Saturday, February 04, 2017

Weekly Overseas Health IT Links – 4th February, 2017.

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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Four Questions For: Geoff Hinton

Jan 16, 2017 - 8:00 AM CST
You’ve been referred to as the “godfather of neural networks.” Do you believe you’ll see true artificial intelligence in your lifetime?
It depends on what you mean by true artificial intelligence.  If you mean autonomous agents with human level abilities at perception, natural language, reasoning and motor control, probably not.  However, it’s very hard to see more than about 5 years into the future so I would not rule it out. Ten years ago, most people in AI would have been very confident that there was no hope of doing machine translation using neural nets that have to get all their linguistic knowledge from the raw training data. But that is now the approach that works best and it has just halved the gap in quality between machine translations and human translations.
What is there to fear about the existence of true artificial intelligence?
I am not too worried about the popular fantasy that evil robots will take over the world. I am much more worried about what people like Hitler or Mussolini might do if they had armies of intelligent robots at their disposal. I think there is a pressing need for international agreements on militarization of this technology.
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With HHS Pilot, First Responders Can Access Your Health Data Immediately

By Mohana Ravindranath January 26, 2017
One day, first responders will be able to quickly pull up your medical records if they find you during a disaster like an earthquake or forest fire.
That's the vision the Health and Human Services Department is working toward with a pilot that would let emergency medical services pull up clinical documents at the point of care—potentially at makeshift aid stations—so they can "make more informed clinical decisions for patients," according to an HHS blog post.
It's not there yet, and HHS has been working on the project since 2014 when it got a $50,000 seed investment from its internal venture fund; that was compounded by a $2.75 million grant from the Office of the National Coordinator for Health Information Technology.
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'Automated dermatologist' detects skin cancer with expert accuracy

By Susan Scutti, CNN
Updated 2337 GMT (0737 HKT) January 26, 2017
(CNN)Even though the phrase "image recognition technologies" conjures visions of high-tech surveillance, these tools may soon be used in medicine more than in spycraft.
A team of Stanford researchers trained a computer to identify images of skin cancer moles and lesions as accurately as a dermatologist, according to a new paper published in the journal Nature.
In the future, this new research suggests, a simple cell phone app may help patients diagnose a skin cancer -- the most common of all cancers in the United States -- for themselves.
"Our objective is to bring the expertise of top-level dermatologists to places where the dermatologist is not available," said Sebastian Thrun, senior author of the new study, founder of research and development lab Google X and an adjunct professor at Stanford University. He added that those who live in developing countries do not have the same level of care as can be found in the US and other industrialized nations.
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Shared records starting to make headway

Sharing records between care settings is starting to become much more commonplace, but is viewing patient and clinical data enough to deliver joined-up care?
Vivienne Raper revisits some of the pioneers of information and record sharing, and examines how they are beginning to use shared records to change how they interact with patients.
In 2013 NHS England set out its vision for trusts to achieve a “fully integrated digital care record [IDCR] across all care settings by 2018”.
The vision first set out in Safer Hospitals Safer Wards: Achieving an integrated digital care record, defined an IDCR as the ability of users in local health and care services to view patient and clinical data in a joined-up manner.
According to Markus Bolton, joint chief executive of shared records specialist Graphnet, real progress has been made in achieving the target. He estimates that around 35% of health communities in England now have what he describes as large-scale solutions.
“We already have 12 million patients on our systems on CareCentric [Graphnet’s shared records software]”, he says. “And we’re expecting to double that in nine months – it’s really picking up pace.”
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January 27, 2017

Patient-Reported Symptoms May Be Left Out of EMRs

By Amy Orciari Herman
Patient-reported symptoms may fail to make it into a practice's electronic medical record (EMR), according to a study in JAMA Ophthalmology.
Roughly 160 patients waiting to be seen at an ophthalmology clinic completed an eye symptom questionnaire. After their visits, eye symptoms reported on the questionnaire were compared with those recorded in the EMR.
Overall, there was a high rate of discordance between patient-reported and clinician-recorded symptoms. In particular, reports of glare were discordant nearly half the time; in 90% of these instances, glare was present in the patient questionnaire and absent from the EMR. Similarly, reports of pain/discomfort and redness were discordant a quarter of the time; in roughly 75% of these, symptoms were noted in the questionnaire and absent from the EMR.
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Open source enlightenment needed to end 'dark ages' of health IT

Image: Dark ages of health IT is a akin to medieval alchemy, says Tony Shannon
Tony Shannon
11 January 2017
Your article - "Whatever happened to Open Source in 2016?" highlights the brief vogue that open source recently enjoyed in the NHS – 2014-15 – and now seems to have lost. It raises some good questions and important issues, though I sense some broader perspective may be worth adding here.
It’s worth remembering that healthcare is a well-established science – the first medical school established in the 9th century.  While information technology is still a young science – the first MSc in software engineering dates from 1979.
We know that the relatively risk averse culture of healthcare differs very significantly from the frenetic pace of innovation we see in the software world.
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Gates Foundation gives $279 million to bolster University of Washington Population Health Initiative

The grant will be awarded over the next decade and will help expand the UW’s Institute for Health Metrics and Evaluation as a global population health hub.
January 25, 2017
The Bill and Melinda Gates Foundation awarded $279 million to the University of Washington’s Institute for Health Metrics and Evaluation to support expansion of IHME’s work over the next 10 years, the organizations announced today.
The funding will help IHME build its independent health evidence to foster population health, officials said. Thursday’s award complements past donations from the Gates Foundation, which supports the 25-year vision of the University of Washington’s Population Health Initiative launched in May 2016.
IHME provides measurement and analysis of the most prevalent and expensive global health issues and evaluates strategies to improve outcomes.
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Are EHRs a patient safety necessity or a barrier to care?

Jan 26, 2017 9:20am
Doctors are still divided about whether the physician community should embrace EHRs.
EHRs have emerged as a divisive issue within the physician community, with some urging widespread adoption to improve care, while others lament the administrative burden for doctors.
Both arguments were on display in a recent BMJ article that addressed whether doctors should “embrace” EHRs, underscoring the deep divide among clinicians regarding the benefits and shortcomings of computerized records.
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Johns Hopkins Hospital command center is first of its kind

Published January 24 2017, 6:53am EST
Command centers crammed with monitors displaying real-time data and staffed by personnel hunched over workstations serve as war rooms for the military and space operations facilities at NASA.
However, The Johns Hopkins Hospital in Baltimore has established a similar state-of-the-art command center that is a model for how healthcare organizations can increase their efficiency in managing patient care.
The 2,550-square-foot command center is touted as the first-of-its-kind in healthcare, combining the latest in systems engineering, predictive analytics and situational awareness to better manage patient care and safety, as well as the movement of patients in and out of the Johns Hopkins School of Medicine’s teaching hospital.
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DirectTrust messaging use soars in 2016

Published January 25 2017, 7:08am EST
Use of DirectTrust secure electronic messaging between providers, patients and other healthcare consumers via the Direct Project protocols for secure communications, grew significantly last year, underscoring increasing national interest and activity in exchanging health information during the care delivery process.
The service uses DirectTrust-accredited health information service providers (HISPs) that commit to complying with certain protocols for secure messaging.
More than 98 million Direct message transactions were conducted during 2016, according to the vendor; more than 33.5 million messages were sent in the last three months of 2016 alone. The service reports a total of 165 million transactions since it was launched in 2013.
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Yale researchers tapping into emerging secure cloud platform for sharing patient data

The technology, known as Hugo, empowers patients to compile data from multiple EHRs and synchronize them with a research database.
January 24, 2017 09:12 AM
Harlan Krumholz said the technology makes patients true partners in care and research.
Yale researchers are working with a platform, dubbed Hugo, to mobilize patients so they can help with medical research, by allowing them to share their personal health information with researchers, via a cloud-based platform. Hugo was announced last May and is still in the testing phase.
According to Yale researchers, the platform is “highly secure,” and allows patients to draw records from multiple electronic health records held by a patient’s various healthcare providers. Hugo then synchronizes them with a research database.
“This could be a game changer,” says Harlan Krumholz, a developer of Hugo, and professor of medicine and epidemiology and public health at Yale School of Medicine. Krumholz is also the director of the Center for Outcomes Research and Evaluation (CORE) at Yale-New Haven Hospital. “Hugo harnesses the very latest in digital health technology and puts patients in the center, making them true research partners.”
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Technology—not life expectancy—drives up healthcare costs

Jan 25, 2017 9:43am
Americans are living longer, but that's not the primary driver behind healthcare spending increases.
Even though Americans are living longer and often spending more on healthcare services later in life, pervasive use of new technology is to blame for burgeoning health costs, according to one economist.
A large portion of healthcare spending is tied to chronic conditions, particularly among elderly patients, and longer life spans translate to more services later in life. But technology is the true driver behind healthcare spending growth, health economist Austin Frakt writes in The New York Times.  
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How to ensure your clinical data isn't trapped during migration

Published January 25 2017, 3:20pm EST
One can only sympathize with healthcare CIOs who must struggle with interoperability issues, financial restraints and the threat to hospital networks and patient records posed by hackers.
Unfortunately, there is another challenge with which they will be forced to cope: e-Discovery requirements pertinent to audits, common law, statutes and regulations. As CIOs seek to retire and replace legacy clinical systems, these requirements become even more pronounced.
But in too many cases, they are not prepared. For example, they may not be able to identify and prioritize all the required data sets that need to exist and/or complement each other. They may not understand the common requirements set forth at the federal and state level.
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All-Time High of 1,093 Data Breaches Reported in U.S. in 2016

The number represents a 40 percent increase over the previous year, according to a recent report.
By Jeff Goldman  |  Posted January 24, 2017
According to a new report from the Identity Theft Resource Center (ITRC) and CyberScout, 2016 saw an all-time high of 1,093 reported data breaches, a 40 percent increase over the previous year's total of 780.
ITRC president and CEO Eva Velasquez said it's not clear whether the increase is due an actual surge in breaches or simply due to more states making the information available.
"For the 10 years, the ITRC has been aware of the under-reporting of data breach incidents on the national level and the need for more state or federal agencies to make breach notifications more publicly available," Velasquez said in a statement. "This year we have seen a number of states take this step by making data breach notifications public on their websites."
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New Scottish eHealth strategy focuses on data

Article posted on: January 25, 2017
 “We are trying to get really complex core IT systems in place, delivered by NHS Scotland and the Scottish Government, and going forward we are moving towards much more explicit transformations for the delivery of care,” Pieter van de Graaf, eHealth Clinical Strategy Team Leader at the Scottish Government, told BJ-HC
 [Edinburgh, Scotland] In spite of growing pressures, the Scottish Government is embracing the power of person-centred care while harnessing the use of technology in healthcare. 
The country’s Health and Social Care Delivery Plan, published in December, sets out the main framework for enhancing the quality of services while meeting ‘new patterns of care, demand, and opportunities from new treatments and technologies’.
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EMS use of telehealth helps close care gaps

Published January 23 2017, 3:08pm EST
For the past two years, paramedics in the Houston Fire Department have been using telehealth and electronic health record technology to remotely consult with physicians via iPads when responding to calls to patient homes.
Many times, paramedics respond but find they’re not facing an urgent emergency, but the patient may still be best served by being transported to the emergency department. Or perhaps the best route would be to pay the taxi bill to send the patient to a community health center where they can establish a medical home.
Remote consultation with a physician helps make the right decision, says James Langabeer, a professor of clinical informatics at the University of Texas who oversees the program along with Michael Gonzalez, MD, deputy medical director at the fire department and an assistant professor at Baylor College of Medicine.
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Future of healthcare grounded in data, but details fuzzy

Jan 24, 2017 11:49am
Data will drive healthcare transformation, but experts in both the tech and health industries are still exploring pathways.
The collection and integration of patient data will play a key role in transforming the healthcare industry throughout the United States and across the globe, but exactly how that will transpire is still very much up for debate.
Experts in the healthcare and technology fields discussed the future of patient care at the World Economic Forum in Davos, Switzerland, last week, and a reoccurring theme was how hospitals and emerging technology companies are going to use data to improve outcomes and transform the industry. During a panel discussion about the “hospital of the future,” executives with telemedicine and healthcare technology companies argued that the healthcare industry is moving out of the acute care hospital and into homes and clinics, and wide range of data sources are coming together to help inform treatment plans.
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More on Telehealth

20% of consumers would swap doctors for one that offered telehealth services, American Well says

Interest was especially high among parents of children under age 18, caregivers of elderly or ill relatives, results showed.

Beth Jones Sanborn, Managing Editor
Physicians beware: If you don't offer telehealth services you may start losing patients to those that do. American Well, a telehealth company that partners with dozens of health systems nationwide, said according to the results of their 2017 Consumer Study, 20 percent of respondents would switch their primary care physician to another one in their area if they offered telehealth visits. That amounts to 50 million Americans, American Well said.
Harris Poll conducted two studies online on behalf of American Well in late 2016 to gauge consumer experiences with and perceptions of telehealth. The first was conducted in August among 2,100 adults ages 18 and older. The second was in September and involved 2007 adults 18 and older.
Results showed that among those with a primary care physician, 65 percent are interested in seeing that doctor via video. Parents of children younger than 18 were even more likely to express interest, with results showing 74 percent of that group saying they'd like to see their doctor via video.
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Dr. Eric Topol to shiny new venture-backed Silicon Valley startup: Prove it

In the Merchant of Venice, Shakespeare crafted this phrase for the heroine Portia to help her make a wise choice in picking a husband. The proverb is particularly apt today as technology makes inroads in healthcare promising to make better all that ails this tired, old, fearful-of-change industry.
Take the newest tech kid to jump on the extreme healthcare makeover bandwagon: Forward, which has Dr. Eric Topol, cardiologist author of The Creative Destruction of Medicine scratching his head.
The  San Francisco startup, which launched Jan. 17 to reimagine primary care, has a veritable who’s who of investors: Khosla Ventures, Founders Fund, John Doerr, and First Round Capital as well as angel investors including Eric Schmidt, Marc Benioff, Garrett Camp, SV Angel, Aaron Levie, Joe Lonsdale.
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EHRs offer possible solution for trimming unnecessary healthcare

Published January 23 2017, 7:28am EST
As the nation’s healthcare system continues to grapple with the problems of overuse and low-value care that provides little or no benefit to patients, electronic health record systems can serve as powerful technology platforms for data collection and intervention to address overutilization.
So argues David Bates, MD, chief of the Division of General Internal Medicine and Primary Care at Boston’s Brigham and Women’s Hospital and co-author of a new viewpoint article in the Journal of the American Medical Association.
In the article, “We focus on the problem of overuse and what can be done about it,” says Bates. “One of the biggest changes in healthcare in recent years is that we are now using electronic health records, which could really be very helpful in decreasing the overuse problem.”
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Mostashari: Value-based care demands free-flowing data

Former National Coordinator for Health IT: "Even though EHRs have proliferated, we have yet to achieve the interoperability, usability and full utility of them."
January 20, 2017 01:11 PM
To say that a lot has changed in healthcare since last year’s HIMSS conference is an understatement. Right now, a new Congress and a new Administration are wrestling with how to repeal and replace the Affordable Care Act, the signature health reform law of the Obama Administration.
Despite all that's changed, one thing has not: the move from fee-for-service to value-based care. Not only is this a transformation that pre-dates the Obama years and the ACA, but thanks to the overwhelmingly bipartisan Medicare Access and CHIP Reauthorization Act of 2015, or MACRA, the shift to value is enshrined in our law, and will survive any changes to the ACA.
To make value-based care work, however, we need data – lots of it, and free flowing. When doctors are on the hook for the full cost of care, they need to know: what interventions work and which do not; who has been to the ER and needs follow-up care to prevent a costly readmission; who has not been in the office in a while and may be at risk for a complication; and the list goes on and on.
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Smaller, physician-owned practices struggle to adopt IT

Jan 22, 2017 8:42pm
Smaller, physician-owned practices face challenges in adopting health IT.
With fewer resources at their disposal, smaller, physician-owned practices are slower to adopt health information technology than other organizations with more money, staff and technical know-how.
Although the use of IT in small primary care practices has grown, factors such as practice size, ownership and the availability of financial incentives influence the extent to which practices adopt new technology, according to a study published in the Annals of Family Medicine.  
Researchers conducted 40-minute telephone surveys at 566 small primary care practices with eight or fewer physicians; the first interviews were conducted from 2007 to 2010 and the second round from 2012 to 2013. They asked about 18 measures of IT functions, including record keeping, clinical decision support, patient communication and health information exchange with hospitals and pharmacies. Overall, practices significantly increased the use of 16 functions and decreased use of only two: electronic access to laboratory results and to clinical information on patient visits to the emergency department.
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Harvard study of almost 800k lives shows MedAware technology reduces medication error

January 19, 2017
Researchers at Harvard Medical School have demonstrated a new technology can help reduce a widespread problem that harms some 1.5 million people every year – medication error.
In a study published in the Journal of American Medical Informatics Association, researchers looked at five years of EHR-provided clinical data for 747,985 lives at the Brigham and Women’s Hospital and the Center for Patient Safety and Practice, plus retrospective data from Partners HealthCare BWH and Massachusetts General Hospital. Using the algorithmic software from Israel-based startup MedAware, researchers screened the data to detect outliers suggestive of potential medication errors and compared with an existing clinical decision support screening system.
Existing CDS screening systems can only detect a small number of actual errors, the researchers stated, because they are not patient-specific or sufficiently adaptable. Plus they often result in high false alarm rates. Since doctors get so many fake alerts, they begin disregarding them altogether, and the result is more than $20 billion in healthcare losses every year in the United States.
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Telemedicine Market Will Continue to Grow by 2020

Telemedicine is defined as use of telecommunication and information technology to deliver clinical solutions to the patients. It includes use of various applications and services such as smart phones, emails, two-way videos and wireless tools to deliver efficient results. Use of telemedicine helps in improving individual health with the help of electronic media. It also increases accessibility by reducing distance barriers between medical service providers and patients. Various services, such as primary care and specialist referral service, patients monitoring, medical education and healthcare information, are provided with the help of telemedicine.
E-health is a process of delivering healthcare and health resources by electronic means. It helps healthcare providers and patients to interact with each other with the help of electronic media. It is one of the fastest growing sectors in overall healthcare market. Currently, telemedicine market represents a small percentage of e-health market.
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Enjoy!
David.

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