Saturday, April 15, 2017

Weekly Overseas Health IT Links – 15th April, 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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Has health IT’s rapid growth rendered HIPAA obsolete?

Apr 7, 2017 9:10am
Privacy experts wonder whether a 20-year-old law needs an overhaul to align with health IT innovation.
More than two decades after HIPAA was signed into law, privacy experts are split on whether the landmark privacy legislation needs a reboot to keep pace with a rapidly evolving, data-centric industry.
But exactly how the law should be updated remains a point of contention among privacy officers, according to an article in the Journal of AHIMA, published by the American Health Information Management Association.
Although HIPAA has undergone several updates since it was passed in 1996, some argue that new privacy laws can fill the gaps where the law has been outpaced by technology advancements—like mobile apps and wearables—that generate more shareable health data for patients. Others say HIPAA could benefit from an update that would encapsulate telehealth, patient portals and other electronic forms of communication, like texting.
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Dorset Care Record project signs £7.8m deal with Orion

Jon Hoeksma

5 April 2017
People in the county of Dorset are set to benefit from shared health and care records, after a £7.8 million five-year framework contract was awarded to Orion Health.
The Dorset Care Record (DCR) project is being led by Dorset County Council, working in partnership with local NHS organisations and borough councils. Each will contribute to the overall cost of the project, which is estimated at £20 million over 10-years.
The new DCR will bring together information from hospitals, GPs, community teams and local councils, enabling summary details of a person’s medical or care history to be accessed in one place.
Hoped for benefits should include improved coordination of care and communication between different health and care agencies, improving treatments and reducing delays. Patients will be able to access and contribute to their records online.
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Patients to get access to GP records via NHS.uk in September 2017

Laura Stevens

6 April 2017
Patients will be able to access their GP record via the revamped NHS.uk from September 2017, according to NHS Digital.
NHS Digital’s latest board papers, which were published 28 March, mention the aim and state a target go live date of 30 September 2017. A spokeswoman subsequently confirmed the timing to Digital Health News.
A spokesman for TPP, providers of the SystmOne EPR which is widely used in primary care, said the company is working with NHS Digital to give patients access to their GP record via NHS.uk. “TPP is providing access to SystmOnline APIs.”
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University of Kansas Health System taps mobile app to treat stroke, sepsis

Apr 6, 2017 11:41am
Clinicians at The University of Kansas Health System will use an app to identify signs of stroke and sepsis. Image: Getty / Sam Edwards
The University of Kansas Health System is providing physicians with a mobile app to speed up the time it takes to diagnose two deadly conditions.
For patients exhibiting signs of stroke or sepsis, time is critical. However, recognizing those signs can be difficult. Through the grant-funded Kansas Heart and Stroke Collaborative, the University of Kansas Medical Center announced it is pilot-testing an app that incorporates evidence-based protocols at the point of care.
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65 percent of healthcare organizations have documented mobile strategy

Apr 4, 2017 at 1:47 PM
The rise of technology in healthcare is causing many organizations to implement a mobile strategy.
This finding comes from part one of a two-part Spok report. Titled “The Evolution of Mobile Strategies in Healthcare,” part one highlights a number of key points in Spok’s annual survey. The survey results include responses from more than 300 U.S. healthcare professionals, which were gathered in February 2017. Thirty-five percent of respondents held various hospital roles such as quality directors, risk managers, infection prevention specialists and mobility engineers. Another 22 percent of respondents were physicians, 13 percent were nurses, 10 percent were IT staff members and 7 percent were executive leaders.
All the respondents answered questions about their organization’s mobile strategy — though their responses regarding the definition of “mobile strategy” varied across the board. For simplicity’s sake, Spok defined a mobile strategy as something that “brings together elements of security, technology and communications in a collective plan to improve staff productivity and enhance patient care.”
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Top 10 Ambulatory EHR Vendors by Physician Practice EHR Implementations

Choosing a flexible, cost-efficient EHR vendor is vital to meeting the unique needs of ambulatory practices in the healthcare industry.

Kate Monica

April 05, 2017 - While the market for inpatient EHR/EMR systems is mostly dominated by a select group of well-known EHR companies such as Epic Systems and Cerner, the wide range of specialties and practice sizes comprising ambulatory care has allowed for more competition among EHR vendors.
Big EHR vendors with hefty price tags don’t always appeal to smaller practices. With cost, customization, and specialty being major focal points in ambulatory settings, lesser-known EHR vendors have a better chance of gaining traction among physicians on the outpatient side.
The following is an alphabetized list of the top ambulatory EHR vendors according to number of physician practice EHR implementations based on data from Definitive Healthcare.
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Why We Can’t Ignore AI

04/03/2017 By Brian Thomas
Brian Thomas, VP & CIO, Swope Health Services
We know that Artificial Intelligence (AI) is a hot topic right now, yet on the flip side there has been criticism around its hype, especially at HIMSS17 this year. However, we need to continue to invest into AI research and development so we can maximize the benefits, such as lower healthcare costs, improved provider efficiency, more accurate billing, and safer patient care.
It’s unlikely that robots and computers will totally take the place of doctors and nurses, but AI can’t be ignored in its efforts to revolutionize the healthcare industry. Not only does it predict outcomes and improve diagnostics, it also changes the way providers think about how they deliver care, says Forbes. The future possibilities are endless: industry analysts say that 30 percent of providers will use cognitive analytics with patient data by 2018.
Access to big data is essential. Think about how we grew up with the Dewey Decimal system. A trip to the library could take hours as we pored through the stacks trying to find what we wanted. Today, our kids are astonished that we didn’t have Google at our fingertips to learn anything we wanted to know. With the advent of AI, our kids’ kids will be the ones shocked that all their parents had to obtain information was a simple computer and search engine. Just like that, the future takes hold even, when we can’t comprehend the next step.
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Emory Healthcare eICU program saves Medicare millions

Apr 5, 2017 10:21am
Emory Healthcare's eICU program saved nearly $1,500 per patient by streamlining care.
An Atlanta health system saved Medicare $4.6 million during a 15-month span through a telehealth program that shortened length-of-stay and streamlined care for patients in the ICU.
Emory Healthcare reduced Medicare spending by nearly $1,500 per patient between April 2014 and June 2015 through its eICU program, according to a press release. The health system also saw more discharges home and fewer post-acute care facilities admissions, an indication that patients were healthier upon discharge.
The initiative, which used telehealth technology provided by Philips, was designed to allow ICU physicians 24/7 access to critical care patients and was backed by a $10.7 million Health Care Innovation award from the Centers for Medicare and Medicaid Services in 2012. The findings were part of an independent audit conducted (PDF) by Abt Associates on all aware recipients.
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5 things to know about new ONC chief Donald Rucker

Long history of clinical and technology work should benefit the nation’s hub for healthcare IT policy.
April 03, 2017 12:01 PM
The newly named chief of the Office of the National Coordinator for Healthcare Information Technology, Donald W. Rucker, MD, is being lauded as one of the most qualified choices to lead that agency.
He has been emergency room doctor, internal medicine physician, a clinical informatics expert, an inventor, a designer and researcher and innovator and for the past four years, he was professor at Ohio State University, where he taught clinical Emergency Medicine and Biomedical Informatics.
Here are five things you might not know about the new ONC chief:
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Report: Adoption of Telehealth Can Generate Cost Savings for Rural Communities, Hospitals

March 30, 2017
by Heather Landi
The adoption of telehealth technologies in rural areas can result in significant cost savings for hospitals and their communities due to transportation cost savings, lost wages savings, hospital cost savings and increased revenues for local labs and pharmacies, according to a white paper by the NTCA-The Rural Broadband Association.
In the white paper, titled “Anticipating Economic Returns on Rural Telehealth,” Rick Schadelbauer, manager, economic research and analysis at the organization, outlines the case to be made for increasing adoption of telehealth in rural areas, and throughout the country, by keeping patients using local health care services rather than traveling to bigger, nearby cities for health care services. Schadelbauer noted that within the United States, there is a distinct health disparity between rural and non-rural Americans, primarily as a result of demographics and limited access to health care.
Telehealth and telemedicine, or the remote delivery of health care services and clinical information using telecommunications technology, holds potential to improve the quality, cost and availability of health care in rural areas. However, telemedicine is not viable without access to robust, reliable broadband service, Schadelbauer wrote. “Rural areas currently lag in broadband deployment, but continue to make impressive gains due in large part to the efforts of small telecommunications providers. Wireless applications require wireline infrastructure in order to be viable options,” he wrote.
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Hospital EHR Use Helps Improve Weekend Health Outcomes

New research points to EHR use having a positive effect on patient recovery from weekend surgeries.

Kyle Murphy, PhD

Director of Editorial
kmurphy@xtelligentmedia.com
March 30, 2017 - According to researchers from Loyola University Medical Center, hospital EHR use can counteract the weekend effect, a phenomenon wherein health outcomes for patients following weekend surgeries compared to those of their weekday counterparts.
The research published in JAMA Surgery built on a previous study into the benefits of fully implemented EHR systems for mitigating temporal disparities in health outcomes for patients undergoing urgent weekend surgeries.
“Implementation of EHR system is one mechanism to help hospitals combat an important temporal disparity of care, the weekend effect, for patients undergoing urgent general surgical procedures,” write Kothari et al. “Specific components of EHR systems, including electronic operating room scheduling and electronic bed management systems, are most strongly associated with decreasing the odds of the weekend effect.”
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Healthcare pros increasingly using tablets, smartphones for job functions

Execs, IT pros and clinicians are using mobile devices to access clinical information and EHRs, a new HIMSS Analytics study says.
March 31, 2017 02:14 PM
A new HIMSS Analytics study of 129 C-suite executives, IT professionals, clinicians and department heads has found 79.8 percent use tablets and 42.6 percent use smartphones to access the information needed to provide and coordinate care.
On the other hand, 37.2 percent use laptops and 94.6 percent still use desktop computers.

“The use of mobile technology within our daily lives has become habitual,” said Brendan FitzGerald, director of research at HIMSS Analytics. “People can use their smartphone, tablet or laptop to do most everything they need, such as shopping, staying in touch with friends and family, or conducting business. However, the use of mobile technology has not easily translated to clinician needs around providing better patient care.”
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Why EHR optimization is on the to-do list of most CIOs

Published April 04 2017, 4:35pm EDT
Why, if over 95 percent of hospitals have implemented EHRs, are so many planning to invest in improvements or replacements this year?
A new survey of hospital executives showed that 24 percent are conducting a major EHR system upgrade, and 21 percent are replacing their EHR at one or more sites. KPMG’s recent survey of CHIME members found that at least 38 percent of CIOs are investing in EHR optimization projects this year; in fact, they plan to spend more on EHR optimization than any other area of HIT.
These numbers are huge when you consider that most hospital EHRs are newer versions implemented to meet MU attestation requirements. A central reason for the continued need to upgrade or optimize, cited by both groups, was straightforward. Doctors and nurses still don’t like their EHRs. The problem seems straightforward, but it’s not.
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Metabolic syndrome severity calculator outperforms traditional methods

Published March 31 2017, 7:09am EDT
An online calculator for metabolic syndrome is able to predict patients’ risk of developing heart disease and diabetes more accurately than traditional assessment methods.
That’s the finding of a new study of more than 13,000 people that concluded that the online tool was a better risk predictor than evaluating individual risk factors alone.
Traditionally, physicians predict risk for cardiovascular disease, type 2 diabetes and stroke through five factors—increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol and triglyceride levels. Using this traditional approach, patients are diagnosed with metabolic syndrome—a cluster of conditions that occur together—if they have at least three of the five abnormalities.
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Mass General’s application helps determine cause of stroke

Published April 04 2017, 7:03am EDT
Researchers at Boston’s Massachusetts General Hospital have developed software that provides evidence-based automated support to physicians for diagnosing the cause of ischemic stroke.
However, determining the cause of such strokes—which occur as a result of an obstruction within a blood vessel supplying blood to the brain—is no small feat.
That’s because there are more than 150 different abnormalities that are potential causes—or etiologies—of ischemic stroke, and about half of patients exhibiting symptoms show more than one possible cause, says Hakan Ay, MD, a vascular neurologist and director of stroke research at Mass General’s Martinos Center for Biomedical Imaging.
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Project launched to create artificial intelligence virtual GP

Laura Stevens

30 March 2017
A project has been launched to create a virtual GP using artificial intelligence and machine learning.
Those behind the project say that the planned virtual GP won’t replace traditional human GPs but be complimentary.
The University of Essex and digital company Orbital Media, in partnership with Innovate UK, started the four-year research initiative with a combined investment of £250,000.
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Bryant says NHS Digital must become more responsive

Jon Hoeksma

30 March 2017
Beverley Bryant, director of digital transformation at NHS Digital, says the organisation needs to undergo a cultural revolution, move away from thinking of programmes “as king”, and become far more responsive to the needs of NHS customers.
She says a change in “mindset” and even “tone of voice” is required from the organisation to enable it to effectively support local NHS trusts, social care providers, CCGs and STPs in achieving their digital aspirations.
The goal she says must be to become a “responsive customer-focused partner of local NHS organisations”, and she argues the establishment of four new regional teams is a vital step in this direction.
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Computerized Clinical Decision Support Systems Linked with Fewer Blood Clots

Alexandra Wilson Pecci, March 28, 2017

Decision support systems integrated with EHR/EMRs have been shown to decrease venous thromboembolism events postoperatively compared with routine care.

Using a computerized clinical decision support system (CCDSS) is linked with a significant increase in the proportion of patients with adequately ordered treatment to prevent blood clots, according to a study published online by JAMA Surgery.
The systems are also linked with a significant decrease in the risk of surgical patients developing blood clots.
According to the study authors, healthcare professionals do not adequately stratify risk or provide preventive treatment for venous thromboembolism (VTE) among surgical patients.
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HIEs have 'reached the limits of their effectiveness,' says Chilmark

Written by Jessica Kim Cohen | March 28, 2017 | Print | Email
Application programming interfaces will solve the healthcare industry's issues with data interoperability, according to a Chilmark Research report.
The report, titled 2017 Clinician Network Management Market Trends Report, provides an overview of the challenges and potential solutions to data interoperability in the healthcare industry.
While document-based health information exchanges have helped healthcare coordination in the past, these approaches "have reached the limits of their effectiveness," according to the report.
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Direct-To-Consumer Telehealth May Increase Access To Care But Does Not Decrease Spending

Published in: Health Affairs, v. 36, no. 3, March 2017, p. 485-491. doi:10.1377/hlthaff.2016.1130
Posted on RAND.org on March 28, 2017
This article was published outside of RAND. The full text of the article can be found at the link above.
The use of direct-to-consumer telehealth, in which a patient has access to a physician via telephone or videoconferencing, is growing rapidly. A key attraction of this type of telehealth for health plans and employers is the potential savings involved in replacing physician office and emergency department visits with less expensive virtual visits. However, increased convenience may tap into unmet demand for health care, and new utilization may increase overall health care spending. We used commercial claims data on over 300,000 patients from three years (2011–13) to explore patterns of utilization and spending for acute respiratory illnesses. We estimated that 12 percent of direct-to-consumer telehealth visits replaced visits to other providers, and 88 percent represented new utilization. Net annual spending on acute respiratory illness increased $45 per telehealth user. Direct-to-consumer telehealth may increase access by making care more convenient for certain patients, but it may also increase utilization and health care spending.
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Donald Rucker, former Siemens exec, named ONC national coordinator

Mar 31, 2017 2:13pm
Don Rucker, former Siemens executive, will head the ONC.
Former Siemens Chief Medical Officer Donald Rucker, M.D., has been named the new national coordinator for the Office of the National Coordinator for Health IT.
Rucker was among those rumored to be considered for the position. On Friday, he was listed as the national coordinator in the Department of Health and Human Services directory. He is currently an adjunct professor in the bioinformatics department at the Ohio State University College of Medicine.
A spokesperson with HHS declined to comment.

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Health IT community applauds new ONC pick

Apr 3, 2017 10:08am
Health IT leaders reacted favorably to news that former Siemens executive Donald Rucker would take over as national coordinator.
Health IT industry leaders and associations reacted favorably to news that former Siemens executive Donald Rucker, M.D., would serve as the national coordinator for health IT, highlighting his vast industry experience in both the provider and vendor communities.
On Friday, FierceHealthcare reported that Rucker had been identified in the Department of Health and Human Services directory as the national coordinator at the Office of the National Coordinator for Health IT (ONC). Rucker served as the chief medical officer at Siemens for 13 years before transitioning to a career as a professor of clinical emergency medicine and biomedical informatics at Ohio State University in 2013.
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ONC updates health IT safety guides for providers

Published March 29 2017, 7:25am EDT
The Office of the National Coordinator for Health Information Technology has released updated guides to help providers assess the safety and usability of their respective electronic health record systems.
First published in January 2014, the ONC Safety Assurance Factors for EHR Resilience (SAFER) guides are voluntary provider self-assessments that take the form of vulnerability checklists as well as evidence-based recommendations and best practices for how to safely use health IT.
Recommended best practices in the SAFER guides help organizations know what to do to optimize the safety and safe use of their EHRs. Specifically, the guides address nine areas—high-priority practices; organizational responsibilities; contingency planning; system configuration; system interfaces; patient identification; computerized provider order entry with decision support; test results reporting and follow-up; and clinician communication.
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Physicians spend half of their time face-to-face with patients, half on the computer, study finds

Apr 3, 2017 6:40pm
Doctors are splitting time between patient visits and computers, study finds.
Doctors are splitting their time pretty evenly between face-to-face visits with patients and time on the computer, a new study found.
The study of 471 primary care physicians, published in Health Affairs, found physicians spent an average of 3.08 hours on office visits and 3.17 hours on what was called desktop medicine, such as typing progress notes in an electronic health record, each day. 
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France still seeks an electronic health record

The idea of a ‘dossier médical personnalisé’ (DMP, or electronic health record) for every French citizen was first inaugurated in 2004. Now, over 10 years and €500 million later, we can look at the pros and cons encountered during this still incomplete journey and consider if similar projects would be a useful addition to healthcare administration in other European countries, or not.

Report: Jane MacDougall
The main DMP aim was that all doctors involved in a patient’s treatment would have immediate access to a complete medical record, to avoid repetition of investigations/prescriptions or risk from overlooked illnesses etc., which can occur when relying on an oral medical history.
Also wanted: Faster exchange of secure information between the various healthcare structures involved in a case e.g. an in-patient having exams in different locations. Another long-term aim was to use the information collected for epidemiological and eco-epidemiological syndromic surveillance to help in the early detection of health problems, as has been the case in the USA from 2013-2014.
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78% of Physicians 'More Prepared' When Patients Enter EHR Notes Ahead of Appointments

Alexandra Wilson Pecci, April 4, 2017

An OpenNotes study found that letting patients type pre-visit agendas into the electronic health records system before seeing the physician made appointments more efficient and improved communication.

Joann Elmore, MD, MPH, professor of medicine at the University of Washington School of Medicine, is a slow typist. So slow, that one of her patients grabbed the keyboard away from her while she was entering the patient's information into the electronic health record.
"Come on doc, let me type," the patient said. She and asked her Elmore what she should write. Elmore told her she should decide. It was about her, after all.
That simple idea of letting a patient contribute to the medical record in their own words is the central focus of a new study published in the Annals of Family Medicine.
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Enjoy!
David.

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