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, July 25, 2021

You Have To Worry Just What Is Going On With This Collection Of GP Data.

This appeared a day or so ago:

GPDPR September implementation date is scrapped

The implementation date of the GP Data for Planning and Research (GPDPR) programme has been scrapped and instead data collection will now only begin once certain criteria have been met.

Hanna Crouch – 20 July 2021

Originally planned to go live from 1 July 2021, concerns were raised about the programme and eventually led to the implementation date being moved to September.

However it looks like this date has now been scrapped as the minister for primary care and health promotion, Jo Churchill, sent a letter to all GP’s on 19 July which set out a new process for commencing data collection.

“While we are continuing to work on the infrastructure, and communication for the project, we are not setting a specific start date for the collection of data,” the letter states.

Instead, data will only begin to be uploaded when the following is in place:

  • the ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded;
  • the backlog of opt-outs has been fully cleared;
  • a Trusted Research Environment has been developed and implemented;
  • patients have been made more aware of the scheme through a campaign of engagement and communication.

Churchill’s letter also delves into the opt-out process, saying “we want to make the position around opt-out much simpler”.

“While 1st September has been seen by some as a cut-off date for opt-out, after which data extraction would begin, I want to reassure you that this will not be the case and data extraction will not commence until we have met the tests,” it adds.

As a result, three changes will be introduced to the opt-out system, they are:

  • Patients do not need to register a Type 1 opt-out by 1st September to ensure their GP data will not be uploaded;
  • NHS Digital will create the technical means to allow GP data that has previously been uploaded to the system via the GPDPR collection to be deleted when someone registers a Type 1 opt-out;
  • The plan to retire Type 1 opt-outs will be deferred for at least 12 months while we get the new arrangements up and running, and will not be implemented without consultation with the RCGP, the BMA and the National Data Guardian.

On the issue of data security and governance, Churchill’s letter confirms that the “government has committed that access to GP data will only be via a Trusted Research Environment (TRE) and never copied or shipped outside the NHS secure environment, except where individuals have consented to their data being accessed e.g. written consent for a research study”.

“This is intended to give both GPs and patients a very high degree of confidence that their data will be safe and their privacy protected,” the letter adds.

This TRE will be built in “line with best practice developed in projects, such as OpenSAFELY and the Office for National Statistics’ Secure Research Service”, Churchill confirmed and data collection will only begin once this is in place.

“We will ensure that the BMA [British Medical Association], RCGP [Royal College of GPs] and the National Data Guardian have oversight of the proposed arrangements and are satisfied with them before data upload begins,” the letter states.

“I can also confirm that the previously published Data Provision Notice for this collection has been withdrawn.

“Once the data is collected, it will only be used for the purposes of improving health and care. Patient data is not for sale and will never be for sale.”

More here:

https://www.digitalhealth.net/2021/07/gpdpr-september-implementation-date-scrapped/

There is a little more info here:

UK government halts GP data sharing scheme after 'mistakes' were made

The previous launch date of 1 September has been dropped until new targets are met.

By Sara Mageit

July 22, 2021 05:22 AM

The government has halted its controversial GP data sharing scheme, following Lord Bethell admitting 'mistakes' have been made in the way the programme has been run and managed.

The launch was previously delayed by three months, with patients being given the option to opt out of plans to share GP medical records with third parties by 1 September.

In a letter to GPs, the government has now said that it would only go live once the following four conditions have been met:

  • The ability to delete data already collected prior to a person choosing to opt out;
  • The backlog of existing opt outs being fully cleared;
  • The development of a “trusted research environment” — a repository into which the data will be collected and accessed only by NHSD-approved users without further extracting the data; and
  • Greater patient awareness of the scheme.

WHY IT MATTERS

During the committee, Bethell also said letters could be a “clunky form of communication”, but added he would not rule it out.

Health minister, Jo Churchill has called for a simple system of opting out of data sharing, after it emerged thousands of opt outs have not yet been processed due to COVID-19 disrupting operations and the administrative burden it has put on GPs.

Campaigners, the BMA and the Royal College of GPs (RCGP) are among those who have expressed concern that the plans have not been well-publicised, leaving doctors to inform patients.

There are also fears about sensitive information on GP records being shared, including mental and sexual health, criminal records, smoking, drinking habits and instances of domestic abuse.

NHS Digital says the current system for collecting patient data is more than 10 years old and needs replacing.

THE LARGER CONTEXT

The NHS tried to put GP records in a central database in 2013 under the Care.data programme, but it was abandoned in 2016 after confidentiality complaints.        

More here:

https://www.healthcareitnews.com/news/emea/uk-government-halts-gp-data-sharing-scheme-after-mistakes-were-made

Regular readers will recall I expressed concern about some of the aspects of a similar Australian initiative last week:

Friday, July 23, 2021

I Am Not Sure I Am Comfortable With (Private) Public Health Networks Holding All This Data.

I noticed this during last week.

Data hosting

17 June 2021

Primary Health Insights, the health data storage and analytics platform initiated and built by PHNs, is now operational.

The roll out of the data onboarding process and governance audits has been completed and most of the 27 participating PHNs are now storing de-identified patient data, sourced from general practices, in their secure lockboxes.

Lead by WAPHA, his has been the largest and most complex national project undertaken by PHNs, and the first at this scale by PHNs operating as a collective.

Here is the link:

https://aushealthit.blogspot.com/2021/07/i-am-not-sure-i-am-comfortable-with.html

Reading about what is going on in the UK my concerns are deepened.

Firstly with this list of issues the UK need to resolve – viz:

  • The ability to delete data already collected prior to a person choosing to opt out;
  • The backlog of existing opt outs being fully cleared;
  • The development of a “trusted research environment” — a repository into which the data will be collected and accessed only by NHSD-approved users without further extracting the data; and
  • Greater patient awareness of the scheme.

I would wonder how close we are to addressing these issues?

Also this is a pretty long list of concerns:

“There are also fears about sensitive information on GP records being shared, including mental and sexual health, criminal records, smoking, drinking habits and instances of domestic abuse.”

We don’t seem to have either opt-out, awareness or consent addressed at all.

I really wonder how good a leadership we are seeing from the leaders in General Practice in Australia to properly address these issues as we are seeing with the UK GP organasations.

Prima facie I would say this really is not good enough in 21st Century Australia.

Read the earlier blog, linked above for more sources of concern!

What do you think? I would say that the UK are, at least,  trying to do the right thing and listening to public opinion to some degree (having been sprung in the past) whereas little is being done here.

We seem to be trying to repeat mistakes made elsewhere!

David.

 

AusHealthIT Poll Number 589 – Results – 25th July, 2021.

 Here are the results of the poll.

Was Premier Gladys Berejiklian Too Slow To Tighten COVID19 Restrictions In Greater Sydney To Get Prompt Control Of The Present Outbreak?

Yes 58% (42)

No 21% (15)

I Have No Idea 21% (15)

Total votes: 72

An interesting outcome with most thinking Gladys has been a bit slow to act more firmly. By the end of the week it rather looks like things are slipping out of control and what comes next is not at all clear.

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

A good number of votes with a pretty clear outcome! 

It must also have been a very hard question as 15/72 (21%) readers were not sure how to respond.

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

David.

Saturday, July 24, 2021

Weekly Overseas Health IT Links – 24 July, 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/2021/07/why-best-of-breed-doesnt-mean-complexity-and-compromise-for-the-nhs/

Why best of breed doesn’t mean complexity and compromise for the NHS

David Elliott, director of IT at Northumbria Healthcare NHS Foundation Trust, explores the misconceptions of a “best-of-breed” approach to digital transformation and why his trust decided to take this particular approach. 

DHI News Team – 13 July 2021

Having worked in utilities for over a decade before joining Northumbria Healthcare NHS Foundation Trust, naturally I made comparisons between the sectors, and I was particularly struck by the limitations to investment. Whilst it was considered normal for a utility company to allocate four to five percent of its annual turnover to digital, it’s just not possible in the NHS. Yet, digital transformation shouldn’t be about the ‘best you can afford’, it should be about the ‘best you can achieve’.

This rhetoric about affordability is often associated with the best of breed (BoB) approach, often in comparison to enterprise-wide single systems. It’s seen as second best when trusts can’t afford an enterprise-wide EPR.

And as a recent NAO report highlighted, it can be considered too complex because of the multiple business cases, integration between solutions and the extensive management of different suppliers. However, I want to redefine BoB.

Redefining best of breed

Northumbria Trust serves a patient population of 500,000 people and provides a wide range of hospital and community services across Northumberland and North Tyneside, so we need technology that can respond to different clinical settings and specialisms.

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https://www.digitalhealth.net/2021/07/hl7-fhir-everything-you-need-to-know/

HL7 FHIR: everything you need to know

As the interoperability standard HL7 format has evolved over the years, its use has opened up to current web practices such as HTML, XML and JSON.

This has led to the FHIR (Fast Healthcare Interoperability Resources) standard which broadens the field of possibilities with its library of open source resources.

FHIR is seen to be one way to help boost interoperability in healthcare and is defined as a standard describing data formats and elements (known as “resources”) and an application programming interface (API) for exchanging electronic health records (EHR).

Benefits can include making data sharing easier, it can be fast to implement and it is vendor-neutral.

To understand how and why the FHIR standard came into being, Frédéric Laurent, project manager at Enovacom, reflects on the origins of this interoperability standard.

This white paper outlines everything you need to know about HL7 FHIR.

Find out more below.

Read the full case study

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https://www.nytimes.com/2021/07/16/technology/what-happened-ibm-watson.html

What Ever Happened to IBM’s Watson?

IBM’s artificial intelligence was supposed to transform industries and generate riches for the company. Neither has panned out. Now, IBM has settled on a humbler vision for Watson.

By Steve Lohr

July 16, 2021

A decade ago, IBM’s public confidence was unmistakable. Its Watson supercomputer had just trounced Ken Jennings, the best human “Jeopardy!” player ever, showcasing the power of artificial intelligence. This was only the beginning of a technological revolution about to sweep through society, the company pledged.

“Already,” IBM declared in an advertisement the day after the Watson victory, “we are exploring ways to apply Watson skills to the rich, varied language of health care, finance, law and academia.”

But inside the company, the star scientist behind Watson had a warning: Beware what you promise.

David Ferrucci, the scientist, explained that Watson was engineered to identify word patterns and predict correct answers for the trivia game. It was not an all-purpose answer box ready to take on the commercial world, he said. It might well fail a second-grade reading comprehension test.

His explanation got a polite hearing from business colleagues, but little more.

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https://www.healthcareitnews.com/news/amazon-web-services-introduces-aws-health

Amazon Web Services introduces AWS for Health

The announcement came alongside the news that Amazon HealthLake, the company's HIPAA-eligible data management service, is now available in select regions.

By Kat Jercich

July 16, 2021 11:33 AM

Amazon Web Services this week introduced AWS for Health, a range of services aimed at helping healthcare and life science organizations reach their goals.  

"AWS for Health provides proven and easily accessible capabilities that help organizations increase the pace of innovation, unlock the potential of health data, and develop more personalized approaches to therapeutic development and care," wrote Patrick Combes, director, head of technology – healthcare and life sciences at AWS, in a blog post Thursday.  

"AWS for Health simplifies the process for healthcare and life-science enterprises and innovative startups to identify industry-leading, cloud-based solutions across 16 critical solution areas in healthcare, genomics, and biopharma," Combes continued.

WHY IT MATTERS

When it comes to healthcare specifically, Amazon says AWS will allow organizations to accelerate the digitalization and utilization of their data.

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https://healthitsecurity.com/news/californiaupdates-health-facilitydatabreach-requirements

California Updates Health Facility Data Breach Requirements 

California updated its health facility data breach regulations.

By Lisa Gentes-Hunt

July 15, 2021 - California is tightening up its health facility data breach regulations and recently issued an update to its administrative penalties and reporting requirements. 

The newly updated health facility data breach regulations went into effect on July 1, according to the California Department of Public Health.  

“The regulations implement California's Health and Safety Code Section 1280.15, which requires a clinic, health facility, home health agency, or hospice licensed by the Department [of Health] to prevent any unlawful or unauthorized access to, or use, or disclosure of, a patient's medical information,” according to a report by the law firm Baker Donelson

In an All Facilities Letter published by the California Department of Public Health, Acting Deputy Director Cassie Dunham stated that the updated “regulations require healthcare facilities to report a medical information breach to CDPH no later than 15 days after the breach has been detected. The regulations describe the information the health care facility must provide to CDPH. Delays in reporting may result in additional administrative penalties.” 

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https://www.healthcareitnews.com/news/tackling-interoperability-ehrs-and-billing-systems-different-vendors

Global Edition

Interoperability

Tackling interoperability with EHRs and billing systems from different vendors

Differing EHR vendors for inpatient and ambulatory abound, as they do for inpatient EHR and billing systems. What to do? An interoperability expert offers helpful advice.

By Bill Siwicki

July 14, 2021 12:02 PM

Although the topic and importance of interoperability has been discussed for years, according to new research from health IT and market-intelligence company Definitive Healthcare, about one in five hospitals report different vendors for their inpatient and ambulatory EHR systems.

This disconnect can lead to suboptimal patient experiences where critical information from a hospital stay may not make it in front of the primary care provider or outpatient results are not accessible by the inpatient team.

These are prevalent issues, ones even more relevant as a result of the COVID-19 pandemic. With nearly one-third of hospitals reporting different vendors for their inpatient EHR and billing systems, according to the Definitive Healthcare data, missed procedures or miscoding can mean revenue losses.

Healthcare IT News interviewed Todd Bellemare, senior vice president of professional services at Definitive Healthcare, to learn more about today's interoperability challenges and what hospitals and health systems can do to address them.

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https://www.washingtonpost.com/politics/va-veterans-records-system/2021/07/14/fd508732-e4e9-11eb-8aa5-5662858b696e_story.html

VA chief halts rollout of massive digital health system for veterans, citing serious flaws

By  Lisa Rein

July 14, 2021|Updated yesterday at 9:46 p.m. EDT

Veterans Affairs Secretary Denis McDonough on Wednesday acknowledged fundamental flaws in the agency’s troubled $16 billion effort to modernize veterans’ medical records, a project championed by former president Donald Trump and his son-in-law that is beset by cost overruns, delays, misrepresentations to Congress and a disastrous rollout at its first hospital.

McDonough told Senate lawmakers that a three-month internal review of the electronic health records system found so many structural problems that he cannot continue to deploy it at other hospitals until VA leaders are confident of success. He could not say when the rollout will resume.

“It’s a lot of money you’ve entrusted to us,” McDonough, confirmed in February as President Biden’s pick to lead the agency, told the Senate Veterans' Affairs Committee at a hearing. He called the digital health project a “potential game changer for medicine” that could improve veterans’ health care. But he cited serious “governance and management challenges” that have dogged it from the outset, saying, “That’s on us.”

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https://ehrintelligence.com/news/tefca-interoperability-infrastructure-go-live-set-for-q1-2022

TEFCA Interoperability Infrastructure Go-Live Set for Q1 2022

ONC announced that TEFCA’s health information exchange infrastructure for nationwide interoperability will be live in the first quarter of 2022.

By Hannah Nelson

July 14, 2021 - ONC has announced that the Trusted Exchange Framework and Common Agreement (TEFCA) interoperability infrastructure and health information exchange (HIE) standards will be live in the first quarter of 2022.

Drafted by ONC to fulfill the aims of the 21st Century Cures Act, TEFCA is a set of policies, procedures, and standards to support the development of the Common Agreement for nationwide HIE across health information networks (HINs).

“The overall goal for TEFCA is to establish a floor of universal interoperability across the country,” National Coordinator Micky Tripathi and Mariann Yeager, CEO of TEFCA’s Recognized Coordinating Entity (RCE) The Sequoia Project, explained in a blog post. “We need networks to be seamlessly connected with each other.”

“While the nationwide networks have made considerable progress in this area, cross-network exchange is still not frictionless, and most state/regional HIEs serve only their local markets and many are not connected to any other networks at all,” they wrote.

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https://mhealthintelligence.com/news/cms-expands-telehealth-coverage-in-proposed-2022-physician-fee-schedule

CMS Expands Telehealth Coverage in Proposed 2022 Physician Fee Schedule

The proposal includes expanding Medicare coverage for telehealth services that address mental health and substance abuse issues and extending most COVID-19 freedoms until the end of 2023, as well as some coverage for FQHCs and RHCs.

By Eric Wicklund

July 14, 2021 - The Centers for Medicare & Medicaid Services’ proposed 2022 Physician Fee Schedule offers some good news for telehealth advocates.

The 1747-page draft, released this week, proposes to make permanent some provisions enacted years to address the coronavirus pandemic, while continuing most until at least Dec. 23, 2023 “so that there is a glide path to evaluate whether the services should be permanently added to the telehealth list following the COVID-19 PHE (Public Health Emergency).”

CMS is proposing to eliminate geographic restrictions on telemental health coverage and to make the patient’s home an originating site, as long as patient and telemental health provider meet in-person within six months of beginning telehealth services and at least once every six months after.

“We are seeking comment on whether a different interval may be necessary or appropriate for mental health services furnished through audio-only communication technology,” the agency said in a press release. “We are also seeking comment on how to address scenarios where a physician or practitioner of the same specialty/subspecialty in the same group may need to furnish a mental health service due to unavailability of the beneficiary’s regular practitioner.”

As for audio-only telehealth, CMS is proposing to amend its requirements for interactive telecommunications systems, which now focus on real-time, two-way, audio-visual telemedicine technology, to include audio-only telehealth when used for the diagnosis, evaluation or treatment of mental health issues in the patient’s home.

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https://www.theverge.com/2021/7/13/22573753/covid-data-health-records-machine-learning-disease

Machine learning model from the largest US COVID-19 dataset predicts disease severity

The study also showed how treatment of the disease changed over time

A centralized repository of COVID-19 health records built last year is beginning to show results, starting with a new paper published today. The repository is the largest set of COVID-19 records to date, and was built by a team of researchers and data experts last year to help make sense of COVID-19.

The study, published in the journal JAMA Network Open, looked at risk factors for severe cases of COVID-19 and traced the progression of the disease over time. The authors built machine learning models to predict which hospitalized patients would develop severe disease based on information collected on their first day in a hospital.

Using the centralized database, called the National COVID Cohort Collaborative Data Enclave, or N3C, meant the research team was able to include hundreds of thousands of patients’ records in its analysis. The study used data from 34 medical centers and included over 1 million adults — 174,568 who tested positive for COVID-19 and 1,133,848 who tested negative. It includes records stretching from January 2020 to December 2020.

The analysis shows how treatment for COVID-19 changed over the course of 2020, as doctors tried new treatments and gained more experience with the condition. The percentage of patients who were treated with the anti-malaria drug hydroxychloroquine, which was promoted by former President Donald Trump before proving to be ineffective, dropped off to nearly zero by May 2020. Use of the steroid dexamethasone ticked up in June, after studies showed it could improve survival rates.

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https://www.fiercehealthcare.com/tech/microsoft-taps-teladoc-to-integrate-telehealth-into-teams-app

Microsoft taps Teladoc to integrate telehealth into Teams app

by Heather Landi 

Jul 14, 2021 11:08am

Teladoc Health is partnering with Microsoft to integrate telehealth into the Teams app for hospitals and health systems.

The combination of communications, collaboration and workflows in Microsoft Teams with Teladoc Health’s virtual care delivery technology will simplify the way care providers work by streamlining the technology and administrative processes associated with providing virtual care, according to the companies.

"We will deliver what hospitals and health systems want: integrated, enterprise solutions that make the full breadth of virtual care available in their daily workflows,” said Joseph DeVivo, president of hospitals and health systems at Teladoc Health, in a statement. “Our collaboration will deliver a more seamless, unified experience for clinicians and patients that makes healthcare better, leveraging leading data, artificial intelligence and machine learning expertise from both companies.”

During the COVID-19 pandemic, many hospitals and health systems adopted Microsoft Teams to connect clinicians and patients on video. Clinicians already have the ability to securely access clinical data included within their electronic health record system using Teladoc Health's Solo platform and will be able to do so without having to leave the Teams app, according to Teladoc.

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https://www.healthcareitnews.com/news/5-useful-tools-combat-ransomware-attacks

Global Edition

Privacy & Security

5 useful tools to combat ransomware attacks

A cybersecurity expert details some technologies that can help secure hospitals and health systems stretched thin by the COVID-19 pandemic.

By Bill Siwicki

July 14, 2021 10:56 AM

Though ransomware continues to affect organizations across all sectors, its impact on healthcare has been devastating. Cybercriminals continue to target the parts of the industry that are most vulnerable – including hospitals already stretched thin from the COVID-19 pandemic.

Hospitals manage an abundance of personally identifiable information and protected health data, so they are tasked with ramping up ransomware protections and handling information securely in the wake of evolving compliance regulations.

Healthcare IT News sat down with Dan Timpson, chief technology officer at Kaseya, an IT management software company whose products include IT security, to discuss some of the best ways for hospitals to handle the numerous security challenges they face – namely, seeking out technologies that can prevent, detect and mitigate account compromise and data loss.

Q. What are automated phishing defenses and how do they help stop ransomware attacks?

A. The healthcare industry continues to be one of the most targeted sectors by cybercriminals, because short periods of downtime can lead to detrimental patient outcomes. Automated phishing defense solutions can help to quickly detect and quarantine emails containing malware before employees can interact with them.

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https://www.healthcareittoday.com/2021/07/14/why-human-error-is-just-as-risky-as-ransomware-for-healthcare-cybersecurity/

Why Human Error is Just as Risky As Ransomware for Healthcare Cybersecurity

July 14, 2021

The following is a guest article by Tim Sadler, CEO of Tessian.

Ransomware attacks continue to plague the healthcare industry. In all, cyberattacks on healthcare more than doubled last year, with ransomware making up 28% of those attacks. But healthcare IT leaders have another cybersecurity challenge to overcome: human error. According to Verizon’s 2021 Data Breach Report, miscellaneous errors are the number one cause of data breaches in healthcare today, with the most common of these mistakes involving an email or file attachment being sent to the wrong person.

While these errors are not maliciously motivated, they can result in lost data and significant reputational damage. When you consider how much valuable and sensitive information healthcare employees are responsible for, a simple slip-up on email could cause a serious cybersecurity incident.

In fact, I would argue that human error can be just as damaging as ransomware attacks — and in some cases, more damaging given that healthcare IT leaders often lack visibility into employees’ mistakes and risky behaviors. A deeper look at employee behavior patterns can help organizations prevent a simple mistake from turning into a major breach.

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https://patientengagementhit.com/news/what-are-omnichannel-patient-engagement-technologies

What Are Omnichannel Patient Engagement Technologies?

Omnichannel patient engagement technologies include the multimodal systems organizations use to connect with consumers.

By Sara Heath

July 13, 2021 - Add yet another phrase to the list of healthcare buzzwords: omnichannel patient engagement technologies.

The rise of the health IT sector, combined with a growing appetite from patients for more healthcare consumerism, has pushed omnichannel patient engagement technologies into the limelight.

The term omnichannel engagement derives from the sales space, where companies pitch a seamless customer shopping experience, according to BigCommerce.com. Using a variety of tools, each of which is connected to one another, customers are able to enter the shopping experience from multiple platforms without friction or interruption.

For example, a shopper might scroll on social media, see a targeted ad, view the item on the store’s website, and then purchase it in the brick-and-mortar location.

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https://www.vox.com/recode/22570076/health-apps-privacy-opioid-addiction-app-report

The struggle to make health apps truly private

Why privacy and patient advocates are worried that substance use disorder apps aren’t keeping data private.

By Sara Morrison Jul 12, 2021, 11:20am EDT

Jonathan J.K. Stoltman already knew how hard it can be for people with addiction to find the right treatment. As director of the Opioid Policy Institute, he also knew how much worse the pandemic made it: A family member had died of an opioid overdose last November after what Stoltman describes as an “enormous effort” to find them care. So Stoltman was hopeful that technology could improve patient access to treatment programs through things like addiction treatment and recovery apps.

But then he consulted last year with a company that makes an app for people with substance use disorders, where he says he was told that apps commonly collected data and tracked their users. He worried that they weren’t protecting privacy as well as they should, considering who they were built to help.

“I left after expressing concerns about patient privacy and quality care,” Stoltman told Recode. “I’m a tech optimist at heart, but I also know that with that widespread reach they can have widespread harms. People with an addiction already face substantial discrimination and stigma.”

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https://www.healthcareitnews.com/news/data-175k-covid-19-patients-fuels-predictive-severity-model

Data from 175K COVID-19 patients fuels predictive severity model

Researchers relied on records stored in the National COVID Cohort Collaborative's Data Enclave, which now includes information from 6.3 million patients.

By Kat Jercich

July 13, 2021 11:50 AM

A study published in JAMA Network Open this week used the largest data repository of COVID-19 patients in the United States to develop a model to predict clinical severity based on first-day admission data.  

The research relied on roughly two million medical records stored in the Data Enclave of the National COVID Cohort Collaborative, or N3C. 

As the researchers explained, "This cohort study characterizes the largest U.S. COVID-19 cohort to date, including 174,568 adults who tested positive for SARS-CoV-2."  

WHY IT MATTERS

The study was the first to use the N3C database, which is specifically designed to support research on COVID-19.   

The N3C was developed by the National Center for Advancing Translational Sciences, the hub for research of this kind at the National Institutes of Health. As of December 2020, the N3C release set included information from 1,926,526 patients from 34 sites across the United States.   

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https://www.healthcareitnews.com/news/how-geisinger-uses-telehealth-keep-patients-home-and-out-hospital

How Geisinger uses telehealth to keep patients at home and out of the hospital

An executive at its Center for Telehealth explains how the Pennsylvania health system evaluates virtual care models – and when it knows it's time for an ER visit instead.

By Bill Siwicki

July 13, 2021 11:18 AM

Geisinger Health, based in Danville, Pennsylvania, embarked on a telehealth journey to develop a single solution that could bring care closer to home for patients across the care continuum.

Geisinger evolved its telehealth program for its patients and its health plan members, and then leveraged this program to respond to the COVID-19 pandemic. The telehealth program now offers more than 70 specialties, including neurology, pulmonology, dentistry, behavioral health and others. It connects patients to a local physician, urgent care or primary care clinic, or a regional hospital.

Telehealth models for in-home care

At his HIMSS21 educational session, "Providing Care Closer to Home," David A. Fletcher, associate vice president of the Center for Telehealth at Geisinger, will explain how an executive evaluates telehealth models that can be used for in-home care, even for patients with complex health needs.

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https://www.healthcareittoday.com/2021/07/13/insights-into-ehr-documentation-workstations/

Insights Into EHR Documentation Workstations

July 13, 2021

John Lynn

One of the most important and least covered things in healthcare IT is the various EHR Documentation Workstations.  No doubt it’s a regular topic of conversations at healthcare organizations because an EHR workstation configuration really impacts EHR users experience and therefore the patient.  It’s not as sexy to talk about workstations when you could talk about AI.  However, a healthcare organization’s approach to the right workstations for their users can have one of the biggest impacts on their users’ experience.

Over the years, we’ve seen quite the evolution when it comes to workstations in healthcare.  Most people will remember the COWs (Carts on Wheels) that many didn’t appreciate so they changed it to the more respectful WOWs (Workstation on Wheels).  Of course, the early iterations of these were heavy and often lacked the battery life needed to match a busy clinician’s needs.  Thankfully, both of these have improved over time as far as weight and battery options.

Once the iPhone and even more so the iPad arrived on the scene, many were saying that the workstation was dead in healthcare.  Well, we’ve certainly not seen that happen largely because mobile devices like a smartphone or tablet aren’t great input devices.  Much to their chagrin, a lot of what healthcare professionals do is input data.  So, the EHR documentation workstation in healthcare lives on.

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https://www.healthleadersmedia.com/telehealth/telehealth-use-stabilized-38x-higher-pre-pandemic-mckinsey-says

Telehealth Use 'Stabilized' 38X Higher Than Pre-pandemic, McKinsey says

Analysis  |  By John Commins  |   July 13, 2021

Favorable patient responses and new investments in the technology will propel the growth of telehealth in 2021


KEY TAKEAWAYS

·         Overall telehealth use for office visits and outpatient care was 78 times higher in April 2020 than in February 2020, representing nearly one-third (32%) of office and outpatient visits for the month.

·         The surge in telehealth use was prompted by the pandemic, the shutdown in in-person visits, an increased willingness by patients and providers to use telehealth, and the availability of federal reimbursements for telehealth.

After a spike at the onset of the coronavirus pandemic, telehealth use has stabilized at levels 38 times higher than before the pandemic.

This strong continued uptake, along with favorable patient responses, and new investments in the technology will propel the growth of telehealth in 2021, according to a report from McKinsey & Co.

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https://www.fiercehealthcare.com/payer/how-unitedhealthcare-harnessing-predictive-analytics-to-target-social-needs

How UnitedHealthcare is harnessing predictive analytics to target social needs

by Paige Minemyer 

Jul 12, 2021 3:45pm

UnitedHealthcare is harnessing predictive analytics to more effectively address members' social determinants of health.

The health insurance giant has rolled out the program to employers who have selected the Advocate4Me Elite and Advocate4Me Premier products, with plans to launch it for fully insured employer plans later this year, according to an announcement.

The tool uses de-indentified claims data to proactively identify members who may be at greatest risk for social concerns. The insurer's call center advocates are then armed with a curated database of community resources to assist members with their social needs.

"When we are looking at our population, we want to make sure we are addressing all of the variables to help support our members," Rebecca Madsen, UnitedHealthcare's chief consumer officer, told Fierce Healthcare.

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https://www.news-medical.net/news/20210709/Health-information-exchange-event-notification-can-be-a-promising-tool-for-better-patient-care.aspx

Health information exchange event notification can be a promising tool for better patient care

Emily Henderson, B.Sc.

A new study from U.S. Department of Veterans Affairs, Regenstrief Institute, IUPUI and Icahn School of Medicine at Mount Sinai researchers reports that primary care physicians recognize the need for better coordination and welcome health information exchange (HIE) event notifications as a means of improving the flow of information to enable provision of better patient care.

Individuals often receive medical care from more than one healthcare system. Care coordination among providers, for example after discharge from an emergency department or hospital in one system, with the patient's primary care physician in another, is challenging and frequently doesn't occur. This siloed approach to medical care with incomplete sharing of clinical information, may adversely affect health outcomes.

"While our study focused on patients whose primary care was provided in the VA system, this is an issue faced by patients and their providers in many, if not most, healthcare systems in the United States," study senior author Brian Dixon, PhD, MPA, the Regenstrief and Indiana University Richard M. Fairbanks School of Public Health at IUPUI director of public health informatics.

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https://www.healthcareitnews.com/news/onc-updates-interop-specs-sexual-orientation-gender-identity-and-sdoh

ONC updates interop specs for sexual orientation, gender identity and SDOH

Version 2 of the United States Core Data for Interoperability offers "clearer direction toward the standardized, electronic exchange" of those data types and others, enabling better care for "all patients."

By Mike Miliard

July 12, 2021 04:53 PM

The Office of the National Coordinator for Health Information Technology on Friday released the United States Core Data for Interoperability version 2, with updated details on how data elements related to sexual orientation, gender identity and social determinants of health can enable streamlined exchange and improve care for "all patients who access the nation's healthcare system," said Dr. Rachel Levine, HHS assistant secretary for health.

WHY IT MATTERS
Updated after drawing on extensive stakeholder feedback, USCDI v2 – the standardized set of health data classes and constituent data elements for nationwide health information exchange – is now updated with more data types: three new data classes and a total of 22 new data elements.

"Today's release makes USCDI version 2 available for consideration as part of ONC's Standards Version Advancement Process, which will take place this fall," said agency officials in a news release. "The SVAP allows health IT developers to update their certified health IT to support newer versions of the USCDI (among other standards) and provide those updates to their customers, including providers and hospitals, before they are required by regulation."

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https://www.healthcareitnews.com/news/northwell-health-uses-machine-learning-reduce-readmissions-nearly-24

Northwell Health uses machine learning to reduce readmissions by nearly 24%

The health system's medical director explains how clinical AI is better than predictive analytics when it comes to improving patient outcomes.

By Bill Siwicki

July 12, 2021 11:22 AM

Reducing readmissions is a major focus for healthcare organizations operating under value-based care contracts.

Clinicians at Northwell Health, the largest healthcare provider in New York State, are applying clinical artificial intelligence to augment their post-discharge workflows and have reduced readmissions by 23.6%. The clinicians studied clinical AI stratified patients for their risk of readmissions, identified the clinical and nonclinical factors driving their risk, and recommended targeted outreach and interventions to reduce patient risk.

Clinical AI versus predictive analytics

The clinicians noted the contrast between prescriptive clinical AI and traditional predictive analytics, and their impacts on patient outcomes.

"Predictive analytics as a whole is a powerful tool using a combination of historical data, statistical modeling, data mining and machine learning in order to predict events and identify patterns," said Dr. Zenobia Brown, vice president and medical director at Northwell Health, a health system based in Manhasset, New York.

"Despite those powerful insights, predictive analytics are really just a starting place in terms of enacting meaningful change at the population and individual levels.

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https://www.healthcareitnews.com/news/building-tomorrows-healthcare-it-workforce

Building tomorrow's healthcare IT workforce

Healthcare organizations need to be thinking about what their future IT workforce will look like, and figuring out ways to ensure a robust pipeline of talent in an era of rapid digitalization and disruption.

By Nathan Eddy

July 12, 2021 09:54 AM

State-of-the-art talent in health IT is vital to the future of the healthcare industry. Health information-sharing is rapidly extending to support telemedicine, predictive medicine, and population health; address social determinants of health; and facilitate remote monitoring of patient and family-generated data, including data from personal medical devices.

"Experience is the biggest leak in the pipeline today," explained Lauren Kosowski, service delivery consultant at Michigan Health Information Network Shared Services. "When looking for full-time staff, we expect candidates to have some type of experience in the field or position they are applying for. But how can we anticipate them to have that experience if we are not the ones providing them with those opportunities?"

Right now, she said she is seeing a big spike in health informatics, a rapidly emerging discipline that can assist in the use of information technology for better decision-making and better patient outcomes.

She said the need for and adoption of health IT skyrocketed last year due to the ongoing COVID-19 pandemic – and she doesn’t anticipate for that to slow down anytime soon.

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https://www.healthcareittoday.com/2021/07/12/the-1-clinical-communication-system-requirement/

The #1 Clinical Communication System Requirement

July 12, 2021

John Lynn

In a recent clinical communications survey we did of the Healthcare IT Today community sponsored by Halo Health, we found some really fascinating insights into how healthcare organizations look at their clinical communication systems.  We had over 140 healthcare leaders respond to the survey and had a nice mix of large, medium, and small organizations take part in the survey.

One of the biggest insights we gleaned from healthcare leaders was around priorities they had for their clinical communication system partner. While considerations such as cloud architecture and experience with large system deployments were not unimportant, the survey respondents did indicate even higher priorities.

The biggest priority for healthcare leaders was a solution that was purpose built for clinical communication that reached the right person at the right time and consolidated the experience for the user.

Considering our current environment, these results make sense.  The main benefit healthcare leaders wanted from their clinical communication system was how it improved the workflow for the clinician or other users.  No doubt we are all tired of implementing government driven software that doesn’t provide a great experience for the end user.  It seems like end users are feeling it and healthcare IT leaders are feeling it too.

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https://histalk2.com/2021/07/09/weekender-7-9-21/

Weekly News Recap

  • FDA clears AliveCor’s phone-attached EKG sensor and app to allow professionals to calculate QTc interval for diagnosis of irregular heartbeat.
  • Intelerad acquires Heart Imaging Technologies.
  • A second OIG review of the VA’s Cerner project warns again of unbudgeted infrastructure costs of several billion dollars.
  • Sophia Genetics announces IPO plans.
  • UC San Diego Health adopts the SMART Health Card.
  • Three institutions form Texas Health Informatics Alliance and announce its first conference.

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Enjoy!

David.

Friday, July 23, 2021

I Am Not Sure I Am Comfortable With (Private) Public Health Networks Holding All This Data.

I noticed this during last week.

Data hosting

17 June 2021

Primary Health Insights, the health data storage and analytics platform initiated and built by PHNs, is now operational.

The roll out of the data onboarding process and governance audits has been completed and most of the 27 participating PHNs are now storing de-identified patient data, sourced from general practices, in their secure lockboxes.

Lead by WAPHA, his has been the largest and most complex national project undertaken by PHNs, and the first at this scale by PHNs operating as a collective.

Ultimately, Primary Health Insights will allow PHNs to analyse the de-identified data collected and provide new insights to general practices.  This will enable practices to deliver better patient care and lead to improved health outcomes by supporting data driven continuous improvement.

Primary Health Insights is a highly secure environment that has passed independent cybersecurity tests against industry and government benchmarks. It has also undergone, and will continue to undergo, stringent privacy impact assessments, as part of the operational processes and governance framework of the platform.

Built using Microsoft Azure cloud technology, each participating PHN has its own independent, secure “lock-box” for the hosting of their data, with complete control over its access and use.

Alongside the transition from project to operational mode, WA Primary Health Alliance is now focussed on the development of the platform’s analytics and reporting capabilities.

Historical data

In late August 2020, the project transitioned from a platform development phase to a pilot phase. WA Primary Health Alliance established its own secure “lock-box” on the Primary Health Insights platform, tested the platform’s capability and migrated its own data into this environment. This included data that was routinely collected from WA general practices and previously stored by Curtin University on behalf of the WA Primary Health Alliance. This data has been erased from the University’s servers to the full extent that is technically practicable.

Here is the link:

https://www.wapha.org.au/health-professionals/general-practice-support/data-hosting/

First we need to realise the PHNs are relatively small incorporated organisation that are mostly government funded with varying levels of technical skills in data protection and security

Second we know that, thank to Vanessa Teague and he colleagues that de-identified data isn’t!

Third having all this data with one provider is hardly confidence building!

Fourth I am totally unclear that the average patient has any idea their data is collected and stored in this fashion. You can read commentary on that in this context here:

Juanita Fernando

Commonwealth Health Department going for data grab under cover of COVID

While Australia is focussed on COVID, the government acts to quietly collect our personal health data.

The Department of Health funded project, Primary Health Insights, has been uploading detailed health records from GP databases.

Industry sources have revealed that up to 25 million individual health records have been uploaded to “the Cloud”.

400 items of medical data per patient include medications and prescribing dates, including opioids, antidepressants, antipsychotics, MBS items, allergies, alcohol consumption, diagnoses, pathology dates and results, including STIs, chlamydia, gonorrhoea, syphilis, hepatitis, HIV, HPV and pap smear information.

While almost 10% of Australians opted out of My Health Record, most may be unaware they are giving consent to their default data upload, when they sign the patient registration form to see their own doctor.

Lots more here:

https://privacy.org.au/2021/05/21/commonwealth-health-department-going-for-data-grab-under-cover-of-covid/

All in all this has way too much of ‘Big Brother’ about it! Who knows how to opt-out?

David.