Saturday, March 04, 2017

Weekly Overseas Health IT Links – 4th March, 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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4 keys to managing the latest healthcare IT developments

Published February 24 2017, 2:21pm EST
Worries about making bleeding edge technology decisions have caused industries like healthcare to be reluctant to implement new technologies for fear of incurring unbounded risk. However, healthcare organizations that invest more heavily in technology leaders, their ideas and the technology that is advancing daily can improve patient outcomes and keep costs down.
Healthcare leadership should position their organizations to take advantage of torrid advances in technology, by following some of these suggestions.
Look to technology giants for models of success
At Apple’s Worldwide Developers Conference in 2014, Tim Cook announced Healthkit, Apple’s software development kit for maintaining medical data within iOS devices; ResearchKit followed shortly thereafter. These announcements came with backing from marquee names in the medical field: University of California San Francisco, Massachusetts General Hospital and Mount Sinai Health System, which operates Mount Sinai St. Luke's Hospital in New York. These organizations are not the only healthcare systems embracing technology innovation, but stamping new ideas with approval from industry heavyweights shows top leadership is amenable and open to these kinds of engagements.
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How drug development is speeding up in the cloud

  • 21 February 2017
Developing new drugs to fight major diseases can take years and cost billions of dollars
Developing a drug from a promising molecule to a potential life-saver can take more than a decade and cost billions of dollars.
Speeding this process up - without compromising on safety or efficacy - would seem to be in everyone's interests.
And cloud computing is helping to do just that.
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Health Data Exchange Falling Short of Patient Expectations

Ninety-seven percent of patients say health data exchange between provider is key to quality healthcare.

Sarah Heath
February 23, 2017 - Patients think health data access between multiple disparate providers is critical to quality healthcare, according to a recent survey, but that reality is not yet realized.
The survey, conducted by Humana subsidiary Transcend Insights, found that 97 percent of patients want for healthcare organizations of any location or specialty to have access to their full patient records.
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Most hackers can steal data within 24 hours, study shows

Security Editor

Most hackers are able to access company systems and steal valuable data within 24 hours, according to the Nuix Black Report, which aims to show which security technologies are worth investing in

More than eight in 10 hackers can break through cyber security defences, access IT systems they target and steal data within 12 hours, a study has revealed.
However, the breach may not be discovered for hundreds of days, according to the study by global technology company Nuix.
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Hospitals that track their performance don’t improve healthcare

Tracking problems with no incentive to do better doesn't have much effect.

Roheeni Saxena - 2/24/2015, 6:57 AM
In recent years, perhaps in response to an uptick in inquiries about hospital performance and its effect on patient outcomes, a number of programs have been developed to help hospitals track how the patients they care for do. The most prominent of these is the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). This system allows hospitals to compare their performance relative to that of other participating hospitals and provides them with detailed descriptions of patient outcomes as adjusted for the patients' risks.
Since 1994, the ACS NSQIP has been tracking data on 135 patient-related variables. As its name implies (Quality Improvement Program), the hope is that this will lead to improvements for patient care—having this information will hopefully motivate hospitals to improve their outcomes and reduce the payments charged to Medicare. However, there has not been a study examining whether this expectation has been met until now. The new study published in JAMA seems to indicate that a hospital’s participation in this outcomes/costs-tracking program does not directly lead to improved patient care or reduced Medicare costs.
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Why your data security plan deserves a close, critical look

Published February 22 2017, 4:25pm EST
 “Gasp” is rarely a word associated with a presentation during the week of the HIMSS conference. Keynotes and presentations can be informative, enlightening or surprising. Shock and awe are not descriptions that typically come to mind.
But truly, you could hear the breath being sucked out of CIOs during the opening keynote presentation at the 2017 CIO Forum, of the College of Healthcare Information Management Executives. You see, Kevin Mitnick was making mincemeat of fairly traditional IT security practices.
Over the course of 75 minutes or so, the vulnerability of IT systems was on full display, sliced and diced by Mitnick, an internationally recognized security consultant who works with Fortune 500 companies and governments around the world.
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Laura’s Digital disruptors: healthcare gets smart on AI

Digital Health News reporter Laura Stevens explores how the brave new world of artificial intelligence is now being applied to healthcare, the huge potential opportunities and the new ethical and privacy challenges it raises.
20 February 2017
The unsettling yet fascinating power of artificial intelligence is a favourite dystopian trope for film-makers. From robots taking over the world to falling in love with an operating system, the future seems to be disconcertingly jam packed full with this particular technology.
However, stepping back from Hollywood into the world of the NHS, how much do these fantastic scenarios relate to healthcare reality?
Firstly, while it may not be a mature technology, AI is definitely not a tool from the future; it’s in use right now by allowing researchers to compute vast amounts of data and replicating clinicians’ professional opinions.
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Great North Care Record signs up nearly all North East GP practices

Laura Stevens

22 February 2017
A single ‘Great North Care Record’ across North East England has take another step forward, with nearly all GPs practices agreeing to share their patient records.
About 2,700 practices, or 96% in the North East, have agreed to turn on information sharing, allowing secondary care providers to view the GP records of 3.6 million people.
The Great North Care Record was created 12 months ago as part of the £20 million Connected Health Cities, set up by former chancellor, George Osborne. The scheme had four projects across the North of England, with one of the main aims to improve access to patient data for researchers.
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Overcoming the hurdles slowing the use of genomics data

Joel Diamond says genomic data needs to be integrated into clinical workflows before its potential can be realized.
February 20, 2017 04:41 PM
ORLANDO - What purpose does genomic data serve if it can’t be used in traditional clinical workflows?
This question was posed by 2bPrecise CMO Joel Diamond on Monday. And he made it very clear: Genomic will not be useful until workflows are changed.
The Allscripts’ subsidiary is seeking to solve this major issue, Diamond said. Currently, data is collected and stored discreetly in the cloud. In an ideal world, these tools would be blended into clinical workflow to make genomic data easier to use.
“Rather than talking about genomics on a big scale, we’re still in an era of making this information available and easy to understand,” Diamond said. “Right now, an average doctor can’t really interpret this information.”
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HIMSS study shows positive impact of health IT, but challenges ahead for expansion

IT staffing structures and experiences in provider sites outside the hospital point to a need to address challenges faced by these providers, the study finds.
February 22, 2017 07:25 AM
A new study from HIMSS, unveiled at the 2017 HIMSS Conference & Exhibition, reinforces the positive impact health IT has on the U.S. economy while signaling challenges ahead for the expansion of health IT’s footprint.
HIMSS has woven together two HIMSS research efforts: the annual HIMSS Leadership Survey and the biennial HIMSS Workforce Study, which detail the health IT priorities of key stakeholder groups and their links to various strategic initiatives (for example, employment of select IT leaders) and economic measures (for instance, workforce projections).
The new 2017 Leadership and Workforce Survey reflects the responses of 368 U.S. health IT leaders between late November 2016 and early January 2017.
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HIMSS 2017: ECRI, Bon Secours on the future of health information technology to support patient safety

Feb 23, 2017 9:37am
ORLANDO, Fla.—Technology will play a crucial role in helping hospitals and health systems maintain a focus on patient safety, building on a movement that has emerged as a priority within the healthcare industry over the past two decades. 
Healthcare has been increasingly focused on patient safety and medical errors since the Institute of Medicine’s landmark report in 1999, “To Err is Human,” which brought to light concerning patient safety statistics that were lingering in the background. During a session at HIMSS 2017 in Orlando, representatives with the ECRI Institute and Bon Secours Health System outlined some of the ways technology has both helped and hurt patient safety initiatives, and how health IT is poised to assist care improvement efforts over the next decade if providers are willing to adopt a collaborative approach with IT professionals.
William Marella, executive director of PSO Operations and Analytics at ECRI, said the flood of data created by the widespread adoption of EHRs is “like drinking from a fire hose.” But that data has also created opportunities to identify patient safety weaknesses that were previously undiscoverable.
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White Paper Outlines Recommendations to Improve EHR Usability

DirectTrust Urges Physicians to Provide Feedback

February 21, 2017 02:16 pm Sheri Porter – A brand new draft white paper that addresses issues related to the usability and interoperability of electronic health records (EHRs) has the potential to rock the world of family physicians -- and in a very good way.
The paper's authors are asking the companies that develop EHR systems to make long-overdue improvements to products physicians need to support health record sharing for care coordination and transitions of care.
The white paper(www.Directtrust.org) from DirectTrust lays out 50-plus feature and function recommendations aimed at jump-starting action among the more than 350 vendors who provide information exchange through Direct Interoperability, a protocol for secure electronic sharing of health care information.
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Stolen Health Record Databases Sell For $500,000 In The Deep Web

2/21/2017 06:40 PM
Electronic health record databases proving to be some of the most lucrative stolen data sets in cybercrime underground.
Medical insurance identification, medical profiles, and even complete electronic health record (EHR) databases have attracted the eyes of enterprising black hats, who increasingly see EHR-related documents as some of the hottest commodities peddled in the criminal underground.  A new report today shows that complete EHR databases can fetch as much as $500,000 on the Deep Web, and attackers are also making their money off of smaller caches of farmed medical identities, medical insurance ID card information, and personal medical profiles.
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Emerging trends at HIMSS—focusing on practical uses of IT

Published February 23 2017, 2:51pm EST
As another HIMSS Conference wraps up, it’s time to reflect on the overall perceptions of all that was seen and experienced. This always takes me some time. As an editor, I’ve almost invariably gotten this question, usually at one of my first Monday morning meetings at the conference: “So, what are you hearing at HIMSS this year?”
It’s the dreaded question—I’m forced to make up an answer that seems educated, even when I can barely remember where my hotel is. “Let’s see, what I am hearing…well, the exhibit hall is the size of six aircraft carriers; people are getting hungry at odd hours and falling asleep while standing in the line at Starbucks; everyone wants to win a big prize on the show floor and go home. Yes, I believe those are my main observations.”
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Medical device security reaches a tipping point

Hospitals have recognized the need to fix flaws in connected devices but solutions will require a sustained effort.
February 21, 2017 01:09 PM
ORLANDO – Medical device security is flawed, but the fix isn’t going to happen overnight. And there’s no one entity to blame, according to Dale Nordenberg, executive director of MDISS (Medical Device Innovation, Safety and Security Consortium)
But just as there’s no one person at fault for unsecured medical devices, there’s no one solution to the problem, Nordenberg explained.
“There’s no vendor out there today with the solution: There’s no magic wand,” Nordenberg said. “There’s no way to fix these devices tomorrow, and there’s no way hospitals can fix systems overnight — and we shouldn’t expect it.
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AMA CMIO: EHRs are falling short of meeting the needs of doctors

Michael Hodgkins warns that innovation needs to consider integration with clinician’s workflow.
February 21, 2017 12:38 PM
ORLANDO — Health IT vendors are still missing the mark when it comes to answering the needs of America’s burnt-out physicians.
“This is not about putting our hands up and saying stop innovation,” said Michael Hodgkins, MD, vice president and chief medical information officer at the American Medical Association. “It is simply about the need to focus on evidence, accuracy, how it’s integrated with our EHRs and how it’s integrated within our practice.”
It’s not necessarily news that broad dissatisfaction is darkening the mood in the physician community. According to Hodgkins, who delivered his remarks at HIMSS17 on Tuesday, physicians are spending twice the amount of time on deskwork and EHR maintenance, including 38 hours a month spent on EHRs after work hours, than they are treating patients.
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Personalized contact improves outcomes in mobile-based weight-loss interventions

February 21, 2017
Adults with overweight and obesity participating in a mobile phone-based weight-loss intervention are more likely to achieve meaningful weight loss when the intervention includes personalized contact, according to a recent meta-analysis of randomized controlled trials.
 “Weight-loss interventions delivered via mobile phones are effective when there is some form of personal contact with the people delivering the intervention,” Mandy Schippers, MSc, an e-research developer at the Centre for Social Research in Health, University of New South Wales, Sydney, told Endocrine Today. “For example, if text messages are sent to participants, these are not automated messages, but personal messages. Interventions also lead to more weight loss if they include communication via other mediums in addition to mobile phones, such as email, telephone calls and face-to-face meetings.”
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Argonaut Project’s FHIR activities to continue in perpetuity

Published February 22 2017, 4:19pm EST
The sponsors of the Argonaut Project, an industry-wide effort to accelerate the development and adoption of HL7’s Fast Healthcare Interoperability Resources, have agreed on an annual sustainability model that will focus on key FHIR use cases for the foreseeable future.
A collaboration of vendors and providers, including Accenture, athenahealth, Cerner, Epic, Meditech, Surescripts, and The Advisory Board, the project has gained significant traction in developing implementation guides that are basis for their FHIR implementations. The interoperability framework leverages the latest web standards including a RESTful application programming interface.
“Once we had created the implementation guides, the initial thought was that we would be done and disband. But, I think we all realized that the process worked pretty well,” says David McCallie, MD, Cerner’s senior vice president of medical informatics.
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Argonaut Project building on success with FHIR implementation guide

At the HL7 booth, interoperability guru Micky Tripathi details the progress made on public APIs.
February 21, 2017 12:41 PM
Earlier this month, the HL7 Argonaut Project published its FHIR Data and Document Query Implementation Guide, which it bills as a "major step forward" for the agile interoperability standard.
At HIMSS17 on Tuesday, Argonaut leader Micky Tripathi offered updates on the new guide, and put the project's accomplishments these past three years into perspective.
The Argonaut Project, launched under the HL7 umbrella in 2014, comprises heavy hitters from both the vendor and provider sides: Accenture, athenahealth, Cerner, Epic, McKesson, Meditech, Surescripts, The Advisory Board Company, Beth Israel Deaconess, Intermountain, Mayo Clinic, Partners HealthCare and Boston Children's Hospital.
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26 percent of consumers have had health data accessed

Published February 21 2017, 6:56am EST
The personal side of cyber attacks on patients’ medical information shouldn’t be lost on healthcare organizations, as a sizable percentage of the U.S. population has been victimized by hacks and face personal expense in resolving the incident.
More than one in four U.S. consumers (26 percent) have had personal medical information stolen from technology systems, according to results of a survey from Accenture, a consultancy, released Monday at the HIMSS17 conference and exposition in Orlando.
The findings of Accenture’s survey show that 50 percent of those who experienced a breach were victims of medical identity theft and had to pay approximately $2,500 in out-of-pocket costs per incident, on average.
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Epic CEO Judy Faulkner reveals two new EHR versions are in development

The new versions will provide pathways for providers who don’t need the full version of Epic.
February 21, 2017 12:29 PM
What a difference one year can make. In the world of Epic founder and CEO Judy Faulkner, where creating new technology meets with a delight for words, 2016 was a productive and rewarding year.
How so?
“We’re developing some really nifty new software,” she told Healthcare IT News on Sunday after attending the daylong CHIME-HIMSS CIO Forum at HIMSS17.
“There’s going to be three versions of Epic,” Faulkner said. “That’s what we’re working on now. There’s Epic Sonnet.” She pauses to note that an “epic” is a long poem – as in Homer’s Odyssey. As she put it, “even though we’re computer scientists, we can still be literate.”
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Former CMS administrators agree: Health IT needs more private development, less regulatory interference

Slavitt and McClellan say software is still not meeting the needs of clinicians and patients.
February 20, 2017 04:28 PM
ORLANDO - Former CMS acting administrator Andy Slavitt says the health IT marketplace is not addressing the real needs of patients and doctors, during a fireside chat with former CMS Acting Director Mark McClellan, MD.
John Kansky, CEO of the Indiana Health Information Exchange and a member of the HIMSS North America board of directors, served as moderator for this unusual opportunity to compare the perspective of CMS administrators from two different administrations.
The stage for this town hall was set by comments Slavitt made on twitter Feb. 10 in referring to his upcoming visit to HIMSS. Slavitt tweeted “… we’ve got this massive industry that puts on a great party and has massive shows and yet they have a customer base that is basically unsatisfied with the product. That seems like it’s where we should put all our energy.”
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Artificial intelligence set to transform the patient experience, but many questions still to be answered

'We're not trying to replace the human interaction, we're trying to augment it,' AI developer says.
February 20, 2017 10:22 AM
ORLANDO – From Watson to Siri, Alexa to Cortana, consumers and patients have become much more familiar with artificial intelligence and natural language processing in recent years. Pick your terminology: machine learning, cognitive computing, neural networks/deep learning. All are becoming more commonplace – in our smartphones, in our kitchens – and as they continue to evolve at a rapid pace, expectations are high for how they'll impact healthcare.
Skepticism is, too. And even fear.
As it sparks equal part doubt and hope (and not a little hype) from patients, physicians and technologists, a panel of IT experts at HIMSS17 discussed the future of AI in healthcare on Sunday afternoon.
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Healthcare industry leaps into the cognitive era, IBM’s Ginni Rometty says

Published February 21 2017, 6:42am EST
The healthcare industry is in the midst of a new era in computing, according to Ginni Rometty, chairman, president and CEO of IBM. Cognitive computing—systems that learn—will profoundly change medicine and the way that care is delivered to patients.
“We’re in a moment where we can actually transform many parts of healthcare,” said Rometty in an opening keynote address on Monday at the HIMSS17 conference in Orlando. “Healthcare will be the industry impacted more than any other,” adding that “cognitive as an era could usher in what people call a Golden Age, but it’s only if we shape it wisely.”
As CEO of IBM since 2012, she has worked to transform the technology behemoth into a cognitive solutions and cloud platform company. Rometty noted that two years ago at HIMSS15, IBM launched Watson Health, the first commercially available cognitive computing capability delivered through the cloud to analyze high volumes of data, understand complex questions posed in natural language, and propose evidence-based answers.
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HIMSS survey: Providers set their sights on quality, EHRs amid workforce challenges

Feb 21, 2017 9:43am
EHRs are one of the most pressing concerns for hospitals in the coming year, according to a new survey.
ORLANDO, Fla.—Quality care, EHRs and cybersecurity are the top three IT issues facing healthcare providers, according to a new survey, and the majority of hospitals indicate they have positions to fill in their IT department.
The results of the survey conducted by HIMSS were announced at the organization’s annual conference on Monday, which included responses from 210 provider organizations and 158 vendor/consulting organizations.
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Health apps could be doing more harm than good, warn scientists

App development likened to the ‘wild west’ as researchers raise concerns over one-size-fits-all targets and absence of sound science
More than 165,000 health-related apps are available on the Apple store, including ones that offer to monitor blood pressure, calculate insulin doses for diabetics and encourage mindfulness exercises. Photograph: Getty Images/Hero Images
Hannah Devlin in Boston
Fitness trackers and mental health apps could be doing more harm than good because they are not based on sound science, researchers have warned, comparing some health app developers to “snake oil salesmen of the 1860s”.
Greg Hager, professor of computer science at Johns Hopkins University, said that in the absence of trials or scientific grounding it was impossible to say whether apps were having the intended effect.
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Healthcare Data Breaches Up 40% Since 2015

Alexandra Wilson Pecci, February 21, 2017

Reports of hacking and insider theft are at an all-time high in the healthcare industry.

When a U.S. attorney called South Florida "an epicenter of identity theft" last month, it was in the context of announcing federal charges against more than 100 suspected fraudsters.
One of them was a former Jackson Health System employee accused of accessing the health system's computer databases to steal patient data. The rogue employee, a former secretary, was accused of pilfering the social security numbers of more than 24,000 people over the course of five years. She was placed on administrative leave in 2016.
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February 13, 2017

Electronic Medical Record Prompt Increases Rate of New HIV Diagnosis

Keith Henry, MD reviewing Felsen UR et al. J Acquir Immune Defic Syndr 2017 Jan 30.
Instituting an electronic medical record prompt to offer testing resulted in a 4.5-fold increase in the rate of new HIV diagnosis.
Although routine HIV screening is recommended by the CDC for persons aged 13 to 64, many people have not been tested even in high-risk areas of the U.S. To assess whether adding a prompt recommending HIV testing to the electronic medical record (EMR) affected testing rates and results, investigators performed a pre-postimplementation study at three hospitals in the Bronx, New York, from September 1, 2013, to March 31, 2015. The rate of HIV testing and new diagnosis for admissions of patients 21 to 64 years old was determined before and after adding a screening prompt (for those with no prior HIV test or a high-risk diagnosis after their last HIV test).
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EHRs, and companies that make them, are at risk for disruptive change

Published February 20 2017, 6:01am EST
Healthcare organizations are increasingly choosing electronic health records systems from among a handful of leading HIT vendors. Depending on how you measure penetration, among the leaders are Epic, Cerner and Allscripts.
While the market is being dominated by major vendors now, Eric Topol, MD, recently said he anticipates radical change ahead. “I don’t see Epic, Allscripts or Cerner in existence in another decade,” Topol contends.
Joel Selanikio, MD, sees the rationale for Topol’s prediction. As healthcare morphs from an emphasis on institutional care to empowering consumers to become active participants in maintaining their health, current vendors need to change or risk irrelevance.
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Precision medicine's Holy Grail: Anticipate cancer's next step

Intermountain is using genomics to attack the Darwinian nightmare.
February 19, 2017 12:59 PM
ORLANDO ― At the Precision Medicine Symposium on Sunday, Intermountain’s gastrointestinal medical oncology director, Mark Lewis, MD, outlined both the challenges and solutions to cancer treatment.
“Our Holy Grail isn’t just to treat now, but to anticipate what cancer is going to do,” Lewis said, adding, “Cancer is a Darwinian nightmare, with millions of cells competing for survival. If we can anticipate the changes, we may be able to get ahead of it.”
Lewis’ opening keynote at Sunday’s HIMSS17 Precision Medicine Symposium highlighted the results of Intermountain’s precision medicine program, which has reduced cancer treatment costs and improved patient outcomes. Intermountain Healthcare is located in Salt Lake City, Utah.
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ICU Medical touts dosing errors study

ICU Medical (NSDQ:ICUI) said today that a multi-hospital study showed improvements in potentially catastrophic dosing errors and drug library compliance when its Plum infusion pumps and Hospira (NYSE:HSP) MedNet safety software were integrated with the hospitals’ electronic medical records.
The rate of potentially catastrophic dosing errors fell by 52% after smart-pump EMR integration, the study found, and compliance with a participating hospital’s drug libraries increased by 156%, on average.
One hospital found that the rate of potentially catastrophic dosing errors fell by as much as 73%.
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Interconnectivity, more devices heighten security risk to EHRs

February 16, 2017
The federal Office for Civil Rights reported 24 healthcare cyber breaches January. The list includes not just big institutions but a number of smaller providers as well.
Health IT experts said such news should remind physicians that cyberattacks remain a serious threat – and one that many fail to address properly. They said many physicians still don’t understand that their electronic health record (EHR) systems are part of a large ecosystem where threats can come in anywhere and migrate throughout.
“Some doctors in these standalone practices have someone come in and do a firewall. That’s not going handle the threats,” said Michael Ebert, a partner at consulting firm KPMG who specializes in healthcare cybersecurity.
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At the start of HIMSS17—which way is healthcare IT headed?

Published February 20 2017, 2:00pm EST
Suggestions about how the market for healthcare information technology will fare in the next year, or two, or 10, can vary from one person to the next. At HIMSS17, you’re likely to get 40,000 different prognostications.
Solid answers, based on certain reasoning, is difficult to find. That’s because the healthcare landscape, and direction of healthcare, appears mostly cloudy under the emerging new White House administration and Republican-controlled Congress.
While there’s no shortage of posturing and chest-thumping over what folks want to do with healthcare policy, the actual execution of philosophy will be the proverbial devil in the vast ocean of details that direct the healthcare industry.
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Enjoy!
David.

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