Sunday, August 20, 2017

AusHealthIT Poll Number 394 – Results – 20th August, 2017.

Here are the results of the poll.

Do You Anticipate The New National Digital Health Strategy Will Be Successfully Implemented By The ADHA And Achieve Its Stated Objectives?

Yes 1% (1)

Probably 1% (2)

Probably Not 75% (128)

No Chance 23% (40)

I Have No Idea 0% (0)

Total votes: 171

The numbers speak for themselves. The vast majority (98%) are not all that confident in the new Strategy. The ADHA should take this as the readership not being convinced of the quality of what we have been told so far and wanting to be convinced that the plan can actually make a difference.

I would be keen to hear comments on the result.

A huge turnout of votes!

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

David.

Saturday, August 19, 2017

Weekly Overseas Health IT Links – 19th August, 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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Trump declares opioid epidemic a national emergency

Published August 11 2017, 7:02am EDT
President Donald Trump on Thursday declared the opioid epidemic a national emergency and instructed his Administration to use all appropriate authorities to respond to the crisis.
That paves the way for the Department of Health and Human Services and other agencies to step up efforts to fight drug abuse that has claimed the lives of more than 500,000 Americans so far this century.
“Today’s announcement demonstrates our sense of urgency to fight the scourge of addiction that is affecting all corners of this country,” said Health and Human Services Secretary Tom Price, MD. “Traveling the country, we have seen firsthand the devastation this crisis is inflicting on individuals, families and communities. President Trump’s announcement further punctuates his clear commitment to combating this epidemic.”
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DOD researchers want to peek into the black box of AI, which could impact adoption in healthcare

Aug 11, 2017 12:22pm
Federal research efforts to explain the reasoning with neural network could impact AI adoption in healthcare.
Researchers at the Department of Defense are undertaking a significant task to better explain the decision-making processes within artificial intelligence, which could have significant implications for the healthcare industry as it explores machine learning as a diagnostic tool.
AI’s biggest advantage—the ability to mimic human learning through neural networks that can process vast quantities of information—is also its biggest flaw. As those networks become more advanced, the technology’s decision-making process becomes harder to understand, creating a black box of deep learning.
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Does your doctor have the right patient? NJ combating medical mix-ups

By David Matthau August 10, 2017 6:32 PM
An effort is underway to create a comprehensive database of the health history of every man, woman and child in the Garden State.
According to Tom Gregorio, the senior executive director for the healthcare innovation lab at the New Jersey Innovation Institute, the idea behind the Master Person Index is to bring together the islands of different healthcare information that exist across the state, to create a reliable patient identifier system.
He says this will ensure that when patients have the same or similar names there is no mix-up in the care or medication they’re given.
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More and more businesses are offering telehealth services as an employee benefit

Aug 9, 2017 at 5:44 PM
Telehealth is no longer an anomaly — it’s becoming ubiquitous, even among large companies.
A new study from the National Business Group on Health took a closer look at the healthcare benefits big businesses are offering their employees. Called the “Large Employers’ 2018 Health Care Strategy and Plan Design Survey,” it was conducted among 148 employers across various industries in May and June 2017. Combined, the employers provide coverage to over 15 million employees and their dependents.
Nearly all — 96 percent — of the respondents said they plan to make telehealth services available as an employee benefit. Fifty-six percent will offer telebehavioral health services in 2018.
As far as employees’ use of telemedicine, almost 20 percent of respondents said they’re seeing utilization rates of 8 percent or more.
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HIT Think Opioid epidemic makes EHRs essential to public health

Published August 11 2017, 4:13pm EDT
When public health is threatened by an outbreak of SARS or Zika or avian influenza, widely disseminated information becomes a crucial tool used to curtail the spread of disease.
But transmittable diseases are not the lone threats to public health. Other metaphorically pathogenic events—the current opioid epidemic, for example—are more effectively managed by making sure doctors have complete information when evaluating patients, and especially when they’re writing prescriptions.
Even if you know what the opioid epidemic is doing to America, you may not be familiar with the devastating numbers. Here are a few.
  • Drug overdose is the leading cause of death for Americans under 50.
  • From 2015 to 2016, drug overdose deaths rose 19 percent. In Ohio, they increased by more than 25 percent.
  • Summit County (Akron), Ohio, experienced 312 drug deaths in 2016, a 46 percent increase over the previous year.
  • In 2016, Fentanyl became all the rage, and this past January and February, the area around Dayton, Ohio, saw 100 overdose deaths—99 from fentanyl or something similar.
  • It’s estimated that more than 2 million Americans are dependent on prescription opioids, but more than 95 million—almost 30 percent—used prescription painkillers last year.
  • About 6 percent of patients who take a prescription opioid for one day will be using them a year later; that number jumps to 35 percent for those who take the pills for more than 30 days.
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Cerner's John Glaser: How to finally fix the EHR usability problem

The veteran executive proposes a multi-pronged approach to ending the tyranny of wasted time and effort created by today’s technologies.
August 09, 2017 11:09 AM
The HITECH Act resulted in near universal adoption of electronic health records (96 percent in hospitals and nine out of ten physician offices, according to the latest ONC tally) and having all that clinical information in electronic form is a remarkable advance. 
It enables a wide range of possibilities for improving care, assessing its value, and managing populations in ways that might actually improve our collective health and reduce the overall healthcare bill. On the most basic level, caregivers should have an easier time getting up to speed on each patient's history and current condition than in the old days where they had to thumb through a paper chart trying to decipher other physicians' handwriting. Moreover, this advance means that patients can become more active and equal participants in their care; they can use their phones to discuss healthcare issues with their care team and see when they last had a tetanus shot.
But this significant progress in adoption also gave rise to concerns about the usability of EHRs.  
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PRSB publishes new outpatient letter standards

Shireen Khalil

10 August 2017
Patients and professionals who provide care are set to benefit from new standards for the drafting of outpatient letters, produced by the Professional Record Standards Body (PRSB).
The standards aim to improve communications between hospitals, other professionals and patients following outpatient appointments.
Outpatient letters are often the main method of communication between outpatient services and a GP surgery. They are sent to the GP practice following appointments at hospital, community hospitals, health centres or online assessments such as Skype.
“The new standards define the content and structure of outpatient letters so that professionals, patients and carers receive consistent, high-quality information”, a PRSB spokeswoman said.
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HIT Think Why healthcare must make the shift to Interoperability 2.0

Published August 10 2017, 3:26pm EDT
In today’s shifting health industry landscape, as more organizations are going at risk and accountable care organizations continue to proliferate, healthcare providers are searching for ways to improve value-based care metrics to improve their processes. An essential component is a local or regional health information exchange organization.
By aggregating data from across the community that are in disparate systems, these data are then parsed, patients are all properly identified in the system in real time, so the clinical data that are necessary to deliver improved care can provide a variety of tools for better managing populations and individual patients.
Value based care and alternative payment models are here to stay. MACRA—which repealed the flawed SGR payment mechanism for physicians and which was passed overwhelmingly in both houses of Congress and signed into law by President Obama—creates a framework for clinicians who are caring for Medicare beneficiaries to be to be reimbursed based on various levels of performance and improvement activities. The ultimate goal is to put all clinicians in value-based care arrangements, replacing fee-for-service reimbursement forever.
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Data sanitization isn't what you think it is, but a new group hopes to change that

A new alliance of IT and security professionals wants to promote best practices and spread awareness of a standard definition.
August 08, 2017 01:19 PM
There's a misconception among many that factory resets, data wiping and reformatting are enough to safely clear away old data but that's not the case.
The International Data Sanitization Consortium wants to encourage IT professionals to think harder about the ways they get rid of old data.
"I am astounded by how little is known and understood about data sanitization," said Richard Stiennon, chief strategy officer at Blancco Technology Group and acting director of the IDSC, which launched on Tuesday with other members including the Information Governance Initiative, Ingram Micro ITAD, Kroll Ontrack and others.
The group wants to get rid of ambiguity around what data sanitization means, its members say, bringing specificity to terminology, standards and guidelines.
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67% of Malware Attacks Came via Phishing in Second Quarter

8/8/2017 12:13 PM
During the second quarter, cyberattacks soared 24% worldwide with phishing attacks playing a large role and Adobe Flash one of the favorite attack targets.
Organizations hit with malware during the second quarter had it delivered via phishing attacks in 67% of the cases, according to a Global Threat Intelligence Center (GTIC) report released today by NTT Security.
GTIC's 2017 Q2 Threat Intelligence Report, which gleans data from both successful and unsuccessful attempts on its customers, found phishing emails were by far the most heavy used delivery method for malware.
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HIT Think Why emotional design should play a larger role in health IT

Published August 08 2017, 4:33pm EDT
A lot of people can talk about emotional design at a high level, but the nitty-gritty, practical details of it can be difficult to grasp. Right now, it's a buzzword hitting at every level of the design industry and across several more – including healthcare. If we're going to wield the powers of emotionally centered design, we all need to understand it better.
To get to the essence of what we really mean when we talk about the rising trend of emotional design in healthcare, we can start by looking at a game design theory known as “Mechanics, Dynamics and Aesthetics.”
Mechanics are the functional requirements of software. They’re the rules and the design—the “We need it to do this.” The dynamics are how those elements are coded and implemented in the software and how the user interacts with them—whether that means the program is button-controlled, voice-controlled or even extending into augmented or virtual reality applications, the process still applies.
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Ransomware 2.0: It's coming, and healthcare needs to get prepared

Next wave of attacks will likely target Internet of Things and medical devices, which remain tempting targets for their lack of sufficient protections, experts say.
August 08, 2017 01:07 PM
Medical devices need to be reviewed for software vulnerabilities and mitigated by the security team.
Some cybersecurity experts say healthcare has only dealt with “Ransomware 1.0” to date, which begs the question: How much worse will “Ransomware 2.0” be for a sector already under siege?
“The latest variation on a theme regarding this threat is what can appropriately be called a ransomworm,” said Rich Curtiss, managing consultant at Clearwater Compliance, a former hospital CIO, and liaison for cybersecurity vulnerability projects with the National Cybersecurity Center of Excellence. “This is a combination of two types of malware, ransomware and a worm. While we have become all too familiar with ransomware in the healthcare sector, we have ignored other forms of malware.”
The use of a worm coupled with a ransomware payload is a new exploit, but the techniques are not. A worm allows the ransomware payload to move laterally or across internal and external networks, exploiting unpatched vulnerabilities.
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Special Report: RIS and imaging

The song tells us love and marriage go together, as does a horse and carriage. If you were penning a healthcare IT version of this famous ditty, you might mention PACS and RIS.
For as long as these two types of systems have been in existence, they have been seen as interdependent. Radiologists have used picture archive and communication systems (PACS) to electronically review images, turning to a radiology information system (RIS) to track imaging requests and to share their findings.
But, to borrow from another song, the times they are a-changin’. As PACS and RIS have advanced, and as the needs of the market have evolved, the separate but complementary roles of each are becoming blurrier.
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6 in 10 healthcare organizations have a dedicated cybersecurity executive, and it makes a big difference

Aug 9, 2017 1:27pm
Data from a HIMSS survey shows having a CISO makes a big difference when it comes to overall cybersecurity posture.
Healthcare providers that have a dedicated information security executive are more likely to adopt a holistic approach to privacy and security that includes the use of a validated cybersecurity framework, reviewing new technology prior to purchase and testing systems for a potential attack.
Sixty percent of healthcare organizations have a senior executive that oversees cybersecurity, like a chief information security officer, according to a new survey released by the Healthcare Information and Management Systems Society (HIMSS), which included responses from 126 information security professionals at acute care hospitals, vendors, and payers as well as ambulatory clinics and physician practices.
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Hospital Impact—To improve patient engagement, leverage the power of digital content

Aug 9, 2017 3:32pm
Most medical offices have adopted the use of technology, online marketing and social media. They’ve also embraced content in the form of blog posts, videos, social shares and more.
But while it’s not a new concept in the medical field, the challenge has become how to use this material to increase patient engagement. When patients are engaged in their medical care, they may be more proactive and able to receive a greater benefit from available health services. This can also lead to improved health and, ultimately, a better experience with a physician or facility.
To use content as a method for boosting patient engagement, it’s important to create and test different types of online media, creating a mix of materials that your patients can interact with, use and share. This content could include infographics, photos, quizzes, online calculators, educational blog posts and videos.
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Top 3 Most Significant Challenges for EHR Optimization Success

Benefitting from EHR optimization requires first surmounting the challenges accompanying EHR data reporting, standardization, and usability.

August 08, 2017 - Costly, labor-intensive EHR implementation projects require a full-court press from all hospital staff and health IT experts involved. However, the process of refining and streamlining an EHR system to maintain a level of provider satisfaction and accommodate the constant influx of developments in health IT lasts long after the initial launch.
EHR optimization requires that healthcare organizations continually modify and improve their technology to meet the needs of physicians, nurses, and various other staff members.
While EHR optimization can improve patient health outcomes, provider communication, and the pace of daily clinical tasks, persistent problems can slow the process and cause additional frustrations.
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Stop treating users as the enemy when it comes to cybersecurity

Users get a bad rap for cybersecurity. Find out why making them part of your organization's cybersecurity solution is critical to staying secure.
By Gregory Michaelidis | August 7, 2017, 10:56 AM PST
What are the biggest roadblocks to better cybersecurity? If you look at the major cybersecurity conferences, the usual presentation topics are risk assessment, encryption, zero-day exploits, and insider threats. But there's no shortage of technical and human challenges to cybersecurity; often these factors are competing against each other for time and resources, making the problem even more complex.
Listen to expert Michael Daniel's view on the subject, though, and the list looks very different. In an article for Harvard Business Review, Daniel poses a simple question about a complex problem: "Why Is Cybersecurity So Hard?"
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Patient Privacy Included in Recent Opioid Records Senate Bill

The Senate passed a bill to establish guidelines for when providers should display a patient’s opioid history, while still maintaining patient privacy.

August 08, 2017 - Recently passed legislation states that HHS will establish guidelines for when healthcare providers should prominently display a patient’s history of opioid use on his or her medical record. The bill also underlines the importance of maintaining patient privacy throughout the patient care process.
The Senate passed Jessie’s Law (S. 581) the end of last week, and now moves on to the House Committee on Energy and Commerce.
West Virginia Senator Joe Manchin sponsored the bill, and said in a statement that the law would help physicians be “better prepared to deal with the medical records of recovering addicts.” Complete medical records will ensure that individuals will not mistakenly fall into relapse by being prescribed an opioid medication.
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Analytics aid healthcare systems in cutting unnecessary blood use

Published August 09 2017, 4:14pm EDT
Data analysis and other policies can help reduce blood utilization, enabling hospital systems to save money and helping them increase patient safety by reducing the likelihood of complications.
A study by Premier, a group purchasing organization, found that analytics and other blood use policies had a significant impact on blood transfusions and other types of blood use.
The potential for savings across the industry could be sizable, Premier estimates. It says that one unit of blood can cost as much as $1,000, including overhead expenses and transportation costs.
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HIT Think Why portals are a key to effective patient engagement

Published August 09 2017, 4:11pm EDT
It’s no surprise that this year’s HIMSS17 conference dwelled on high-profile topics around population health, data analytics, more affordable EHRs and security. What is now surprising is that patient engagement is being reported right up there as an HIT priority. Why?
Most hospitals are still experiencing dismal usage of patient portals, especially in community and rural hospitals. But this is a problem plaguing even our large health systems. As a result, the many anticipated benefits to patients and to hospitals—including cost savings and efficiencies—are still not a widespread reality.
Until recently, patient engagement has dwelled quietly on the “soft” side of healthcare IT, exemplified by patient portals that are required by Meaningful Use provisions, but which have remained dispensable for many patients. Lack of EHR interoperability has required patients to register in many providers’ portals—a waste of time by any measure. And, too often, portals have not offered the features patients want most—online scheduling and bill payment, full views of their medical records and test results, and secure messaging with physicians.
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Boston Medical uses tech to cut patient handoff errors by a third

Published August 07 2017, 7:39am EDT
Boston Medical Center has achieved positive results from its two years of testing a set of web and cloud-based tools from I-PASS Patient Safety Institute that standardize the patient hand-off process during nurse shift changes.
A published study in the New England Journal of Medicine finds a 30 percent reduction in medical errors during patient handoffs at the hospital, with potential cost savings from prevention of adverse events estimated at $10 million to 20 million over three years.
I-PASS defines what information needs to be included in a patient handoff. For example, is the nurse coming off shift worried about the status of a particular patient, or is the patient stable? How does the status of the patient tie into the plan for the patient? These are questions that the nurse coming off shift and the nurse or physician coming on shift should consider during the handoff.
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Researchers: Meaningful Use legislation led to a 'substantial change' in EHR adoption

Aug 8, 2017 11:11am
New research shows the Meaningful Use program increased EHR adoption by as much as 8% each year following HITECH.
An incentive program established under the HITECH Act in 2009 was a primary driver behind EHR adoption in hospitals across the country, according to a new study. And researchers say the legislation could serve as a model to influence health technology adoption in the future.
The impact of the HITECH Act and the Meaningful Use program has been hotly debated, with proponents arguing the legislative intervention and accompanying incentives spurred EHR adoption, while opponents say the transition was already underway. Research published last year indicated the Meaningful Use program has fallen short of expectations.
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Indiana University’s Regenstrief Institute to develop and test an automated patient identification tool

Aug 8, 2017 12:27pm
A five-year grant from AHRQ will fund the development of new patient matching software.
Backed by a $2.5 million grant from the Agency for Healthcare Research and Quality (AHRQ), Indiana University’s Regenstrief Institute is building a new automated tool to accurately match patient records.
The five-year grant given to the Regenstrief’s Center for Biomedical Informatics will allow researchers to develop and test the tool in a real-world setting using the Indiana Network for Patient Care, the largest inter-organizational health data repository in the country, according to an announcement.
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Tracking Patients’ Moods: There's an App for That

Mobile app helps University of Missouri Health Care clinicians find patterns in patients’ emotions

August 7, 2017
Many patients with depression only see a psychiatrist once every two or three months and often forget how they felt between visits and what factors might have affected their moods.
Keeping a mood diary can help patients remember, but their entries aren’t part of the electronic health record, so clinicians can’t develop a view of patterns and triggers for their patients. Enter Ganesh Gopalakrishna, M.D., a psychiatrist at University of Missouri Health Care, who was convinced there had to be a better way.
Working with a computer scientist at Missouri University of Science and Technology, Gopalakrishna developed a mobile app that could collect patient-reported mood data and incorporate it into the EHR, where it could be clinically useful. The pair worked with Missouri S&T’s technology transfer and economic development staff to create an initial proof-of-concept application that collected patient mood data. They then coordinated development of the app with the Tiger Institute for Health Innovation, a partnership between the University of Missouri and Cerner Corp. It has earned University of Missouri Health Care a Most Wired Innovator Award from the American Hospital Association and Hospitals & Health Networks.
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Internet-based EHRs gaining some customers but still a small segment

By Rachel Z. Arndt  | August 7, 2017
The hospital Brad Huerta leads simply didn't have enough money to pay for a traditional electronic health record system.
It couldn't afford the software.
And it couldn't afford hiring a single information technology employee, not to mention a complete staff.
THE TAKEAWAY:
Cloud-based EHRs are becoming more popular, attracting providers with promises of lower prices and higher security.
So Huerta, CEO of Lost Rivers Medical Center in Arco, Idaho, decided to put the 14-bed critical-access hospital's records and billing systems in the cloud. There, they'd be overseen and maintained by a software vendor, not by an internal employee that the hospital couldn't afford to pay anyway.
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UC San Diego is switching to Epic's cloud-based EHR

The move kicks off a three-year migration to put all of its data storage needs in the cloud, officials said.
August 07, 2017 04:26 PM
University of California San Diego Health on Monday announced that it is putting its Epic electronic health record in the cloud.
The transition from managing its own on-premise Epic EHR to a cloud-based service has already involved moving some 10,000 workstations and integrating more than 100 third-party apps with Epic’s cloud, UC San Diego Health said.
While hospitals and health systems have historically been somewhat tentative about mass migrations to the cloud, industry luminaries such as Beth Israel Deaconess Medical Center John Halamka, MD, have been making bold predictions of late about datacenters vanishing as hospitals go the cloud for analytics, EHRs and clinical decision support. Halamka, for one, backed that claim up by placing 7 petabytes of BIDMC data on Amazon’s cloud.
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Adi Gaskell, Contributor A London based innovation scout

Ireland Opens E-Health Open Data Portal

08/08/2017 04:41 am ET
I’ve written extensively about the growing importance of data in healthcare in the past year, and it’s pleasing to see that changes are slowly beginning to emerge in the sector.
The latest of these comes from Ireland, where an open data portal has been launched by eHealth Ireland.  The portal aims to bring together some 300 different open data sources into one place, making it easier to find data from across the Irish Health Sector.
The portal includes data from a range of sources, including statistics on hospital day and inpatient cases, waiting list statistics and information around key new digital initiatives.
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ONC calls for shift to industry-developed testing tools

Published August 07 2017, 7:23am EDT
Over the next five years, the Office of the National Coordinator for Health Information Technology would like the Health IT Certification Program’s current electronic testing portfolio of taxpayer-funded tools to include as many industry-developed and maintained tools as possible.
Testing tools are used by health IT developers and others during the creation of software that implements standards applicable to certification criteria used in ONC’s HIT Certification Program. However, the current testing tools developed and used as part of the program have historically been government supported.
According to Steve Posnack, director of the Office of Standards and Technology at ONC, the agency’s five-year goal is to leverage industry’s test tools to enable the program to more efficiently focus its resources and better align with the private sector, as well as support “real world testing” mandated by the 21st Century Cures Act.
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Epic says it absolutely supports patient access to medical records despite reports of tense chat with Biden

The EHR vendor said the issue was related to how it could translate a patient’s EHR information in a way that is easy to understand.
August 04, 2017 11:44 AM
EHR vendor Epic Systems came under the gun again this week over data sharing and access. 
Generally, the criticism is that Epic claims its electronic health record system is interoperable while most of the health data exchange takes place among other hospitals also using Epic, rather than rival EHRs. 
But now it’s about patients’ right to access their entire medical record. Politico reported on Wednesday that “Epic CEO Judy Faulkner asked Biden during an (until now) private meeting between EHR executives and administration officials, 'Why do you want your medical records? They’re a thousand pages of which you understand 10.’ Biden responded, ‘None of your business. If I need to, I’ll find someone to explain them to me and, by the way, I will understand a lot more than you think I do.' ” 
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Conveying information to patients: Too much or not enough?

Aug 7, 2017 12:53pm
Too much information can overwhelm patients, but sometimes it's OK to give them a longer list of instructions.
What’s the best way to give information to patients? Do you dole it out, two or three recommendations at a time? Or lay it all out there, presenting all the information so you don’t leave out something that might be useful?
A new study says it depends on the nature of the recommendations a healthcare provider makes. The best method for conveying information to patients depends on the goal of a specific health objective, the study from the University of Illinois, published in Clinical Psychological Science, finds.
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Smart belt helps Parkinson's patients with balance

A vibrating belt and a smartphone app could help reduce falls by assisting people who have balance problems.
Wearable Tech
by Edward Moyer August 2, 2017 2:34 PM PDT @edatnews
A high-tech belt and a phone app may one day help Parkinson's patients and the elderly stay on their feet.
Researchers at the University of Houston are developing Smarter Balance System, an app with a sensor-equipped belt that records patients' movements and sends feedback via vibrations to guide them through a series of balance exercises.
"The smartphone application records and creates a custom motion for their body tilt based on their individual limits of stability," UH researcher Alberto Fung said in a release posted on the university's site last month. "The touch guidance from the vibrating actuators is almost acting as if a physical therapist is guiding them."
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Study Finds Near Universal EHR Adoption at Hospital-Owned Practices

August 3, 2017
by Heather Landi
The adoption of electronic health record (EHR) systems at outpatient practices has been accelerating, with the hospital-owned outpatient market showing near universal adoption.
According to research from HIMSS Analytics, in its 9th Annual Outpatient PM and EHR Study, 92 percent of hospital-owned outpatient facilities have a “live and operational” electronic medical record (EMR) systems. The research is based on a web-based survey aggregating data from a total of 436 respondents including physicians, practice managers/administrators, practice CEO/president and practice IT directors and staff, as well as HIMSS’s market intelligence that provides insight into 47,800 hospital-owned practices and 92,000 free-standing practices.
The research indicates strong growth in the implementation of outpatient EHRs over the years. This growth coupled with high adoption rates suggest the hospital-owned outpatient market has neared universal adoption.
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Enjoy!
David.