to digital electronic care records.205 The Government has further supported the use of electronic discharge summaries through My Health Record.206 The Government also supports changes to encourage the use of My Health Record by aged care providers.207 The Government has, however, submitted that ‘My Health Record has been designed as a fundamentally voluntary system’ and that ‘the My Health Record system is voluntary for providers as well as health care recipients’.208 We accept that a person receiving health care is entitled not to participate in the My Health Record system, but observe that the Australian Digital Health Agency has said that over 90% of Australians have a record.209 We also do not consider that the participation of aged care providers should be voluntary.

Paper-based systems are outdated, inefficient, and can lead to errors during the transfer of residents between residential aged care and hospital settings. Transition to a digital care management system interoperable with My Health Record will result in a safer, more efficient and more comprehensive transfer of critical information relating to a person’s relevant care and medical history. Such a transition

Here is the evidence cited

“198 Exhibit 6-23, Darwin and Cairns Hearing, Supplementary Statement of Johanna Westbrook, WIT.0196.0002.0001 at 0006 [34].

199 Submissions of the Commonwealth of Australia, Canberra Hearing, RCD.0012.0058.0001 at 0029 [99d].

200 Australian Digital Health Agency, Public submission, AWF.500.00298.0002 at 0010.

201 Exhibit 14-31, Canberra Hearing, Statement of Glenys Ann Beauchamp, WIT.0573.0002.0001 at 0065 [269].

202 Australian Digital Health Agency, Public submission, AWF.500.00298.0002 at 0010.

203 Exhibit 14-31, Canberra Hearing, Statement of Glenys Beauchamp, WIT.0573.0002.0001 at 0064 [263].

204 Exhibit 14-9, Canberra Hearing, Supplementary statement of Anthony Bartone, WIT.1301.0001.0001 at 0002 [11].

205 Transcript, Canberra Hearing, Glenys Beauchamp, 12 December 2019 at T7584.5–13

206 Submissions of the Commonwealth of Australia, Canberra Hearing, RCD.0012.0058.0001 at 0027 [92]; 0033 [109]–[111].

207 Submissions of the Commonwealth of Australia, Response to Counsel Assisting’s final submissions, RCD.0013.0014.0037.

208 Submissions of the Commonwealth of Australia, Response to Counsel Assisting’s final submissions, RCD.0013.0014.0037.209 Australian Digital Health Agency, Public submission, AWF.500.00298.0002 at 0009.”

So some very general evidence on some rather old fashioned communication tech and a lot of assertions, with no evidence, that the #myHealthRecord would be wonderful and needs to be adopted in 18 months having languished, almost unused, for almost a decade.

Talk about the ADHA seeing a main chance to try and show value in a non-automated sector when the more digitally enabled sectors have “walked on by”!

Worse we see the ADHA plan is in the “The first phase includes My Health Record conformance, viewing capability and the ability to upload advanced care planning information”.

The second phase is “to have 100 per cent integration and adoption of My Health Record among aged care providers by 30 June 2023.”

The third phase seems not to have been worked out yet!

Words fail me that the ADHA would have such a plan, and apparently think it is even ½ reasonable or urgent given all the other sad and really urgent problems we see in aged care.

They are really on some sad and distant island unrelated to the real world!

I note they offer not a single cent to help and fail to realise how many internal systems would be far more useful for Aged Care if tech it must be. I see the self-interested hand of the ADHA offering a plan for its survival and not a plan to improve Aged Care. Typical I guess! The RC was badly advised in Digital Health seeing it as a solution to many problems without testing the evidence!

David.

AusHealthIT Poll Number 577 – Results – 02nd May, 2021.

 Here are the results of the poll.

How Frequently Do You Believe GPs Are Currently Using, And Finding Valuable, The #myHealthRecord in Daily Clinical Practice?

Never 49% (36)

Rarely 32% (24)

Occasionally 1% (1)

Frequently 0% (0)

I Have No Idea 18% (13)

Total votes: 74

It seems that anything approaching regular use by most GPs is still very infrequent!

Any insights on the poll are welcome, as a comment, as usual!

A rather poor number of votes and a lot of indecision. Probably a poor question!  

It must also have been a very, very hard question as 13/74 readers were not sure how to respond.

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

David.

Saturday, May 01, 2021

Weekly Overseas Health IT Links – 01 May, 2021.

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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https://www.digitalhealth.net/2021/04/ai-tool-can-identify-risk-of-heart-attack-years-before-it-strikes/

AI tool can identify risk of heart attack ‘years before it strikes’

An artificial intelligence tool that can identify people at risk of a heart attack years before it strikes is now ready to be rolled out across the NHS.

Andrea Downey – 20 April, 2021

The CaRi-Heart tool, developed by Caristo Diagnostics and based on research funded by the British Heart Foundation (BHF), predicts possible heart disease using routine heart scans.

It works by scanning “ticking-time-bomb” arteries that could become clogged to cause a heart attack. Looking at regular heart scans the artificial intelligence (AI) technology produces a ‘fat attenuation index score’ (FAI-Score), which accurately measures inflammation of blood vessels in and around the heart.

It’s this inflammation that could eventually lead to a heart attack.

Those identified at high risk of a future heart attack can then be given personalised medication, as well as being monitored more closely, to prevent a life-threatening situation.

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https://www.digitalhealth.net/2021/04/new-partnership-to-develop-ai-platforms-for-faster-diagnosis-and-treatment/

New partnership to develop AI platforms for faster diagnosis and treatment

Artificial Intelligence (AI) platforms which can provide faster diagnosis and treatments for clinicians are to be developed as part of a new partnership.

Hanna Crouch – 19 April, 2021

The London Medical Imaging and AI Centre for Value-Based Healthcare and digital transformation consultancy Answer have teamed up to help pave the way for AI-enabled hospitals.

The platforms will be developed to support clinicians with faster diagnosis and treatments, personalised therapies, and effective screening across a range of conditions and procedures.

Federated learning – a model seeking to address the problem of data governance and privacy by training algorithms collaboratively without exchanging the data itself – will also be used to help address long standing privacy issues.

Beverley Bryant, chief digital information officer for Guy’s and St Thomas’ NHS Foundation Trust and King’s College Hospital NHS Foundation Trust, and senior responsible owner for the London Medical Imaging and AI Centre for Value-Based Healthcare, said: “This is a unique programme to implement AI at scale within the NHS.

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https://www.scientificamerican.com/article/how-real-world-data-can-help-us-better-prepare-for-the-next-pandemic/

How Real-World Data Can Help Us Better Prepare for the Next Pandemic

Rapid testing is important, but there’s a wealth of other information that could have offered us quicker insight into the spread of COVID

·         By Joseph Menzin, Peter Neumann on April 22, 2021

When we look back at the COVID pandemic, what will hindsight tell us? Will we remember the turn of the decade as the year that finally brought real change to pandemic preparedness, or will our eventual return to “normal” stymie our progress?

Although epidemiologists have long warned about the potential for global pandemics, their admonitions have largely gone unheeded. However, industrialized animal farming practices, increased human-animal contact, globalization, decreasing biodiversity and other factors all point to the likelihood of another zoonotic disease (one transmitted from animals to humans) with pandemic potential .

A slim silver lining of the current COVID-19 pandemic is that it can help us better prepare for future outbreaks—if we harness what we’ve learned correctly. In particular, we can better leverage one of the most crucial resources we have when it comes to pandemic preparedness: real-world data.

THE IMPORTANCE OF REAL-TIME INSIGHT

The pandemic has created a trove of data that can help us plan for future disease outbreaks. The abundance of research on the U.S. pandemic response provides insight into the benefits and consequences of various courses of action, and we can leverage this knowledge for future response.

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https://www.healthcareitnews.com/news/telehealths-awkward-waiting-room-problem-and-how-one-company-aims-solve-it

Telehealth's awkward waiting room problem, and how one company aims to solve it

Mend, a Florida-based telemedicine platform, has released its "enhanced virtual waiting room" to keep patients engaged.

Kat Jercich April 23, 2021

Even as telehealth has made many aspects of care more seamless, a few elements have routinely emerged as points of difficulty.   

Among them is the waiting room. A new survey from LifeLink Systems out this week found that the vast majority of patients said they'd prefer a virtual waiting room that allowed them to complete paperwork on their phones before they got to a doctors' office.   

But as with in-person services, providers are sometimes running behind, regardless of how much preparation the patient has undertaken.  

And unlike in a brick-and-mortar facility, patients waiting at a computer in front of an open window screen can wonder if they've correctly followed instructions. They may be tempted to click away – or get up and leave altogether.  

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https://www.healthcareitnews.com/news/after-hours-charting-significantly-associated-physician-burnout

Global Edition

Electronic Health Records (EHR, EMR)

After-hours charting significantly associated with physician burnout

A new study links organizational EHR support with lower levels of physician burnout – especially among cardiologists and neurologists.

By Kat Jercich

April 23, 2021 11:25 AM

A study published this week in the Journal of the American Medical Informatics Association found that less after-hours charting was associated with lower burnout scores.  

The study, which relied on survey responses from more than 25,000 physicians, found that satisfaction with organizational EHR support was also significantly associated with lower levels of burnout overall.  

"EHR factors are not solely responsible for after-hours charting, and other efforts besides EHR improvements, such as team documentation and new approaches to care team models for clinical support, may reduce after-hours charting," noted the researchers.  

WHY IT MATTERS  

Physician burnout is a serious problem in the medical industry, associated with poor clinical care, medical mistakes and caregiver attrition. Researchers estimate its economic impact at $4.6 billion each year.  

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https://www.healthcareitnews.com/news/apac/taiwan-s-advancement-digital-health-emram-stage-6-7

Taiwan’s advancement in digital health: From EMRAM Stage 6 to 7

In this webinar, insights were gained on the steps Taiwan has taken towards creating a cohesive digital healthcare ecosystem as well as what is required to create a strong foundation in digital health.

By Roy Chiang

April 23, 2021 04:27 AM

The HIMSS Digital Maturity Series seeks to understand if healthcare organisations are aware of their capacity and capabilities to effectively tap into the power of digital health. During this session which took place in early April, healthcare experts from Taiwan shared their digital transformation stories and thoughts on how to advance towards a digital health ecosystem.

Establishing a strong foundation in digital health

Expenditure on healthcare has experienced a huge surge over the years in order to cater to burgeoning demand. This, in part, can also be attributed to the need to invest in new technologies to increase the quality of care delivered to patients.

"The shift towards digital – many global health systems have almost shifted overnight to virtual visits which now opens up a very interesting opportunity for helping people stay healthy and well," shared Anne Snowdon, Chief Scientific Research Officer at HIMSS. A robust digital health ecosystem is required to support and augment this huge surge in demand for online medical care and services, she continued.

The building block of a digital healthcare ecosystem as outlined by Snowdon, starts with a strong governance and workforce; followed by interoperability of data and analytics combined with the strong ability to track outcomes; and lastly, the digital capacity to engage with patients meaningfully. Through the Digital Health Indicator (DHI), healthcare organisations can keep track of how digitally enabled they are. The DHI measures progress towards a digital health ecosystem based on four building blocks. This ecosystem connects clinicians and provider teams with people, allowing them to manage their health and wellness using digital tools in a secure and private environment whenever and wherever care is needed.

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https://mhealthintelligence.com/news/hhs-fda-backtrack-from-plan-to-deregulate-mhealth-devices-apps

HHS, FDA Backtrack From Plan to Deregulate mHealth Devices, Apps

The federal agencies are reversing course after a Trump administration proposal to end oversight of dozens of mHealth apps, devices and platforms drew strong opposition from within and outside government.

By Eric Wicklund

April 22, 2021 - Federal officials are quietly withdrawing a Trump administration plan to end regulatory review of 83 types of mHealth devices, saying the original plan was flawed and could have put the lives of Americans using that technology in danger.

In a notice posted last week in the Federal Register, the Health and Human Services Department and the Food and Drug Administration announced that they won’t enforce an HHS notice posted on January 15 that, among other things, would have exempted 83 class II devices and one unclassified device from premarket notification. Another 50 devices would have been exempted from review because there had been no reports of deaths associated with their use.

The decision affects dozens of connected health tools, including mHealth apps, smart devices and digital therapeutic services.

Officials said the devices were selected based on a lack of adverse events reported in the FDA’s Manufacturer and User Facility Device Experience (MAUDE) database. But just because adverse events aren’t reported, officials said, doesn’t mean they aren’t happening or could happen.

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https://journal.ahima.org/cms-and-cdc-nchs-discuss-possible-biannual-icd-10-cm-pcs-code-implementation-dates/

CMS and CDC/NCHS Discuss Possible Biannual ICD-10-CM/PCS Code Implementation Dates

April 21, 2021 at 8:00 am

By Sue Bowman, MJ, RHIA, CCS, FAHIMA

The ICD-10 Coordination and Maintenance (C&M) Committee, co-chaired by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics/Centers for Disease Control and Prevention (CDC/NCHS), met March 9-10 this year to discuss proposals for new or modified ICD-10-CM and ICD-10-PCS codes. All ICD-10-PCS code proposals presented at the March ICD-10 C&M Committee would, if approved, go into effect on October 1, 2021. All but one of the ICD-10-CM code proposals were presented for consideration of an October 1, 2022 implementation date. The exception is discussed below.

CMS and CDC/NCHS announced their consideration of an April 1 implementation date for ICD-10-CM/PCS code updates, in addition to the current October 1 annual update. If an April 1 code implementation is adopted, requesters of new or modified codes would indicate whether they are submitting their code request for consideration of an April 1 or October 1 implementation date. The ICD-10 C&M Committee would make efforts to accommodate the requested implementation date for each request submitted, however, the committee would determine which requests would be presented for consideration of an April 1 vs. October 1 implementation date. The first April 1 code update would be April 1, 2022.

The current established process would be used to implement an April 1 code update, which would include presenting proposals for April 1 consideration at the September ICD-10 C&M Committee meeting, requesting public comments, reviewing public comments, finalizing codes, and announcing the new codes, consistent with the new Grouper release information. The code update process for an April 1 implementation date would also involve the release of new code files, coding guidelines, and coding advice on the use and reporting of new codes through the American Hospital Association’s Coding Clinic for ICD-10-CM/PCS publication.

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https://thehill.com/opinion/healthcare/549081-is-telemedicine-the-de-evolution-of-medicine

Is telemedicine the de-evolution of medicine?

13

The views expressed by contributors are their own and not the view of The Hill

Having passed a year’s worth of COVID-19 lockdowns, stay-at-home orders, self-quarantines and other social distancing strategies, it is a good time to reflect on the extent to which we have shifted our lives online. We shop for groceries, consume entertainment, get schooling and attend our yoga classes via the web. During this rapid transformation, telemedicine became one of the major industries that forcibly advanced. According to McKinsey & Company, in 2020, 46 percent of consumers were using telehealth services to replace canceled health care visits, compared to 11 percent who used such services in 2019. We pushed doctors’ office visits online and freed patients from the shackles of waiting rooms into the comfort of their own homes, all in the name of reducing COVID-19 exposure. 

And while this “brave new world” of telemedicine has been deemed a good thing, it is not a panacea. Telemedicine initially was created to fill the void in medical care accessibility for patients in remote environments. But it has become more about survival for doctors. Like any business during the pandemic, fewer services could be rendered because of stay-at-home orders, resulting in less income. Physicians were not immune to this model of compensation. The Canadian Institute for Health Information reported a 50 percent reduction in emergency room visits in April 2020. This presents a potentially dangerous scenario in which medical practices were near the brink of bankruptcy until virtual visits quickly became the norm. Although this appears as a win-win for patients and physicians, there is much more here than meets the eye. From price wars to outsourcing to substandard care, we should consider all the unintended consequences of the telemedicine trend. 

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https://www.healthit.gov/buzz-blog/precision-medicine/health-it-advances-precision-medicine

Health IT Advances Precision Medicine

Kevin Chaney, MGS; Teresa Zayas Cabán, PhD; Courtney C. Rogers, MPH; Joshua C. Denny MD, MS and Jon White | April 20, 2021

Precision medicine creates treatment and prevention strategies that meet patient needs by considering individual variability in their genome, environment, and lifestyle. While precision medicine can revolutionize health care, it requires access to an unprecedented volume and variety of data, and an infrastructure that rapidly brings new discoveries to bear.  Recently, we published an article in the Journal of the American Medical Informatics Association that describes health IT’s vital role in precision medicine based on key insights from a series of ONC projects supporting the Precision Medicine Initiative. 

Four key health IT needs for precision medicine are: 

  1. Determining requirements for data 
  2. Building robust infrastructure 
  3. Integrating precision medicine into clinical care 
  4. Developing relevant policies 

Data Requirements 

Electronic health data are widely available thanks to the prevalence of health IT, but not all data are standardized or include the metadata needed for precision medicine. To increase the availability of rich data sets, ONC’s projects developed methodologies for collecting and exchanging diverse data types using standardized APIs.  

These projects also highlighted data quality issues such as accuracy, consistency, completeness, and usefulness. In particular, these projects highlighted a trade–off between richness of data and simplicity of standards.  

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https://www.healthcareitnews.com/news/ezekiel-emanuel-wants-big-thinking-new-government-health-it-projects

Ezekiel Emanuel wants big thinking for new government health IT projects

"We don't need patchwork solutions. We need structural solutions," said Emanuel, a member of President Biden's COVID-19 advisory board, in a wide-ranging HITN interview.

By Kat Jercich

April 22, 2021 10:22 AM

When President Joe Biden announced his intention to launch a national website to facilitate COVID-19 vaccinations by May 1, many in the health IT industry had flashbacks.  

Some probably had recent memories of the Trump administration's haphazard coronavirus response – not least its move to a new data reporting system, whose two-day turnaround in the summer of 2020 led to "chaos" for many U.S. hospitals.  

Others might have thought back to the 2013 launch of the Healthcare.gov insurance exchange portal, which initially crashed repeatedly thanks to complex coding and crushing public demand.  

"We know that when the government tries to create IT systems, they've been plagued with bugs," said Dr. Ezekiel Emanuel, former health advisor to President Barack Obama, who also served on President Biden's COVID-19 advisory board.  

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https://www.healthcareitnews.com/news/emea/qa-year-down-road-what-has-epr-accomplished-switzerland

Q&A: A year down the road - What has the EPR accomplished in Switzerland?

Healthcare IT News asks Stefan Hunziker, CIO at the Lucerne Cantonal Hospital (LUKS), how the EPD has developed in Switzerland and how the hospital has managed it.

By Anna Engberg

April 22, 2021 03:23 AM

By April 2020 all Swiss hospitals should join a "stammgemeinschaft", a regional community to offer a national EHR, the so-called EPR (electronic patient record) throughout Switzerland, according to the Federal Electronic Patient Dossier Act (EPDG).

A year on, Healthcare IT News asks Stefan Hunziker (pictured below), CIO at the Lucerne Cantonal Hospital (LUKS), how the EPR has developed in Switzerland and how the hospital plans to implement it. 

HITN: The LUKS is considered a pioneer in the Swiss healthcare system - and the EPR is part of the Swiss digitisation strategy. How is the nationwide implementation of the EPR going?

Hunziker: To cut a long story short: The EPR is not yet up and running in Switzerland and we therefore have no experience with it at LUKS. The partly controversial discussion and the pandemic have clearly shown deficits and are giving the digital transformation in the healthcare system a strong push. As things stand, we assume that we will really be able to use the EPR from autumn 2021.

However, via our hospital information system (HIS), which we have been using at the Lucerne Cantonal Hospital for 1.5 years, we have already been exchanging data with the outpatient sector for some time and have also been serving the patient side since June 2020.

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https://ehrintelligence.com/news/4-ways-health-it-ehrs-can-advance-precision-medicine

4 Ways Health IT, EHRs Can Advance Precision Medicine

The ONC is attempting to propel precision medicine through API utilization, EHR integration, policy development, and data standardization.

By Christopher Jason

April 21, 2021 - Healthcare stakeholders must enhance and address health IT data, health IT infrastructure, EHR integration, and policy development to achieve precision medicine, the Office of the National Coordinator for Health IT (ONC) said in a new blog post.    

Precision medicine aims to improve healthcare by customizing patient care to specific patient needs.

Advancing precision medicine requires establishing an evidence base through extensive research built on genomic data at a unique scale. But as precision medicine data becomes increasingly complex and available, health IT and EHRs must evolve to integrate, interpret, and deliver this data.

ONC outlined four critical health IT needs to advance precision medicine: determining data requirements, building robust health IT infrastructure, integrating precision medicine data into the EHR, and developing relevant policies.

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https://healthitanalytics.com/news/machine-learning-tacks-evolution-of-covid-19-misinformation

Machine Learning Tracks Evolution of COVID-19 Misinformation

A new machine learning tool could help public health officials prevent the spread of COVID-19 misinformation.

By Jessica Kent

April 21, 2021 - A machine learning algorithm could help public health officials identify COVID-19-related conspiracy theories on social media, potentially reducing the spread of misinformation online, a study published in JMIR revealed.

“A lot of machine-learning studies related to misinformation on social media focus on identifying different kinds of conspiracy theories,” said Courtney Shelley, a postdoctoral researcher in the Information Systems and Modeling Group at Los Alamos National Laboratory and co-author of the study.

“Instead, we wanted to create a more cohesive understanding of how misinformation changes as it spreads. Because people tend to believe the first message they encounter, public health officials could someday monitor which conspiracy theories are gaining traction on social media and craft factual public information campaigns to preempt widespread acceptance of falsehoods.”

Researchers used publicly available, anonymized Twitter data to characterize four COVID-19 conspiracy theory themes and provide context for each through the first five months of the pandemic.

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https://www.fiercehealthcare.com/tech/digital-mental-health-market-booming-here-s-why-some-experts-are-concerned

The digital mental health market is booming. Here’s why some experts are concerned

by Heather Landi 

Apr 21, 2021 1:03pm

The digital mental health space was growing rapidly even before the COVID-19 pandemic but stress and anxiety brought on by the health crisis have accelerated demand for virtual behavioral health services.

The success of digital mental health startups means that more people can access mental wellness than were potentially able to do so before. 

“I think the benefits are clear. We can increase access to care, at our fingertips, and we can hopefully personalize care to our exact needs. There is the potential to provide care that is more affordable, personalized and accessible,” John Torous, M.D. director of the digital psychiatry division at Beth Israel Deaconess Medical Center in Boston told Fierce Healthcare.

Broadly, the digital mental health space includes direct-to-consumer apps, such as Talkspace and Calm, apps that are designed for a clinician to prescribe, such as reSET, which is used to treat substance use disorders and also mental health platforms that work with employers and health plans, such as Ginger, Lyra Health and Modern Health.

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https://www.fiercehealthcare.com/practices/case-for-electronic-hand-hygiene-compliance-monitoring-costly-infections-and-more

Here's why hospitals are looking to take a tech-enabled approach to hand hygiene compliance

by Dave Muoio 

Apr 20, 2021 11:49am

It’s been more than 150 years since Ignaz Semmelweis, the so-called “father of hand hygiene,” highlighted the benefits of handwashing among healthcare workers, and yet there’s still room for improvement among provider organizations large and small.

According to a 2018 study cited by the Centers for Disease Control and Prevention (CDC), there were an estimated 687,200 healthcare-associated infections (HAIs) in the U.S. during 2015, and about 72,000 patients with HAIs died during their hospitalizations.

Alongside the clinical impact, these infections have a very real cost on the healthcare system. Methicillin-resistant Staphylococcus aureus (MRSA) hospitalizations can cost about $38,500 per event, for example, while Clostridium difficile will cost about $24,000 per event without taking into account other accompanying care.

Handwashing is a core component of any hospitals’ infection control strategy, and there’s little shortage of literature outlining various hand hygiene compliance interventions and the cost savings they can bring to an organization.

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https://www.fiercehealthcare.com/tech/global-investments-telehealth-ai-startups-reached-record-levels-q1-2021

Global investment in telehealth, artificial intelligence hits a new high in Q1 2021

by Heather Landi

Apr 20, 2021 3:45pm

Telehealth investment hit an all-time high of $4.2 billion in just 139 deals in the first quarter, almost doubling the $2.2 billion raised in the same quarter a year ago, according to CB Insights.

That's the highest global funding for telehealth during one quarter on record, according to the company's first-quarter 2021 report. Funding also was up 18% from the $3.6 billion raised in the fourth quarter of 2020.

Industry executive discussions around telehealth and its role in care delivery remain active, based on mentions of telehealth during company earnings' calls, CB Insights reported. During the second quarter of 2020, there were close to 1,200 mentions of telehealth on earnings calls. And, while that dropped to 517 mentions in the first quarter of 2021, it's still much higher than pre-COVID levels.

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https://www.healthcareitnews.com/news/emea/european-data-protection-board-strengthen-sharing-health-data-between-eu-and-uk

European data protection board to strengthen sharing of health data between EU and UK

The European Commission has published its draft on the adequate protection of personal data in the UK.

By Sara Mageit

April 21, 2021 06:05 AM

In February 2021, the European Data Protection Board (EDPB) published two opinions on the European Commission draft Implementing Decisions on the adequate protection of personal data in the United Kingdom.

The EDPB has since announced that it has adopted its opinion on the draft adequacy decision issued by the European Commission.

Although the EDPB opinion is not binding, the adequacy decision will be formally implemented if approved by the EU member states.  

WHY IT MATTERS

Adequacy decisions are critical in granting data flows between the EU and the UK, particularly in the post-Brexit environment. The process enables the EU to decide whether countries outside the bloc offer an adequate level of protection for the data of EU citizens.  

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https://www.healthcareitnews.com/news/hospitals-and-health-systems-post-pandemic-and-how-prepare-future-outbreaks

Hospitals and health systems post-pandemic, and how to prepare for future outbreaks

Dr. Muhammad Ali Chaudhry, CEO of Emerging Health International, discusses the future of healthcare and how technology needs to transform the industry to prepare.

By Bill Siwicki

April 21, 2021 11:29 AM

It's been more than a year since the World Health Organization officially declared the COVID-19 outbreak a pandemic. According to a McKinsey report, an estimated 25% of outpatient services could move to telemedicine, which is among the necessary changes that could mean preparation and prevention for future health epidemics and pandemics, said Dr. Muhammad Ali Chaudhry, CEO of Emerging Health International, a healthcare technology and services company.

Further, the pandemic has caused a massive impact on the healthcare industry, accelerating transformations and hospital design needed to address the medical priorities of their populations and respond effectively to emergencies such as epidemics and pandemics, he added.

To get an idea of what needs to happen in healthcare in the years to come, Healthcare IT News interviewed Chaudhry to gain his expertise in healthcare transformation and healthcare technology.

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https://www.healthcareitnews.com/news/congressional-watchdog-issues-recommendations-va-it-system-overhaul

Congressional watchdog issues recommendations for VA IT system overhaul

The agency has been attempting to replace its decades-old core financial system with an integrated one for years.

By Kat Jercich

April 21, 2021 12:25 PM

The U.S. Government Accountability Office issued a report this week making recommendations for the ongoing Department of Veterans Affairs' IT modernization program.  

As noted in the GAO report, the VA has been attempting to replace its aging financial and acquisitions systems with an integrated system for years.

The latest deployment, in November 2020, followed some IT best practices – but the cost and schedule estimates "only minimally or partially met" many others, said the report.  

"Following information technology management best practices on major transformation efforts … can help build a foundation for ensuring responsibility, accountability, and transparency," wrote report authors.  

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https://www.healthcareittoday.com/2021/04/21/meditech-integrates-genomics-into-their-ehr/

MEDITECH Integrates Genomics Into Their EHR

April 21, 2021

John Lynn

Genomics is one of the most exciting parts of healthcare.  It’s also one of the most complex and challenging topics out there.  As genomic sequencing prices have dropped and genomic research has accelerated, I know of no area of healthcare that’s more exciting than genomics.

While genomics has shown so much progress and promise, I’ll admit that any genomics discussion gets complex really quickly.  With that complexity, I’ve always wondered how EHR vendors were going to approach genomics.  We all know that genomic medicine will eventually get to the bedside, but how it was going to get there wasn’t clear to me.  In fact, I’d often talk about EHR APIs and say that these APIs were needed because there was no way an EHR vendor was going to do all that was needed for genomic medicine (let alone hundreds of other third party apps).

While I still think this is true when it comes to APIs, MEDITECH recently announced their new MEDITECH Expanse Genomics solution that gives a great view on how MEDITECH is working to move genomic medicine to the clinician.  I’d describe their approach as making the key genomic data available to clinicians at the bedside and layering on specific genomic decision support (that’s my new term for clinical decision support based on genomics) using their partner FDB (First Databank).

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https://www.healthleadersmedia.com/innovation/pandemics-wake-healthcare-it-faces-new-realities

In Pandemic's Wake, Healthcare IT Faces New Realities

Analysis  |  By Scott Mace  |   April 21, 2021

Care is morphing to mix of real and virtual, powered by cloud and consumer demands. The desktop phone may be fading.


KEY TAKEAWAYS

·         As virtual care activity subsides somewhat, the new normal appears to be a mix of virtual, real, synchronous, and asynchronous communication with patients.

·         Prospects look favorable for payers to continue to offer reimbursement for virtual care, said the CIO of Mass General Brigham.

·         Cook Children's is building a "tech bar" into new hospital, where physicians will refer patients for mobile, digital apps to manage their health.

New realities in the wake of the COVID-19 pandemic are reshaping healthcare IT in ways that affect leadership, employees, and patients, according to a panel of healthcare system executives convened virtually during the recent virtual CHIME21 Spring Forum, presented by the College of Healthcare Information Management Executives (CHIME).

Various changes include:

  • Moving to a hybrid of virtual and in-person meetings
     
  • Shifting to certain patient monitoring and visits at home instead of in hospitals or clinics
     
  • Consumerization of healthcare
     
  • Accelerating a move to and dependency on cloud-based platforms
     
  • Questioning the expense of traditional desktop phones

"As people are starting to go back into getting care, which is good, we're seeing virtual care numbers now going down," said Rasu Shrestha, MD, MBA, chief strategy and transformation officer and executive vice president at Atrium Health.

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https://ehrintelligence.com/news/using-team-based-approaches-to-ehr-usability-ehr-optimization

Using Team-Based Approaches to EHR Usability, EHR Optimization

Sixty-one percent of clinician respondents said the EHR SWAT team initiative improved EHR usability.

By Christopher Jason

April 20, 2021 - A multidisciplinary team focused on EHR optimization is effective at improving EHR usability and ultimately mitigating clinician burnout, according to a Journal of the American Medical Informatics Association (JAMIA) Open case report.   

It is common for clinicians and health IT experts to emphasize EHR vendor and EHR implementation. However, sustaining the technology and enhancing EHR usability comes down to EHR optimization.

Better EHR usability leads to higher EHR adoption rates, fewer clinical errors, lower clinician burnout rates, financial benefits, and improved patient safety.

A group of researchers established a multidisciplinary “EHR SWAT Team” to combat clinician burden and improve EHR usability. This team consisted of ten individuals, including one chief medical information officer, two clinical informatics nurses, three clinical applications team members, one health information management specialist, and one pharmacy informatics specialist.

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https://patientengagementhit.com/news/tripathi-patient-data-access-about-culture-not-compliance

Tripathi: Patient Data Access About Culture, Not Compliance

Patient data access under the 21st Century Cures Act is a first step in building a culture of patient empowerment, ONC Head Micky Tripathi said.

By Sara Heath

April 20, 2021 - The latest moves out of the Office of the National Coordinator for Health IT (ONC) directly target patient data access by requiring healthcare organizations to host open access to a patient’s own medical record. But that’s just the first step in a long road toward better patient empowerment and engagement, according to ONC’s newly minted leader Micky Tripathi, PhD, MPP.

Mere days before the world turned upside down from the novel coronavirus, ONC dropped its final information blocking rule delivering on certain parts of the 21st Century Cures Act. Among other things, the rule calls on healthcare providers to utilize application programming interfaces (APIs) to allow patients to connect to their own EHRs.

This portion of the ONC information blocking rule intends to improve patient data access, ultimately boosting patient empowerment and engagement in her own care. The logic follows that patients who understand their own current health and wellness levels are able to better engage in patient-provider communication, shared decision-making, and ultimately chronic care self-management or prevention.

After a brief delay to let healthcare organizations focus more on the COVID-19 pandemic, the patient data access provision under the information blocking rule went into effect earlier this month, a first step in an overall cultural change that will put the patient at the center of care.

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https://www.healthaffairs.org/do/10.1377/hblog20210413.13025/full/

In Digital Health, Partnerships Between Business And Academia Are Needed To Advance Health Equity

10.1377/hblog20210413.13025

We have witnessed multiple digital health inequities in the past year, from disparities in access to health care video visits to challenges in scheduling COVID-19 vaccination online. It is clear that we need digital health transformation that is focused on reducing these gaps.

During the past 18 months, we—health care researchers with expertise in health technology and implementation science—launched a digital health incubator at University of California, San Francisco (UCSF). Called UCSF S.O.L.V.E. Health Tech, the incubator is focused explicitly on health equity; it connects public health and medical expertise with digital health companies to adapt, test, and evaluate products to better reach and meet the needs of diverse populations.

The incubator is rooted in our work in the public health care delivery system in San Francisco. Specifically, UCSF S.O.L.V.E. Health Tech focuses on ensuring that digital health tools work better for individuals with high medical and social needs who face structural barriers to health and health care, such as individuals from racial/ethnic minority groups and those facing poverty or other socioeconomic challenges in the US. These are the patients served in our delivery system at the San Francisco Health Network, and they are not a small segment of the health care landscape in the United States, given the growing linguistic and racial/ethnic diversity of the US and the substantial market share of Medicaid nationwide (for example, Medicaid provides insurance for one-third of all Californians).

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https://www.healthcareitnews.com/news/nurses-give-ehr-usability-f-new-study

Nurses give EHR usability an 'F' in new study

The report also finds that poor electronic health record user-experience is associated with nurse burnout.

By Kat Jercich

April 20, 2021 02:07 PM

A study published this week in the Journal of the American Medical Informatics Association found that more favorable electronic health record usability scores are associated with lower odds of burnout – and those usability scores have tanked.   

Researchers found that among 1,285 nurses who responded to a November 2017 survey about usability and burnout the mean nurse-rated EHR usability score was 57.6.   

The research team categorized this with a grade of "F."  

"To our knowledge, this is the first study to measure nurses’ perceptions of EHR-usability nationally using a standardized metric," wrote the researchers.  

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https://www.ausdoc.com.au/practice/call-arms-story-vaccine-hunters

A call to arms: The story of the 'vaccine hunters'

Ordinary citizens in the US are using technology to ensure left-over COVID-19 vaccines don't go to waste

12th April 2021

By Antony Scholefield

Say what you like about the US health system (there’s a lot that can be said), but it has managed to get more than 130 million COVID-19 vaccine doses into people’s arms.

At least a small proportion of those are because of groups calling themselves ‘vaccine hunters’.

These hunters target vaccine doses left over from cancelled appointments.

Sometimes they physically hang around clinics; sometimes they just keep an eye on online booking sites.

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https://ehrintelligence.com/news/modifying-ehr-prescribing-settings-can-improve-prescribing-patterns

Modifying EHR Prescribing Settings Can Improve Prescribing Patterns

A simple and effective way to curb opioid prescriptions is to modify the EHR default prescribing settings.

By Christopher Jason

April 19, 2021 - Optimizing EHR opioid prescribing default settings can boost prescribing patterns, according to a study published in JMIR Publications. Furthermore, reducing the duration of an opioid prescription and cutting down the quantity of pills could minimize the chance of opioid dependence and overdose.

The opioid epidemic continues to be a significant issue across the United States. According to HHS, over 70,000 people died from a drug overdose in 2019, and over 10.1 million people misused prescription opioids throughout 2019.

Increased chronic opioid use is linked to higher doses and longer opioid therapy durations. To combat the opioid epidemic, clinicians can reduce prescription rates. Health systems can also leverage prescription drug monitoring programs (PDMPs) and computerized provider order entry (CPOE) systems to reduce prescribing rates and simplify the prescribing process.

To reduce opioid quantities and reduce overprescribing, the research team evaluated the default Epic Systems EHR prescription settings at Thomas Jefferson University Hospitals. The health system’s CPOE consists of four opioid prescription entry fields: dose, frequency, duration, and quantity.

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https://healthitanalytics.com/news/supporting-equitable-vaccine-distribution-with-ehr-data

Supporting Equitable Vaccine Distribution with EHR Data

Leaders at Jefferson Health are leveraging EHR data to develop strategies around equitable vaccine distribution.

By Jessica Kent

April 19, 2021 - With the broadening availability of COVID-19 vaccines, it seems the US is finally beginning to see the light at the end of the pandemic-enveloped tunnel. After more than a year of uncertainty and unease, the vaccines represent the opportunity to return to some semblance of normalcy.

However, this optimism has been clouded by concerns about equitable vaccine distribution and access. The virus’s disproportionate impact on racial and ethnic minorities, as well as socioeconomically disadvantaged populations, has established a need for strategies around vaccine distribution.

At Jefferson Health, a system with 14 hospitals throughout greater Philadelphia, leaders took action to meet this need.

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https://healthitsecurity.com/news/fed-joint-advisory-patch-these-5-vulnerabilities-under-active-attack

Fed Joint Advisory: Patch These 5 Vulnerabilities Under Active Attack

Nation-state threat actors with ties to Russia are actively exploiting five publicly known vulnerabilities to compromise a range of entities within the US and its allies.

By Jessica Davis

April 19, 2021 - The National Security Agency, the Department of Homeland Security Cybersecurity and Infrastructure Security Agency, and the FBI released a joint alert, warning that nation-state threat actors from Russia are actively targeting and exploiting five publicly known vulnerabilities to compromise US networks.

The news followed the Biden Administration’s sanctions against the Russian government, which formerly attributed SolarWinds Orion supply-chain attack to the country’s foreign service: the Russian Foreign Intelligence Service (SVR) actors, also known as APT29, Cozy Bear, and The Dukes.

“The U.S. Intelligence Community has high confidence in its assessment of attribution to the SVR,” according to the White House statement. “The SVR’s compromise of the SolarWinds software supply chain gave it the ability to spy on or potentially disrupt more than 16,000 computer systems worldwide.”

“The scope of this compromise is a national security and public safety concern,” it added. “Moreover, it places an undue burden on the mostly private sector victims who must bear the unusually high cost of mitigating this incident.”

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https://www.healthcareitnews.com/news/geisinger-lowers-click-rate-phishing-emails-more-50

Geisinger lowers click rate on phishing emails by more than 50%

David Stellfox, a cybersecurity communications specialist at the Pennsylvania-based health system, offers an in-depth look at how they did it.

By Bill Siwicki

April 19, 2021 10:51 AM

As an art of cyber subterfuge, phishing keeps getting more crafty. Bad actors continue to create malicious emails that are convincing innocent workers at healthcare and other organizations the messages are authentic. And many workers click on them, starting a stream of problems.

This is why it's up to CISOs and other cybersecurity professionals to train workers how to identify phishing emails and not click on them or download their malware-infested attachments.

Danville, Pennsylvania-based Geisinger has had great success with its anti-phishing training, lowering the click rate on malicious emails by 50%. 

Healthcare IT News interviewed David Stellfox, cybersecurity communications specialist in the information security office at Geisinger, to get the lowdown on how exactly Geisinger achieved its success against phishing.

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https://www.healthcareittoday.com/2021/04/19/cios-confirm-healthcare-startups-have-a-tough-road/

CIOs Confirm Healthcare Startups Have a Tough Road

April 19, 2021

Colin Hung

A panel of healthcare CIOs at the CHIME Spring Forum confirmed what startups have known for a long time – the odds are stacked against them. The panel confirmed that health systems prefer to work with incumbents on new solutions rather than adopt ones from startups. However, startups with strong clinical champions, seamless integration with existing systems and that truly address an unmet need, will get a shot at earning their business.

The “How Providers and Health Tech Startups are Transforming Care” panel at the CHIME Spring featured 3 CIOs from US health systems:

The panel was moderated by Carina Edwards, CEO of Quil Health.

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https://histalk2.com/2021/04/16/weekender-4-16-21/

Weekly News Recap

  • Digital health vendor K Health, insurer Anthem, and investment firm Blackstone form Hydrogen Health.
  • CHIME will integrate its Spring Forum into Vive, an annual health IT event it will co-host with the HLTH conference beginning next March.
  • Mayo Clinic launches Remote Diagnostics and Management Platform.
  • The VA reaffirms that it will not bring its second Cerner site live in Columbus, OH until it has completed a strategic review of the project and shared the results with Congress.
  • AI solutions vendor Olive acquires Empiric Health, which offers AI-powered surgical analytics software.
  • Google will conduct a user feedback study as it prepares to develop a consumer-facing health record tool similar to Apple’s Health Record app.
  • Microsoft announces that it will acquire Nuance in a deal worth nearly $20 billion.
  • HHS extends TeleTracking’s COVID-19 hospital operating data collection and reporting for a third six-month term.
  • US News & World Report highlights the legal efforts of Hoag Memorial Hospital Presbyterian to leave the 51-hospital Providence system, with a key issue being clinical standardization as enforced by configuration of Epic.

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Enjoy!

David.