Saturday, August 12, 2017

Weekly Overseas Health IT Links – 12th August, 2017.

Here are a few I came across last week.
Note: Each link is followed by a title and few paragraphs. For the full article click on the link above title of the article. Note also that full access to some links may require site registration or subscription payment.
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How Jared Kushner helped the VA pick Cerner... quickly

In a leaked audio, the senior adviser and son-in-law to President Donald Trump discusses meetings with the VA Secretary, Defense Secretary and DoD EHR experts.
August 03, 2017 02:50 PM

When the U.S. Department of Veterans Affairs announced in early June that the agency would move its outdated EHR system to Cerner, Congress and President Donald Trump hailed the decision as the best route to data sharing between the VA and the Department of Defense.
Many people in the government and healthcare sectors were surprised at how quickly the VA made its choice and the fact that it did so without the usual request for information and request for proposal procedures that are common in large-scale IT acquisitions. 
Now, a leaked audio obtained by Wired of a question and answer session with congressional interns led by presidential senior adviser and President Trump’s son-in-law Jared Kushner sheds some light on how the decision was made for the government to go with Cerner.
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HIT Think How caregivers can help seniors adopt health technology

Published August 03 2017, 4:47pm EDT
Health technology, like emergency response-enabled wearables or smart home devices that help monitor activity levels, have the potential to fully transform the way seniors manage their health to support a positive aging experience.

Whether seniors are living independently or in a care facility, family and professional caregivers are a large part of this process.
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http://www.fiercehealthcare.com/ehr/private-physician-practices-spend-more-than-twice-as-much-health-it-compared-to-their-hospital

Independent physician practices spend more than twice as much on health IT than their hospital-owned counterparts

Aug 4, 2017 12:08pm
Physician-owned practices spend far more on health IT compared to those with hospital support.
Health IT costs are steadily increasing for physician practices across the country, but privately owned practices are absorbing a much larger portion of those costs.
Physician-owned practices spent between $2,000 and $4,000 more per full-time physician last year than they did in 2015, according to a survey published last month by Medical Group Management Association (MGMA). Those costs ranged from $14,000 to $19,000 per physician.
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CMS relaxes provisions of Meaningful Use programs for 2018

Published August 03 2017, 1:33pm EDT
The Centers for Medicare and Medicaid Services has acted to substantially reduce burdens on hospitals aiming to achieve the meaningful use of electronic health records.
Hospitals are being given another year to use the 2014 Edition of Certified EHR Technology (CEHRT) software. Facilities also now have the option of continuing to meet modified Stage 2 measures for meaningful use, rather than being required to move to Stage 3 in 2018. Under the new final rule, hospitals now are not required to meet Stage 3 until 2019.
Hospitals, at their option, also can use a combination of the 2014 and 2015 editions of meaningful use software.
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Boston Medical Center is standardizing handoffs, and patients are safer for it

I-PASS Patient Safety Institute is helping the academic hospital achieve safer shift changes with game-based training, EHR mnemonics and benchmarking tools in the cloud.
August 03, 2017 03:24 PM
One sure way to reduce risky patient handoffs in a hospital, where the potential exists for miscommunication and medical errors, is to increase the length of shifts that physicians and nurses work. But a bleary-eyed doctor in the waning hours of a 30-hour shift presents its own patient safety challenges.
"Why are we putting people at risk when really we just need to improve these handoffs?" said  William Floyd, president and CEO of the I-PASS Patient Safety Institute.
It's been estimated that 80 percent of the most dangerous medical errors occur because of communication failures during handoffs, when docs and nurses change shifts, or patients are moved to new locations in the hospital.
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Ransomware attacks rise, accidental breaches most common cause of data loss

In healthcare, unintended disclosure continued to drive the majority of healthcare losses in the first half of 2017, according to Beazley.
August 02, 2017 02:08 PM
Unintended disclosure – such as misdirected faxes and emails – continued to drive the majority of healthcare breaches, Beazley said.
Hackers never quit. Their ceaseless assault on healthcare has continued during 2017, racking up hit after hit against provider organizations.
Ransomware attacks continued their rise in the first half of 2017, up 50 percent over the first half of 2016, according to the Beazley Breach Insights report from Beazley, a cyber and data breach response insurance firm that compares data on its base of clients from multiple industries, including healthcare.
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It’s all systems go for the new Health and Social Care Network

Shireen Khalil

31 July 2017
NHS Digital’s new NHS Network, Health and Social Care Network is in full force with the transition from the old N3 network now underway.
The contract for the legacy NHS National Network (N3) infrastructure, supplied by BT , expired in March this year, with health and care organisations set to start to deploy connections to the replacement HSCN from October.
The migration of organisations and services from the interim transition network arrangements to HSCN is planned to be completed by August 2020.
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Allscripts acquires McKesson’s health technology business line for $185M

Aug 3, 2017 5:11pm
Allscripts announced plans to purchase McKesson's health IT business line.
Allscripts plans to expand its foothold in the EHR market by acquiring McKesson Corporation’s health IT businesses, the company announced on Thursday.
Allscripts will pay $185 million in cash for McKesson’s enterprise information solutions portfolio, which includes the company’s EHR platform, revenue cycle management solution and laboratory analytics, according to the announcement. Allscripts CEO Paul M. Black said the acquisition would increase the company’s scale and “further drive our investment in innovation.”
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Drchrono injects FHIR support into its EHR

New API also integrates with Precision Medicine Sync for Science program, the vendor said.
August 01, 2017 03:59 PM
EHR vendor drchrono has announced that its electronic health record, practice management and revenue cycle products now support the Fast Healthcare Interoperability Resources specification. 
With FHIR, drchrono said it is enabling 10 million patients to access to their healthcare information via the FHIR API through the company’s inpatient health record.
The new application programming interface is designed to support the Precision Medicine Sync for Science Initiative and fulfills one of the requirements of Meaningful Use Stage 3 to enable a patient health record API, the vendor said.
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Privacy and Healthcare Data book explores changing concept of ‘privacy’ and ‘patient control’

Shireen Khalil

4 August 2017
Patients should be empowered by “the choice of control” – that is the key message addressed in the newly released book, Privacy and Healthcare Data.
Written by associate professor in Information and Technology Law at the University of Leeds, Subhajit Basu and the university’s informatics consultant Christina Munns, the thought-provoking book explores the changing concept of ‘privacy’ and ‘patient control’ in healthcare information.
The book is a culmination of four years of research where the co-authors cover a number of topics including privacy and data protection, sociological and psychological issues, information governance issues (analysing NHS information governance policies) and an in-depth look at Care.data.
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Stakeholders look to improve C-CDA as FHIR matures

Published August 02 2017, 6:58am EDT
As the healthcare industry continues to wrestle with interoperability challenges, two standards are poised to play a central role in facilitating the electronic exchange of health information—one is a blunt tool for data sharing, while the other is a surgical instrument.
First adopted in 2012 as part of the Office of National Coordinator for Health IT’s 2014 Edition final rule, the Consolidated Clinical Document Architecture (C-CDA) version 1.1—developed through the joint efforts of ONC and Health Level Seven (HL7) International—is now widely used among healthcare providers. However, as HL7’s emerging Fast Health Interoperability Resources (FHIR) standard matures, stakeholders are taking stock of their respective strengths and weaknesses.
“C-CDA is a document standard for pushing complete medical record or encounter data from one organization to another,” says John Halamka, MD, chief information officer at Boston’s Beth Israel Deaconess Medical Center. “FHIR is a query/response transaction for pulling specific data types on demand, such as problems, medications, and allergies.”
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9 companies will play a huge role in shaping the FDA’s novel approach to digital health

Aug 2, 2017 9:33am
The FDA has a basic structure in mind for its precertification program, but pilot participants will have an outsized influence.
As the Food and Drug Administration begins a substantial overhaul of its approach to regulating health technology, a handful of software companies are poised to have a significant impact on the agency’s methodology moving forward.
Last week, the FDA announced the launch of a software precertification program, drawing praise from some of the agency’s harshest critics. As part of a newly released Digital Health Innovation Plan, the agency will select nine companies to participate in a pilot program that launches September 1.
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mHealth Study Ties App to Improved Outcomes for Pregnant Women

The Medicaid-based study in Wyoming found that pregnant women using the app were more likely to schedule prenatal visits at least six weeks out and less likely to have low-birth-weight babies.

August 01, 2017 - A Medicaid-based mHealth study in Wyoming has found that pregnant women using a customized app are far more likely to consult with doctors during maternity – and they’re more likely to deliver healthy babies.
The study, conducted by the Wyoming Department of Public Health in 2014-15 using the WYhealth Due Date Plus app from Wildflower Health, found that app users were 76 percent more likely to schedule prenatal visits at least six months before delivery than those not using an app.
More importantly, pregnant women using the app were only 25 percent as likely to deliver a low-birth-weight baby as those women who didn’t use an app.
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August 1, 2017 / 10:04 PM / 2 days ago

U.S. senators to introduce bill to secure 'internet of things'

A man takes part in a hacking contest during the Def Con hacker convention in Las Vegas, Nevada, U.S. on July 29, 2017.Steve Marcus
SAN FRANCISCO (Reuters) - A bipartisan group of U.S. senators on Tuesday plans to introduce legislation seeking to address vulnerabilities in computing devices embedded in everyday objects - known in the tech industry as the "internet of things" - which experts have long warned poses a threat to global cyber security.
The new bill would require vendors that provide internet-connected equipment to the U.S. government to ensure their products are patchable and conform to industry security standards. It would also prohibit vendors from supplying devices that have unchangeable passwords or possess known security vulnerabilities.
Republicans Cory Gardner and Steve Daines and Democrats Mark Warner and Ron Wyden are sponsoring the legislation, which was drafted with input from technology experts at the Atlantic Council and Harvard University. A Senate aide who helped write the bill said that companion legislation in the House was expected soon.
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HIT Think How to best limit potential breach risks of 'Shadow IT'

Published August 02 2017, 4:41pm EDT
The cloud is growing. There were 1,427 cloud services in use at organizations in 2016, an increase of 23.7 percent from 2015. Approximately 18 percent of the data that goes into the cloud has some form of sensitive information, whether that's personally identifiable information or trade secrets.
With the typical organization facing 23 cloud security threats every month, there are many opportunities for a breach. In fact, last year, the number of threats rose by 18.4 percent. What is even more troubling is that insiders are becoming increasingly responsible for these breaches, whether through negligence or malicious intent.
Some of those risks are associated with shadow IT, which refers to employees who use their own technology—in this case cloud services—without the approval or knowledge of the IT department or any other entity involved in cloud application governance. IT security teams evaluate the risk profiles of approved cloud applications more comprehensively than individual employees. Non-IT users don't follow the same security considerations, leading to threats, data breaches and legal issues.
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Trump’s power to cut ACA subsidies limited by court ruling

Published August 02 2017, 4:58pm EDT
President Donald Trump’s power to clamp off critical Obamacare subsidies took a hit after a federal court ruled that a group of states can join a legal battle over the payments.
Trump has threatened to end the subsidies if senators don’t resume their efforts to pass an overhaul of the Affordable Care Act, after the latest push failed in a dramatic middle-of-the-night vote last week.
Pulling the plug on the payments, which reimburse insurers for offering reduced deductibles and co-pays to lower-income people, could upend health insurance markets. Lawmakers from both parties and the insurance industry have urged the president not to cut off the subsidies.
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HSE chief: online GPs are no different to psychics

Aaron Rogan, Senior Ireland News Reporter
August 3 2017, 12:01am, The Times
The head of the HSE has compared online GP consultations to psychic phone lines amid claims that patients who use the service are being misdiagnosed and over-prescribed drugs.
Tony O’Brien, director-general of the HSE, was asked if online video calls and mobile apps which allow GPs to diagnose and prescribe drugs without face-to-face consultations met proper standards of practice.
“Personally I would not use such a service. I’d sooner phone Psychics Live,” Mr O’Brien tweeted in response.
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The 5 best (and worst) states for EHR adoption

Aug 1, 2017 10:36am
Massachusetts leads the country in EHR adoption among hospitals and physicians.
Massachusetts, along with several midwestern states, is leading the charge when it comes to EHR adoption among physicians and hospitals.
New Jersey, on the other hand, ranks dead last.
That’s according to a report released by Center for Data Innovation, which ranked all 50 states based on how each one embraces data-driven innovation. Two health IT systems—EHRs and e-prescribing—were among the 25 indicators the organization used to develop its rankings.
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Intermountain CEO: Digital health doesn’t have to conflict with human touch

Aug 1, 2017 12:45pm
Intermountain CEO A. Marc Harrison, M.D., said treating patients with telehealth "may be the most empathic thing we can do for them."
Patients want it both ways: They want better access to new technology and digital health tools that offer more control, but they also want an empathetic doctor to address their concerns. 
Intermountain Healthcare CEO A. Marc Harrison, M.D. says it’s possible to address both needs if the healthcare industry is willing to rethink the way it measures patient progress.
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New Senate bill seeks to reduce restrictions on telemedicine use

July 31, 2017
While the Senate’s efforts to repeal and replace the Affordable Care Act imploded last week, that hasn’t stopped lawmakers from introducing bills that would make tweaks to the healthcare system in smaller ways. One such bill, sponsored by Reps. Doris Matsui, (D-California), and Bill Johnson, (R-Ohio), would expand the use of telemedicine to reduce costs.
The bill, the Evidence-Based Telehealth Expansion Act of 2017, was introduced late last week and would give the Health and Human Services secretary the authority to waive Medicare restrictions on the kinds of telemedicine it covers -- as long as the actuary at the Centers for Medicare and Medicaid Services concludes it would indeed save money.
Restrictions that would be lifted include any geographic limitations, as well as limitations on the use of store-and-forward technologies. Store-and-forward technologies are where patient healthcare data and digital images -- such as radiologic images -- are captured, packaged as a case file, and transferred via telecommunication services to a clinician who then responds with a diagnosis and any relevant therapeutic recommendations.
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Epic dominates among providers eyeing an outpatient EHR change, but athenahealth is creeping in

HIMSS Analytics found 51 percent of providers are considering Epic while 26 percent are looking at athenahealth.
July 31, 2017 09:57 AM
The outpatient electronic health record system market is an epic market – one might also say it’s an Epic market.
When purchasing a new ambulatory EHR, or replacing or upgrading an existing ambulatory EHR system, 51.4 percent of healthcare provider organizations are considering EHR vendor Epic, up from 45.1 percent in 2016, according to the new HIMSS Analytics 9th Annual Outpatient PM and EHR Study.
 “The market has gone back and forth for decades around the benefits of best of breed versus a single, integrated solution,” said Bryan Fiekers, senior director of research services at HIMSS Analytics. “As healthcare drives toward accountable care and value-based care, the integration of solutions and the flow of data across the enterprise becomes more critical.”
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Congressman wants to integrate patients’ addiction treatment records with EMR data

Jul 31, 2017 at 2:02 PM
The quest to digitize behavioral health data has focused on doing a better job of integrating what have historically been disconnected parts of healthcare — mental health treatment and primary care. Much of the mental health community have resisted the push to go digital over concerns that patients’ psychiatric data will be less secure and vulnerable to the kind of cyberattacks we’ve witnessed in the healthcare industry with greater frequency. And yet, that has not deterred digital health companies such as Quartet Health, Lantern, AbleTo, and SilverCloud Health from developing products aimed, at least in part, at resolving this integration of care challenge.
This effort dovetails with the management of substance abuse treatment records, which in some ways is just as sensitive an issue, if not more so. In an effort to make information about patients’ substance abuse history more accessible to clinicians as a way to improve their treatment, Pennsylvania Congressman Tim Muphy has introduced a bill that would extend Health Insurance Portability and Accountability Act (HIPAA) protection to the records of patients treated for substance abuse. The Overdose Prevention and Patient Safety Act would also make it easier for patients to allow these records to be shared between physicians at different health systems. Current law requires patients to sign off on each individual provider who can view these records.
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HIT Think Why robotics and AI still face an uphill battle in healthcare

Published August 01 2017, 4:09pm EDT
While artificial intelligence and robotics have the potential to solve many of today’s healthcare challenges, several obstacles must be overcome for these technologies to dramatically improve our care delivery system.
Artificial intelligence (AI) refers to the use of algorithms that approximate human cognition in the analysis of complex medical data, with the aim of determining relationships between prevention or treatment techniques and patient outcomes. Robotics primarily deals with the design, development and operation of robots for activities such as patient monitoring and evaluation as well as surgical assistance. Together, AI-powered robotics have the potential to completely change the way healthcare is delivered, as machines may someday become powerful and smart enough to replace physicians and medical staff.
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How Clinical Informatics is Gaining Traction at Stanford Children's Health

Alexandra Wilson Pecci, August 1, 2017

Clinical informaticists have a deeper understanding of the opportunities and the limitations of information science, says Stanford Children's Health's chief medical information officer.

This is part two of a conversation with Natalie M. Pageler, MD, chief medical information officer at Stanford Children's Health about some of the clinical decision support tools that the hospital is developing. Read part one.
She is also clinical associate professor of pediatric critical care and Stanford University.
This conversation covers development costs, the evolution of clinical informatics as a subspecialty, and what the Stanford Children's team is working on now. The transcript below has been lightly edited.
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'OpenEHR can reduce the risks of vendor lock-in and enable innovation'

Article posted on: July 11, 2017
 (HealthTech Wire / Interview) – Tomaz Gornik, co-founder of health IT solutions provider Marand, talks about the benefits of openEHR, which include reducing the risks associated with vendor lock-in and supporting innovation
What is openEHR and why is it important for today’s healthcare organisation?
openEHR is an open standard specification that describes the management and storage, retrieval and exchange of health data in electronic health records (EHRs). In openEHR, all health data for a person is stored in a lifetime, vendor-independent, citizen-centered EHR.
The role of openEHR is different depending on the maturity of the market we’re dealing with. In greenfield situations - our customers in Moscow and the Philippines, for example - where they do not have any substantial IT architecture, it’s a no-brainer to implement openEHR infrastructure - because they will want to start off as they mean to go on - and avoid any interoperability issues later down the line. In the developed market where there is legacy software, this journey is much more complex, because you can’t simply move the data over from a closed data model to an open one. Here we use the openEHR as an innovation platform, placing it next to the existing core applications, integrating it with legacy systems data, then using its open APIs to build new and innovative apps and applications. We call this the Postmodern EHR.
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Republicans shellshocked by health defeat split on next steps

Published July 28 2017, 4:38pm EDT
 (Bloomberg) – Republicans in Congress have been unable agree on a way to repeal and replace Obamacare – and now they’re divided on whether they should give up on their GOP-only approach.
Senator John McCain urged fellow senators Friday to "start fresh" and seek a bipartisan plan, hours after he provided the decisive vote against his chamber’s latest Obamacare-repeal proposal. "We can do this," the Arizona Republican said in a statement.
Other Republicans insist they got too close to a GOP-only agreement on demolishing Obamacare to turn back from that idea. The Senate fell one vote short of advancing a partial repeal of Obamacare early Friday, with opposition from McCain and two other Republicans. In May, the House passed its replacement plan on a razor-thin 217-213 vote.
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Cerner posts all-time high of $1.6 billion in second quarter bookings

In the first earnings call since the passing of CEO Neal Patterson, the company also revealed a 6 percent uptick in revenue and offered updates on its work with the DoD and VA.
July 28, 2017 01:10 PM
Cerner's bookings rose 16 percent to a best-ever $1.6 billion in the second quarter of 2017, company officials said on Thursday.
Revenue for the second quarter was in line with the company's guidance range at about $1.29 billion, up 6 percent compared to $1.21 billion for the same period in 2016.
"We are pleased with our execution in the second quarter, which included all key metrics being within or above our targeted ranges," said Cerner President Zane Burke. "Our record bookings reflect Cerner’s strong competitiveness and good marketplace activity."
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Zuckerberg-backed initiative at UCSF looks to merge EHR data across 5 medical centers

Jul 31, 2017 10:33am
UCSF plans to advance precision medicine efforts through new research that pulls in EHR data from across five medical centers.
Backed by a $10 million grant from Facebook founder Mark Zuckerberg and his wife Priscilla Chan, M.D., the University of California San Francisco (UCSF) has launched a new research initiative aimed at consolidating health data across five UC medical centers into one broad research database.
The funding will go toward the UCSF’s Institute for Computational Health Sciences (ICHS), led by Atul Butte, M.D., who was named the Priscilla Chan and Mark Zuckerberg distinguished professor at USCF, according to an announcement from the University.
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AMIA Submits ONC Interoperability Framework Recommendations

AMIA recently submitted comments on the ONC interoperability framework, recommending increased automation in measure reporting and a focus on more high-value standards and use cases.

July 27, 2017 - The American Medical Informatics Association (AMIA) recently submitted a letter to National Coordinator for Health Information Technology Donald Rucker, MD with recommendations to improve the ONC Interoperability Framework.
Representing 5,400 informatics professionals, the association expressed its support for the development of a measurement framework for interoperability standards and emphasized the importance of drafting a framework that benefits providers and reduces administrative burden.
In particular, AMIA recommended that measurement and measure reporting be automated wherever possible, high-value standards and use cases be targeted, and value be delivered to stakeholders being measured.
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Cognitive computing will bring increased intelligence to EHRs

July 26, 2017
The typical electronic health record (EHR) system holds more information than any one person could analyze, as do all the medical journals and medical data repositories that exist.
But physicians could soon leverage all of that information to make better decisions, according to leading health IT experts, as EHRs and other healthcare software systems begin to incorporate cognitive computing.
Cognitive computing, a branch of artificial intelligence, harnesses self-learning systems, data mining, natural language processing and other technologies to analyze information, identify patterns and draw conclusions – just as the human mind does, only on a vastly larger scale and speed.
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HIT Think 4 ways an integrated EHR can improve cancer management

Published July 31 2017, 3:53pm EDT
Even though cancer cases continue to be on the rise worldwide, death rates are dropping as a result of shifts in lifestyle, early detection and new treatment options.
With more people living with cancer, care delivery often involves managing complex treatment regimens with additional co-morbidities, creating a greater need to bridge gaps across care settings and provide simplified care while maintaining patient safety.
An integrated care delivery system can bridge those gaps across the continuum and enable patients and providers to take proactive steps that will continue the trend toward positive outcomes. At the same time, an integrated EHR can help streamline clinical and billing processes, resulting in more satisfied patients as well as a healthier bottom line for organizations.
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Dramatic Surge in Healthcare Cybersecurity Breaches Since 2015

Philip Betbeze, July 31, 2017

A KPMG survey shows that 47% of healthcare payers and providers experienced security-related violations or cyber-attacks that compromised data in 2017, yet 87% rated their readiness to defend at four or better on a five-point scale.

There are two types of payers and providers: Those who have been the victim of a cyberattack and those who will be. At least that’s a reasonable conclusion based on responses from senior leaders in the healthcare provider and payer sectors to the comprehensive 2017 KPMG Cyber Healthcare & Life Sciences Survey.
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Enjoy!
David.


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