FDA not planning to establish guidance on CDS in 2017

Software developers who were expecting that the Food and Drug Administration’s Center for Devices and Radiological Health might release draft guidance on clinical decision support (CDS) software have once again been disappointed.

In accordance to the FDA, its Center for Devices and Radiological Health (CDRH) is considering establishing a variety of guidance in fiscal year 2017, involving its so-called “A-List” documents, those that the organization intends to publish between the time period of Oct. 1, 2016 and Sept. 30, 2017. Although, draft CDS guidance isn’t among CDRH’s priorities going into next year.

Among those disappointed that Clinical Decision Support (CDS) is not on the agency’s near-term agenda is Bradley Merrill Thompson, general counsel for the Clinical Decision Support (CDS) Coalition, which reflects software developers, providers, healthcare payers and medical device manufacturers.

“For the last 2 years, CDRH has placed in the category A priority list draft guidance on clinical decision support software. It is not on the list this year, despite the fact that CDRH hasn’t released the draft guidance,” says Thompson.

Thompson asserts that industry has been waiting for FDA guidance on CDS since the year of 2011. When it comes to software development, 5 years is an eternity, he asserts.

Without clarification on how the FDA plans to regulate CDS, the software category will sustain to be a gray area, leaving developers struggling to get funding and to put together business plans that precisely depict the expected regulatory path for their products, Thompson explains.

Survey results issued earlier this year by the CDS Coalition indicated that one-third of developers reported having to abandon CDS product development efforts due to the uncertainty over FDA regulations. Of those who pressed ahead despite the uncertainty, nearly two-thirds encountered significant delays.

In a written statement, an FDA spokesperson claimed that the agency is “carefully evaluating” the 21st Century Cures Act that was approved by Congress and signed into law earlier this month by President Obama, and it is “exploring all possible options for executing the responsibilities, involving the provision for clinical decision software, that we have been charged with under the new law.”

Thompson considers the FDA removed CDS from CDRH’s FY17 list of guidance documents because the agency plans to re-evaluate the requirement for CDS guidance in connection with implementing the 21st Century Cures Act.

“That legislation, in section 3060, adds the criterion that to be FDA regulated, Clinical Decision Support (CDS) software must not be transparent. In this context, transparent means that the doctor user can’t see through the software to the underlying sufferer data and the clinical logic applied by the software, such that the physician isn’t required to rely on the software,” claims Thompson. “My hope is that in connection with the legislation, FDA proceeds with the guidance, which is more significant now than ever before.”

Particularly, the CDS Coalition would like to comprehend how the agency plans to enforce the transparency concept. “The statute is very useful, but it will be very significant for FDA to express the agency’s views on how the language is to be interpreted and applied,” adds Thompson.

“I’ll be very anxious to see the FDA’s plans for implementing the Cures legislation,” he summarizes. “I certainly expect that they plan to proceed with this much required guidance.”

 

How digital technology will boost mergers and integration

Digital technology and the huge volumes of all kinds of data fueled by the Internet of Things (IoT) are driving vertical integration within the sector of healthcare, in accordance to a recent report from research firm Frost & Sullivan.

Boundaries between the segments in the industry are blurring as agencies seek to expand market reach, drive efficiencies and acquire opportunities emerging from technological advances, the report stated.

Digital technology will assist to support new models of care delivery, expanded access to healthcare services, better outcomes and efficiency, and greater value to all stakeholders. Although, agencies vary highly in their capacity to deliver such solutions, the firm pointed out.

“The imperative to add new Information Technology capabilities and innovate is driving a broad array of stakeholders to converge and collaborate, developing a heated healthcare deal landscape for conventional mergers and acquisitions, joint ventures and new kinds of less-formal partnerships,” claimed Nancy Fabozzi, transformational health principal analyst at Frost & Sullivan.

“Flexible deal structures like joint ventures and partnerships, in specific, give a faster, less-risky path to progress and innovation for healthcare agencies,” Fabozzi claimed.

Digital health strategic partnerships and joint ventures in the year of 2016 have focused on consumer engagement, wellness and analytics, the report stated. The aim for stakeholders is to foster clinically integrated and decentralized care systems that serve motivated, technology-savvy customers, who greatly value convenience and personalization.

“Several CEOs express a deficiency of confidence in their capability to victoriously execute on the partnership strategy,” Fabozzi claims. “Among the potential regions of concern are handling the disruption; establishing solutions to cater to cross-care continuum use from hospital to home; and zeroing in on business models that not just scale solutions but also meet the requirements of multiple client groups and global markets.”

 

Why Chief Data Officers will assists organizations cash in on data

At the end of 2015 year, research firm Gartner Inc. estimated that 25% of major international organizations had already hired a chief data officers (CDO). By the year of 2019, the firm hopes that number to reach 90%.

"This quick shift is the tip of the iceberg," claimed Ted Friedman, research vice president and distinguished analyst at Gartner. Agencies are increasingly finding they require studying results of their inner workings to make better the operations and results.

"It depicts a much deeper change occurring throughout most agencies. Practitioners of distinctive data and analytics disciplines will require broadening their understanding, and working more closely with others to identify the benefits of utilizing data and analytics to capture transformative business opportunities and reduce risks,” Friedman claimed.

Organizations are increasingly developing a single data and analytics team with a new leadership role, as the rise of the Chief Data Officers (CDOs) demonstrates, Friedman said. As silos are broken down, experts in this area increasingly are working on cross-functional teams.

The shift toward digital business is at its core a drive to better collect, handle and exploit information assets and apply analytics for richer insights, the firm stated. By the year of 2018, more than half of huge organizations will compete using advanced analytics and proprietary algorithms, disrupting entire industries, Gartner estimates.

This, in turn, is being driven by the proliferation of devices, connected "things," connectivity and computing power—all of which develops more opportunities to collect information, observe it and potentially acquire a financial return from the data they yield.

The opportunities to produce business value from data and analytics are practically infinite, Gartner stated.

 

FDA expands the approved use of Continuous Glucose Monitoring System

The Food and Drug Administration (FDA) has expanded the approved use of Dexcom’s G5 Mobile Continuous Glucose Monitoring system or CGM system, which could instantly replace fingerstick blood glucose testing for diabetes treatment decisions in diabetic sufferers 2 years of age and older.

In accordance to the regulatory agency, it is the 1st FDA-approved Continuous Glucose Monitoring system that can be utilized to make diabetes treatment decisions without confirmation with a conventional fingerstick test. Initially, the Dexcom system was cleared to complement—not replace—fingerstick testing for diabetes treatment decisions.

“The FDA works really hard to assist ensure that novel technologies, which can decrease the burden of daily disease management, are safe and precise," stated Alberto Gutierrez, director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health. "However this system still requires calibration with 2 daily fingersticks, it removes the requirement for any extra fingerstick blood glucose testing in order to make treatment decisions.

“This might permit some sufferers to handle their disease more comfortably and may motivate them to have routine dialogue with their healthcare providers about the use of real-time continuous glucose monitoring in diabetes management," further added Gutierrez.

Dexcom’s G5 Mobile CGM System uses a small sensor wire inserted merely below the skin that continuously measures and monitors glucose levels, sending real-time results wirelessly every 5 minutes to a dedicated receiver and a compatible mobile device—like the Apple iPhone—running a mobile app. Additionally, alarms and alerts notify consumers when there are glucose levels above or below user-set thresholds.

While the system calculates glucose in fluid under the skin that must be calibrated almost 2 times each day using blood obtained from fingerstick tests, Nicholas Argento, MD, an endocrinologist, claims that extra daily fingerstick blood tests are generally no longer essential because unlike other CGS systems, results from the device can now be used straightly by sufferers to make diabetes treatment decisions without confirmation from a traditional fingerstick test.

“We have seen CGM come from something that was sort of novel and experimental to now actually being the standard of care,” further adds Argento, who has Type 1 diabetes and personally uses the Dexcom Continuous Glucose Monitoring system. “What this system does is reduce the number of fingersticks and increases their level of blood sugar control by motivating sufferers to take action in a safe, discrete, accurate, and timely way.”

Argento points out that in addition to individuals with Type 1 diabetes there are an increasing number of patients with Type 2 diabetes using the Dexcom G5 Mobile Continuous Glucose Monitoring System. He also makes the point that consumers of the system are capable to designate “followers” like family members with whom they can share the CGM data through the app.

“This is a key benefit in specific for parents with young kids and teenagers that are now starting to drive. The technology permits caregivers to have their back and serve as their backups,” in accordance to Argento, who serves as the medical advisor to the diabetes program at the Howard County General Hospital, a Johns Hopkins System hospital in Columbia, Md.

In making its decision to expand the approved use of the CGM system, the FDA verified data from 2 clinical studies during which there were no critical adverse events were reported, according to the regulatory agency.

Nevertheless, the FDA released a written statement that “risks associated with use of the system might involve hypoglycemia or hyperglycemia in cases where data provided by the device is wrong and utilized to make treatment decisions or where hardware or set-up issues disable alarms and alerts, as well as skin irritation or redness over the device’s adhesive patch.”

Moreover, the agency cautioned users that the system “must be calibrated utilizing a fingerstick blood sample at least once every twelve hours and that taking any medications containing acetaminophen while wearing the system might wrongly raise glucose readings.”

 

HIT: IBM, Cleveland Clinic announces 5-year Agreement

Sustaining their decades-long relationship, the Cleveland Clinic and IBM have declared a 5-year compliance to expand the health IT capabilities of Clinics, involving the utilization of IBM’s secured cloud, mobile, social and Watson cognitive computing technologies across its clinical and administrative operations. IBM, Cleveland Clinic announces 5-year Agreement for establishing HIT.

Few of the aims of the cooperation involve developing a model for the transition of healthcare system to value-based care and population health, as well as disclosing potential standards that could be replicated by providers nationwide. IBM, Cleveland Clinic announces 5-year Agreement for establishing HIT.

“As the healthcare industry rises increasingly dependent on technology to deliver effective, high-quality and affordable care, the latest technology execution is created to enable efficient analysis of information from electronic health records (EHRs), information from administrative claims and social determinants of health, permitting for both personalized clinical care and broader population-focused management,” in accordance to the declaration from both agencies.

The Cleveland Clinic was an early adopter of the Epic EHR system, in accordance to Doug Smith, the agency’s interim chief information officer, who points out that the agreement with IBM will better capture the value of this data and modify patient care across its 9 regional hospitals and eighteen full-service family health centers. IBM, Cleveland Clinic announces 5-year Agreement for establishing HIT.

In accordance to Smith, “Predictive analytics and population health at the point of care is incredibly significant for how we’ll deliver care in the future. Analytics, cognitive computing, and advanced capabilities will enable us to give quality, affordable care.”

The cognitive computing capabilities of IBM’s Watson supercomputer have been a specific place of focus between Big Blue and the Cleveland Clinic over the last 5 years:

• 2011—After Watson’s victorious debut on Jeopardy!, IBM and Cleveland Clinic merged with forces to train the technology to “think” just like a doctor.


• 2013—IBM Research started a continual collaboration with Cleveland Clinic faculty, physicians and students to establish a Watson EHR assistant to assist physicians to quickly summarize and cull relevant insights from electronic health records.


• 2014—Cleveland Clinic started its pilot of Watson for Genomics to help its research into new cancer treatments deployed on a genetic makeup of patients. Cleveland Clinic sustains to use the technology for genomic interpretation.


• 2014—Cleveland Clinic and Case Western Reserve University declared that IBM Watson would play an important role as a tool to assist students observe symptoms deployed on evidence-based insights instead of rote memorization. The cognitive technology will become a significant part of a new $515 million Health Education Campus opening in the year of 2019.

“For the last 5 years, Cleveland Clinic has been vital to IBM’s effort to construct Watson’s cognitive capabilities in healthcare,” stated Deborah DiSanzo, general manager of IBM Watson Health. “Together, we’ll bring cognitive computing and a complete portfolio of IBM technology offerings to modify clinical care and administrative operations across the Cleveland Clinic, and assist its famous care providers deliver evidence-based, personalized and cognitive care to the individual sufferers they serve and the populations they handle.”

Additionally, Smith points to IBM’s 2015 acquisition of Explorys, a population health analytics vendor, which was established by Cleveland Clinic physicians and information technology experts before becoming a spin-off company in the year of 2009—as an instance of the technological cross-pollination between the 2 agencies. IBM, Cleveland Clinic announces 5-year Agreement for establishing HIT.

“It is been a mutually beneficial relationship. We are developing value for each other,” summarizes Smith. “That is the type of partnership it has been, and it’ll continue. The sky’s the limit.”

 

Survey: Half of adult females in Brazil avoid pregnancy because of Zika virus

More than half of adult females of reproductive age in the region of Brazil have actively attempted to avoid pregnancy due to the Zika virus epidemic, in accordance to a survey carried out there.

Brazil has assured far more malformations of the brain in babies born to mothers who were affected with Zika in contrast to any other country.

So far, there have been 1,845 confirmed cases of what is now being known as congenital Zika syndrome; a further 7,246 cases are suspected but the link to the virus hasn’t still been firmly developed.

The survey conducted in the month of June, supervised by academics in Brazil, indicates that 56 percent of females who responded have tried to avoid pregnancy as a result. The numbers are no different among those who explain themselves as having religious beliefs – 58 percent of Catholics and 55 percent of Evangelicals in the survey claimed they were ignoring pregnancy.

In a letter to the Journal of Family Planning and Reproductive Healthcare, Dr Debora Diniz from the institute of University of Brasilia and coworkers say there is an urgent requirement for Brazil to review its policies on family planning and abortion, to assist females who need to avoid pregnancy or the risk of having a baby with brain malformation.

“As demonstrated by the high proportion of females who avoided pregnancy due to Zika, the Brazilian government must place reproductive health uncertainties at the centre of its response, involving reconsidering its continued criminalization of abortion,” they write.

The government should make sure the better access to contraceptive techniques and information, they say, arguing for a broader range of techniques to be made available. Long-lasting reversible contraception like intrauterine devices are scarce, they say, and hormonal implants are unavailable through the public services.

Females’ groups are trying to challenge Brazil’s abortion restrictions through the courts, arguing that those affected by the Zika virus should be permitted a termination.

The team carried out a face-to-face survey of more than 2,000 females, who are literate and between the ages of 18 and 38, which corresponds to 83 percent of the women population.

They discovered that 27 percent hadn’t tried to avoid pregnancy and 16 percent were not planning to become pregnant anyway, regardless of the Zika epidemic.

The response depicts the geographical affect of the epidemic, with a larger proportion of females from the hard-hit north-eastern region (66 percent) trying to avoid pregnancy in contrast to the south (46 percent).

“Black (64 percent) and brown (56 percent) females were more likely to report ignoring pregnancy than white women (51 percent), which also likely depicts the disproportionate effect of the epidemic among the most vulnerable racial groups,” they write.

An estimated 174,000 Brazilians are claimed by the ministry of health to have been impacted with the Zika virus, however the last updated figure was in early July.

 

Next Year: Meaningful Use Penalty to struck 171,000 Clinicians

171,000 physicians, nurse practitioners, and other clinicians will take a 3 percent pay cut next year from Medicare for failing to indicate that they met the requirements of government for meaningful use of an electronic health record (EHR) system in the year of 2015, the Centers for Medicare & Medicaid Services (CMS) has declared. Meaningful Use Penalty will hit 171,000 clinicians next year.

A government liaison for a huge medical association blames Centers for Medicare and Medicaid Services (CMS) for setting up clinicians to fail in the controversial EHR incentive program. Although, there is hope that the incoming administration of President-elect Donald Trump may undo the damage.

The snafu, stated Robert Tennant, director of HIT policy for the Medical Group Management Association (MGMA), goes back to the day of October 6, 2015, when CMS released its final Stage 2 rules for acquiring meaningful use that year and ignoring a meaningful use penalty in 2017. The organization said clinicians needed to meet the requirements only during a ninety-day stretch of 2015 year. Although, there were fewer than ninety days left in the year of 2015 by October 6.

Fearful of widespread penalties, Congress approved a bill in the year of December 2015 that permitted CMS to depart from its usual policy of granting meaningful use hardship exemptions on a case-by-case basis and grant 1 for a whole category of physicians who were beset by “extreme and uncontrollable circumstances”.

Several physicians apparently did not take advantage of this escape hatch, provided the multitude confronting a meaningful use penalty next year, MGMA's Robert Tennant claimed.

Inquired if CMS was responsible for several physicians flunking meaningful use in the year of 2015 by releasing its final regulations so late that year, Tennant replied, "Absolutely." CMS didn’t respond to a request for a comment on the matter as of 5 PM CST today.

After Trump takes office next month, MGMA might inquire the US Department of Health & Human Services (HHS) to waive the penalty, Tennant stated. "It’ll be a tough sell," he claimed. "My guess is, the Trump administration will have greatest fish to fry in healthcare."

The choice of Trump to head HHS is Rep. Tom Price, MD (R-GA), a fierce critic of government regulation in healthcare. "We might have a more sympathetic ear should Dr Price be confirmed as HHS secretary," Tennant claimed.

One flaw to a waiver of the next year's meaningful use penalty, he pointed out, would be the requirement to reprocess potentially millions of Medicare claims paid for services rendered beginning on the day of January 1 at the reduced rate.

The number of clinicians confronting a meaningful use pay cut in the year of 2017 is down from 209,000 penalized in the year of 2016, and 256,000 in 2015. The previous year for a penalty — and the EHR meaningful use program itself — is 2018. Although, elements of meaningful use will live on in the latest reimbursement system developed by the Medicare Access and CHIP Reauthorization Act (MACRA).

 

Massive LA County cyberattack impacts 756K people

Massive LA County or Los Angeles County in the recent days has started to notify over 756,000 people of a massive cyberattack that happened in the month of May 2016 across several county departments, involving healthcare, mental health and public health services.

Most of the affected people had contact with the Department of Healthcare Services, the Los Angeles Times reports.

The attacker sent phishing emails to almost 1,000 county workers, and 108 of them clicked on the message and provided usernames and passwords, in accordance to a notice from the county. As has become usual in the time period of cyber attacks, notification to impacted people was delayed far past the HIPAA requirement of sixty days from discovery of a breach at the appeal of law enforcement agencies. The agencies mostly are investigating several breaches launched by the similar attacker, find other HIPAA cover entities that were hit and then notify them.

Compromised information at the massive LA County involved names, dates of birth, Social Security numbers, driver’s license or state identification numbers, home addresses, phone numbers, payment card and bank account data, and medical data, like insurance identification number, diagnoses, treatment histories and medical record number. A known suspect is being sought with an arrest warrant released for a person with Nigerian citizenship, account to the county notice.

The county is providing identity monitoring services to affected people for 1 year; the services involve credit monitoring, identity consultation and identity restoration. Although, attackers usually now wait until after protective services end before using the stolen data.

This isn’t LA County’s 1st key breach of protected health information. The theft of a laptop at a regional office in the year of 2013 affected 18,162 people. The county also was the victim of a huge breach in the year of 2014, when business associate Sutherland Healthcare Solutions had 8 computers stolen, impacting more than 300,000 people. Following the latest breach, the massive LA County has enhanced its cybersecurity awareness training.

 

Cyber Attacks: Ransomware attacks against providers likely to escalate

Skilled nursing facilities, Hospitals, ambulatory surgical centers, MRI/CT scan facilities, diagnostic laboratories, urology centers, physical therapists and physician practices all had one thing in usual this last year. They were victim of cyber attacks.

Market forces will not be altering any time soon, meaning they will sustain to confront an increasing number of issues, specifically ransomware attacks. No one is safe, in accordance to TrapX, a vendor of software to disrupt cyber attacks, in a latest report.

“2 primary trends have emerged with absolute clarity in the year of 2016; the continual discovery and evolution of medical device hijack and the escalation of ransomware across a broad mix of targets,” in accordance to the firm.

Most providers almost install anti-virus software and a firewall, so the majority of their infrastructure is protected, claims Anthony James, chief marketing officer at TrapX. But MEDJACK was developed to attack medical devices, which mostly operate on old versions of Microsoft Windows, so applicable patches might not be available.

Subsequently, medical devices have become a vital open door to MEDJACK attacks, and vulnerable devices involve infusion pumps, CT scanners, ventilators, heart-lung machines, dialysis machines, blood gas analyzers, extracorporeal membrane oxygenation machines, PACS, portable c-arm X-ray machines and other devices. When TrapX representatives visit a hospital, they often always find MEDJACK or other malware on specialized medical devices.

Most of the cyber attacks can be prevented by a second-generation perimeter and second-generation endpoint defenses, but most hospitals do not have this technology, James adds.

Throughout the year of 2015, TrapX discovered MEDJACK almost everywhere. “Many hospitals don’t seem to be capable to track MEDJACK or remediate it,” in accordance to the report. “The great majority of cyber defense suites aren’t capable to trace attackers moving laterally from these hidden sites. Even when they are traced, attempting to remediate an attack in 1 medical device is mostly annoying (and futile) as other attacks propagate again almost instantly and undetected through several medical devices within the hospital, which also go untracked.”

To date, healthcare ransomware and cyber attacks are up 63% in the year of 2016, in contrast to previous year, James claims. There are so many health records being provided for sale that the charges for stolen data have plummeted. A single comprehensive health record fetches over $10; TrapX was provided a set of 3,000 records for $2,000—80% of its content was medical information, while the remaining data was Social Security, credit card and W-2 information.

So with costs no longer optimal, several hackers have shifted to using ransomware, which determines them to get high returns much quicker. While law enforcement organizations and attorneys compel providers not to pay ransom, reasoning that a hacker will merely demand payment of subsequent ransoms, major numbers of victims are paying up to get their data back, James elaborates.

The math is very easy and simple. If a hospital is attacked and doesn’t pay ransom, the agency might have to divert sufferers while it regains its data. A hospital client informed TrapX that the financial loss could be $1 million a day for each day down in immediate revenue and future business if sufferers have to go elsewhere for treatment.

“That is why individuals are paying,” James claims. The report of TrapX is available here.

 

How information from Lyme disease study can affect the patient care

Information from a major Lyme disease study, which impacts 380,000 Americans yearly, indicate the benefits of early diagnosis but also the failure of physicians to rightly diagnose the disease.

Transmitted by the bite of ticks, specifically infected black-legged ticks, people might not even know they have been bitten, which can delay diagnosis. But preliminary analysis in a survey of almost 4,300 sufferers with results presented at the latest Columbia University/Lyme Disease Association Conference finds a third of sufferers diagnosed early reporting being well; by contrast, just 9% of those whose diagnosis was delayed reported that they felt well.

Even so, most sufferers diagnosed early, 68%, reported that their condition was worse, even with early identification of the sickness.

Information in the research comes from the MyLymeData patient registry that has enrolled more than 6,500 sufferers who input data about their condition and experiences with the illness.

“Patient-powered registries that pool huge amounts of information will be a game changer for misunderstood sicknesses like Lyme disease,” claimed Lorraine Johnson, CEO at Lyme Disease.org. “Big data holds the key to future diagnostics and treatments for sufferers.”

Johnson considers the recently enacted 21st Century Cures Act will give required support to patient-driven observational researches, using real-world evidence to make better care.

With data from thousands of sufferers now in the registry, the Lyme disease study is expanding to detect the course of ailment and responses to treatment. Existing registered sufferers and new patients coming into the program are motivated to complete new survey sections. Further information, involving a list of symptoms, is available here.

 

Data Breaches: Clinician sharing of data a key reason for breaches

An analysis of 5 years of data from a database of huge data breaches impacting nearly 500 individuals finds that in the year of 2016 the reporting of such breaches exceeded 300 for the 1st time.

The analysis of the database, operated by the Office for Civil Rights for the Department of Health and Human Services, comes from Safetica North America. It discovered that well-intended clinicians sharing data results in a 10% breach growth rate yearly; and this sharing is the major driver of data breaches, claims Luke Walling, general manager at Safetica, a data loss prevention vendor operating in the region of Europe for 7 years that started operations in the U.S. in the month of September.

When the 10% of well-intended sharing is combined with other tragedies of unauthorized access and disclosure, that category accounted for 41.5% of data breaches during the year of 2016, compared with 25% in the year of 2014. Hacking accounted for almost 32% this year, compared with 14% of tragedies in the year of 2014. Other breach rates in 2016 involved theft (19%), loss (5.4%) and inaccurate disposal (2.3%).

“Workers or associates accessing and sharing data they should not—or revealing it to people they should not—was the single greatest breach factor this year,” in accordance to the analysis.

As 2016 draws to a close, 15.2 million records have been compromised. That is is a lot, but the 2015 number was 113.3 million following a series of very huge attacks that involved the Anthem hack that accounted for 70% of all breaches in the year of 2015.

Medical records’ theft fell to its lowest level this year since the year of 2013, with better security education and protection of documents, as well as better devices to police networks and employee actions, claims Walling.

Hacking in the year of 2017 could really take a dip as healthcare agencies get better at controlling what they can control, and security technology and best practices also sustain to improve, Walling assumes. Although, it is wise not to get complacent, he warns. “The issue with phishing is it still works. It is immensely tough for anyone to distinguish between real and malware emails, so you have to make certain the data cannot leave the agency.”

That leads to another issue—permitting the flow of data without affecting how individuals do their jobs. Encryption obviously is a powerful protector of data, but users do not need to have to consciously decrypt and encrypt data.

Tools are available that develop rules for how files move throughout a network. A rule, for example, could auto-encrypt a file, decrypt the file to use it, and then re-encrypt it, Walling claims. “These rules make files accessible and the encryption and decryption procedures are invisible to the consumer”.

 

HIMSS guidance investigates latest malware, ransom threats

A recent cybersecurity environmental scan report from the Healthcare Information and Management Systems Society (HIMSS) investigates new malware and ransom threats, provides new guidance from various sources and involves few new services from vendors.

For example, The United States Computer Emergency Readiness Team has issued an alert on the Avalanche botnet that distributes malware to victims and provides remediation measures. Information from the Internal Revenue Service can assist healthcare agencies targeted by tax fraud schemes.

Newer ransom threats involve GoldenEye, which is similar to Petya and Mischa malware and encrypts files while also locking the hard drive of computer. And then there is Popcorn Time, which is ransomware that doesn’t need a payment from its victims if they attempt to infect a couple friends, HIMSS reports.

Another innovation: To decrease credit card fraud with “card not present” transactions, OberThur Technologies makes a credit card with a security code that refreshes automatically and randomly each hour.

The HIMSS guidance further involves a link to Nova Labs, which provides a virtual cybersecurity lab to raise awareness within agencies. The lab is a game where players defend a company increasingly under attack by making better the defenses, cracking passwords and creating code.

The report of cybersecurity environmental scan is available here.

 

 

Startup-led team succeeds in FDA opioid overdose app contest

The Food and Drug Administration has chosen a team supervised by a small Venice, Calif.-based startup as the winner of an industry challenge to establish a mobile app to assist connect opioid consumers experiencing an overdose with nearby carriers of the drug naloxone for emergency treatment. Startup-led team has got victory in FDA opioid overdose app contest.

The OD Help app, established by Team PwrdBy, beat 44 other submissions to take home the cash prize of $40,000, claims Peter Lurie, MD, the FDA’s associate commissioner for public health strategy and analysis. Startup-led team has got victory in FDA opioid overdose app contest.

“OD Help is a convenient, easy-to-use mobile app created to connect potential opioid overdose victims with a crowd-sourced network of naloxone carriers,” wrote Lurie in a December 15 blog, further adding that the app “can conveniently be tailored for use in rural or urban regions by expanding or contracting the radius within which naloxone carriers are sought.”

In the month of September, the FDA inaugurated the Naloxone App Competition in an attempt to tackle the dramatic increase in the number of U.S. opioid overdose deaths, several of which could be ignored if people experiencing an overdose had immediately got the life-saving medication, in accordance to the regulatory agency. Although, until now, no app has been available to connect those carrying naloxone with nearby opioid overdose victims.

Among other significant features, OD Help has an optional interface with a breathing monitor to track when a victim’s breathing rate is very low, a symptom of an opioid overdose. “Therefore, if the victim is alone and not able to call for help, OD Help will track the diminished breathing and alert a naloxone carrier of the potential overdose,” Lurie stated.

Other characteristics of the FDA opioid overdose app involve: just alerting people in one’s support network and permitting naloxone carriers to disable alerts when they are not able to respond, as well as giving instructions on how to rightly diagnose an overdose/administer naloxone and contact emergency medical services when assistance is needed.

Lurie asserts that OD Help “has the potential to make a real difference in the fight against opioid overdose.” Representatives from PwrdBy weren’t instantly available for comment.

The FDA hosted a code-a-thon October 19 and 20 at its White Oak campus in Silver Spring, Md., to establish the concepts and initial prototypes. More than 100 people participated either in-person or virtually in the 2-day event.

The rules of the competition needed participants to submit a video of a functional app prototype along with a comprehensive summary of their concept for a crowd-sourced mobile phone app that could assist to accelerate delivery of naloxone to a person experiencing an overdose. The video of the OD Help app can be viewed here.

CMS Analyzes Meaningful Use Reporting Requirements of 2016

Those attesting to meaningful use in the year of 2016 should take note of modifications in secure direct messaging and public health reporting requirements. CMS is reminding the eligible providers over the 2016 meaningful use reporting requirements for the EHR Incentive Programs, involving added flexibilities. CMS has reviewed the Meaningful Use Reporting Requirements of 2016

In a public statement, the organization analyzed the modifications and changes for secure electronic messaging reporting requirements. For this reporting period, eligible professionals (EPs) must send or receive a secure electronic message from nearly 1 unique patient utilizing the certified EHR technology (CEHRT).

CMS has also made certain changes to public health reporting requirements, easing the requirements under this measure. In the 2016 reporting period, eligible professionals must attest to two measures, while eligible hospitals and critical access hospitals must attest to 3 measures. They might also claim alternative exclusions.

In accordance to CMS, it has executed these flexibilities over time to help providers who are scheduled to be in an earlier stage of the programs, impacted by a significant hardship, or executing or upgrading their CEHRT.

Attestation for the 2016 reporting period starts on the day of January 1, 2017, and lasts until the day of February 28, 2017.

 

Data product to enable research, Improve patient care on human genome

As human genome is increasingly incorporated in sufferer records and research databases, IT will be challenged to sort through the huge amounts of data to enable research and make better the patient care.

That is the promise of latest technology launched by a Canadian company, which is making a product intended to assist large provider research agencies that will require managing massive databases to facilitate precision medicine applications.

PHEMI, deployed in Vancouver, is publishing PHEMI Central Precision Medicine Edition to deal the data issued posed by human genome and genomic research. The company assumed that 100 million to 2 billion human genomes will be sequenced in the next decade, with a single human genome predicted to fill at least three gigabytes of data.

The product works of company “out of the box” and utilizes the Oracle Big Data Appliance and is constructed on Hadoop Big Data technology, enabling it to take in millions of variants in less than a minute and give sub-second query response times. The vendor claims these capabilities can assist reduce the time researchers and analysts spend loading, searching and observing vast amounts of genomic and phenotypic data, as well as drive better understanding of disease and treatment options.

“Our clients in precision medicine have informed us they require 2 key things: a unified view across genotypic and phenotypic information at the whole genome level for hundreds of thousands of samples, and the capability to look up and query that information at speed,” claims Paul Terry, PHEMI’s CEO. The product offers “interactive performance across the genotype and phenotype at scale, independent of the amount and kinds of data in the system.”

Standard interfaces within the PHEMI offering give integration with existing analytics tools, while PHEMI’s built-in data management and privacy functionality implement rightful access to data. PHEMI Central Precision Medicine Edition offers the means to combine genotypic, phenotypic and clinical information from individual silos, annotate it using several reference datasets, as well as index and query it at speed and scale to drive discovery and better understanding of disease and treatment options. It’s available as a managed cloud service or on-premise.

 

Sequoia Project establishing new patient identity matching workgroup

The Sequoia Project which operates the eHealth Exchange, a national health information network, is calling on industry stakeholders along with policy and technical professionals to merge with a new workgroup to seek ways to improve and better standardize patient identity matching without utilizing a national patient identification number.

A patient identity matching framework is composed of a set of resources and reference materials, involving substantial demographic data, to enable a provider agency to rightly recognize its sufferers and to match those sufferers when they get treated at other provider agencies, explains Mariann Yeager, CEO of Sequoia. It can be done in healthcare, she asserts, adding that, “Financial institutions have been doing this for years.”

But in healthcare, worst data quality leads to matching mistakes, further hampered by varying ways of formatting the data. “It boils down to the registration procedure and checking to make certain a patient already has a record,” Yeager points out.

The aim of the patient identity matching workgroup will be to develop common problems that relate to suitable patient matching, and rules to be consistently applied, she further adds. Healthcare continues to be an industry of separate agencies each working within their own silo, which further exacerbates appropriate and precise patient matching. Most organizations identify sufferers inside their enterprise but do not think about the other provider down the road.

Subsequently, Sequoia seeks 9 to 12 workgroup members that need to achieve a standardized way to identify sufferers across the industry by using existing technologies that can support 95% of the work. This, although, will rely on agencies providing adequate resources for the job and management commitment, Yeager claims. “You require someone responsible for making it happen with resources available.”

A report, which involves a comprehensive explanation of the need to develop minimally acceptable practices for patient matching, is available here. Individuals interested in joining the workgroup can get an application by emailing admin@sequoiaproject.org.

 

ONC provides challenge to establish latest HIPAA privacy notice

The Office of the National Coordinator for Health Information Technology has inaugurated a challenge for software developers, health data privacy professionals and other stakeholders to update and modify the voluntary Model HIPAA Privacy Notice to be more applicable in today’s mobile health atmosphere.

“The health information technology market has changed significantly in the past 5 years, and there is now a larger variety of products, like mobile applications and wearable devices, that gather digital health information,” ONC elaborates.

Some $35,000 in prizes will be granted in the challenge to establish new HIPAA privacy notice; entries should be submitted to the Challenge.gov website by the day of April 10.

ONC needs participants to utilize content from the existing Model Privacy Notice template “to establish an online tool that can produce a user-friendly snapshot of a product’s privacy practices,” in accordance to ONC. The content will assist developers to create a HIPAA privacy notice that is more convenient to understand.

The current model privacy notice dates back to the year of 2011. It was established in concert with the Federal Trade Commission and focused on personal health records, which were an emerging technology at the time period.

For the latest notice, ONC in the month of March 2016 asked stakeholders for ideas on privacy and security practices that should be on the new notice and how to explain the practices. These comments should assist to inform developers in the new project, ONC stated. Further information is available here.

 

Breach: Quest Diagnostics breach impacts 34,000 individuals’ info

Quest Diagnostics, a famous nationwide healthcare laboratory chain that also sells a suite of information management systems, has informed 34,000 people about Quest Diagnostics breach that few of their protected health information was compromised after an internet application on its network was suddenly hacked.

The impacted application was MyQuest, a patient portal enabling people to access health information and test results from Quest Diagnostics. The app also enables people to schedule an appointment, share health information, and it helps in offering tracking and reminders on medication.

Accessed data involved patient names, lab results, birth dates and few telephone numbers, in accordance to a statement from the company. Social Security numbers, credit card numbers, insurance data and financial data weren’t impacted. Evaluation of information systems sustains to be ongoing.

“There is no prove that information of people has been misused in any way,” the company claimed in a statement. The company is not providing credit and/or identity theft protection services, in accordance to a spokesperson, but sufferers with key concerns are encouraged to call Quest at 888-320-9970.

This tragedy, which will be posted on the HHS Office for Civil Rights web site of breaches impacting 500 or more people, is the 1st major breach for Quest as Quest Diagnostics breach.

 

Major industry groups to keenly enhance best practices for mobile app use

3 major provider associations and an advisory firm have devoted to establishing and promoting best practices for mobile app use.

The alliance, known as Xcertia and operating as a not-for-profit corporation, involves the American Heart Association, American Medical Association, Healthcare Information Management and Systems Society, and DHX Group, which works and functions with stakeholders to accelerate development of digital health via industry collaboration. The group seeks more participants, involving developers, consumers, privacy and security experts, and the academic community, among others.

Xcertia will develop and promote best practices for mobile app use selection to foster use of safe, effective and reputable technologies. HIMSS this week debuted Xcertia at its Connected Health Conference at the Gaylord National Resort and Convention Center in Oxon Hill, Md. The alliance hopes to release its 1st content later in the year of 2017.

The driving force behind the step was the need to expand ongoing attempts to foster safe, effective and honorable health technologies to bring clarity and focus to the marketplace, claims Eric Peterson, chair of the American Heart Association Center for Health Technology and Innovation.

The AMA was encouraged to join Xcertia because its House of Delegates has an established policy for the association to assist develop guidance for the mobile space and be part of the digital strategy of the industry, claims Michael Hodgkins, MD, the group’s chief medical officer. “Our significant focus is to make it more convenient for doctors and consumers to choose the right apps.” Those apps, he adds, should be patient-centered, evidence-based and generate actionable information.

Consumers require asking the right questions about mobile app use before buying them, and app developers should support them and provide answers, the AMA asserts. The first job for workgroups will be to look at what kinds of content already are in the market and incorporate instructions, Hodgkins claims. “This is a void that requires being filled given growth in the mobile market and a rapid shift to value-based care.”

Further information on joining Xcertia is available here.

 

Groups insisting for wireless health technologies compliance

Two major organizations pursuing the wider use of digital, connected and wireless health technologies have combined, consolidating the tasks to foster the utilization of new IT in the healthcare industry.

The Wireless-Life Sciences Alliance (WLSA) has merged its operations with the Personal Connected Health Alliance, a not-for-profit organization developed by the Healthcare Information and Management Systems Society (HIMSS). In return, the Personal Connected Health Alliance has accepted and adopted the WLSA membership model. WLSA’s executive-level engagement and Convergence Summit activities will be enabled into the Personal Connected Health Alliance’s annual conference.

Robert B. McCray, co-founder and CEO of WLSA, has been entitled as a senior advisor of thought leadership for the alliance and will serve on its board of managers.

"This alliance with PCHAlliance and the merger of our activities depicts an exciting chance to more effectively foster international relationships and business opportunities for our members and offer increased visibility in the connected health ecosystem", claimed McCray.

WLSA was developed in the year of 2005 and has emphasized on digital, connected and wireless health technologies driven by science, medicine, technology, and engineering and big data analytics. It developed the Wireless Health Conference series to give a cross-disciplinary research forum for the field. That occasion, hosted in collaboration with leading institutes and academic institutions, will sustain through collaboration with IEEE/EMBS and with the collaboration of the National Institutes of Health and the National Science Foundation.

PCHAlliance executives claim that the organization's aim is to assist people to make health and wellness an effortless part of daily life. The Alliance is convening the global personal connected health community—technology companies, payers, governments, healthcare providers and the public—to modify the technical, business, policy and social initiatives essential to advance the field. Among its tasks, PCHAlliance established and promotes technical standards, facilitates collaboration, shares research, convenes conferences and advocates policy to assist advance personal connected health.

 

Providers face problems in transitioning to value-based care

As providers seek to transformation from fee-for-service to value-based care, they are encountering important problems in transitioning to value-based care, involving restricted access to claims data, risk-based insurance agreements, as well as investment capital.

That is the finding of a latest survey of its members undertook by the American Medical Group Association (AMGA), which depicts medical groups, health systems and other organized systems of care. The 2nd annual survey involved 115 respondents representing 168 member agencies.

However, 58% of those surveyed by AMGA are eager to accept alternatives to fee-for-service payments—involving downside risk—within 2 years, in accordance to Chester Speed, AMGA’s vice president of public policy, the transitioning to value-based care is slowing measurably due to a number of factors. Speed points out that the impediments recognized in its 2016 survey are highly the same as those identified in the year of 2015.

Among the barriers to risk identified in the latest AMGA survey:

• Immature risk market: 64% report none to restricted commercial value-based or risk-based products in their regional markets.

• Deficiency of access to claims data: Providers aren’t able to access administrative claims data from entire payers—without which it is almost impossible to handle quality and cost.

• Non-standard data: Providers have to submit information in different formats to different payers, developing a massive administrative burden.

• Restricted access to capital: Deficiency of capital is an acute problem that delays investments in the infrastructure essential to take risk, which also drives consolidation.

• Inadequate infrastructure: Necessary systems—involving information technology—is costly and difficult to implement, and it needs significant change management.

A white paper briefing the results of AMGA’s survey is available here.

“Providers must be capable to access administrative claims data in both the federal and commercial settings,” claims the white paper. “Without a whole picture of a population of sufferers, it’s virtually impossible to handle the cost and quality of a sufferer’s care. While few payers provide this data to clinicians, many do not.”

“The transition to risk is slowing and there are very real barriers in the way,” added Donald Fisher, president and CEO of AMGA, during a December 8 teleconference in which the group reported the outcomes of its survey as well as suggestions for the incoming Congress and Trump administration.

To reduce the barriers standing in the way of providers, AMGA suggests:

• Data improvements: Congress should need federal and commercial insurance companies and providers to standardize data submission and reporting procedures, as well as to give access to all administrative claims data to healthcare providers.

• Access to capital: Congress should develop a fund that enables providers to utilize income on a tax-free basis to invest in taking downside risk.

• MACRA: For success under Alternative Payment Models (APMs), Congress shouldn’t penalize Advanced APMs if there are insufficient risk products in their regional markets, permit Medicare Advantage revenue to count in performance year 2019 toward meeting the Advanced APM revenue thresholds, as well as permit Track 1 ACOs to be eligible as Advanced APMs.

In accordance to AGMA, it’s imperative that Congress and the Department of Health and Human Services deal the hurdles standing in the way of the transitioning to value-based care sooner rather than later, or progress in moving away from fee-for-service could grind to a halt.

 

Why implementing EHR systems still Worried with Danger

The often-mentioned issues to the implementation of electronic health record (EHR) systems aren’t what healthcare providers say they are. Why implementing EHR systems are still filled with risk and danger?

That is the finding of researchers from the institute of Johns Hopkins University’s Bloomberg School of Public Health who observed data from the American Hospital Association (AHA) Annual Survey Information Technology Supplement.

“Several people were saying that the biggest issues for implementing EHR systems were the purchase price and meeting the Meaningful Use requirements,” claims Eric Ford, professor and associate department chair at the Bloomberg School of Public Health. “While those are the most usual uncertainties, that does not essentially mean they are the largest concerns in terms of being actual issues.”

Researchers utilized a novel analytic method—called item response theory (IRT)—to measure the intensity of difficulty that specific issues pose in implementing EHR systems that meet Meaningful Use requirements.

In accordance to Ford, IRT is a collection of modeling techniques for observing item-level data gained to measure variation between respondents.

What IRT disclosed from AHA’s Annual Survey were importantly different results from descriptive statistics in assuming the magnitude of specific EHR implementation issues. Particularly, researchers founded that “gaining physician cooperation” and “ongoing costs of maintaining and upgrading systems” were the most challenging implementation problems for providers, instead of “upfront capital costs” and the “complexity of meeting Meaningful Use criteria within implementation timeline” referred by the survey.

Results of the research were released this week in the American Journal of Managed Care. AHA officials weren’t instantly present to comment on their survey results.

“Various surveys of hospital administrators have sought to recognize hurdles to the Meaningful Use of electronic health record technology. Although, the surveys used often lack the precision to give a list of hurdles ordered from most difficult to least difficult. Rather, surveys tend to report the most usual or famous hurdles to adoption,” states the article. “However this approach is likely to capture how common a problem is among hospitals, it doesn’t explicitly address how difficult a particular challenge is.”

Based on the results of his team, Ford asserts that hospital administrators require spending more time working with their clinical staffs to ensure that the EHRs meet their requirements and that they are rightly trained to make the best use of the systems.

When it comes to getting clinician buy-in, the researchers suggest that doctors and nurses should be brought in at the earliest stage possible of implementing EHR systems.

Moreover, Ford believes the other issue that has been immensely underestimated is the ongoing cost of EHR ownership.

Ford notes that the significance of handling ongoing ownership and operating costs for EHRs is often not completely understood by organizations until after they start their implementations.

“Post-EHR implementation, health systems have to roll out extra functionalities to meet organizational requirements and comply with ever-increasing regulations,” the researchers summarize. Although, public policies that give rewards for implementing more sophisticated EHR functionalities can be tailored to ameliorate these issues, they argue.

 

Veteran CIO Shafiq Rab moves for Chicago

Veteran CIO Shafiq Rab, chief information officer and senior vice president of information technology at the institute of Hackensack University Health Network in the region of New Jersey since the year of 2012, is heading towards Chicago.

Veteran CIO Shafiq Rab has accepted the positions of CIO and SVP at the institute of Rush University Medical Center, effective January 9.

Hackensack is a quickly growing system that only 5 months ago merged its operations with Meridian Health. In the month of November, the agency declared a contract to affiliate with JFK Health.

At Rush, Rab replaces Lac Van Tran, who served in the position since the year of 2002 before recently retiring.

At Hackensack, Veteran CIO Shafiq Rab assisted usher in the mobile era by launching iPads and the Apple Health Kit to enable patients and families more access to their medical records and electronic communication with care teams. He established an app enabling patient access to appointment scheduling, test results, prescription data and communication with physicians from any device.

He also supervised and led development of facial recognition technology to match sufferers to their information.

Rab initially served as CIO for 4 years at Greater Hudson Valley Health System, one year at Catskill Regional Medical Center, almost 5 years at Saint Mary’s Hospital and almost 4 years at Carrier Clinic/East Mountain Hospital.

As Rush continues to expand access to care across the region, linking our academic health network will be crucial,” Rush University Medical Center President Michael Dandorph claimed in a statement. “His clinical and public health expertise will assist Rush to use technology to grow its mission to make better the health of people and diverse communities it serves.”

 

New Hampshire HIE Establishes links with VA to serve veterans

The New Hampshire HIE or New Hampshire Health Information Organization (NHHIO), which operates a statewide health information exchange (HIE), recently developed a connection with the Veterans Administration (VA) to enable hospitals and other provider agencies to get extra health information about vets they are treating.

Veterans mostly do not get their entire healthcare through the VA, and other providers generally have had to depend on paper-based methods when dealing with VA, claims Jeff Loughlin, a veteran and executive director of NHHIO.

Thus, an electronic link will speed and make better the quality of care, he believes. “This connection assists to remove few of the hurdles in communication and care that veterans face on a daily basis.”

The initiative was started after an outreach coordinator at the Manchester VA contacted Loughlin and they worked to enable an electronic exchange of information. To accomplish their mission, they required establishing and signing several contracts—the project uses the Direct Protocol secure messaging standard for exchange of health information, and VA, which wasn’t utilizing Direct, required contracts written and signed to ensure participants follow certain procedures of the VA.

Most states linked to VA use a shared data repository to exchange information; New Hampshire HIE is one of a handful of states that has shifted to the Direct Protocol, Loughlin says.

Because electronic communication just started 2 weeks ago, it is hard to assess progress thus far. Orion Health is the vendor offering Direct services. 2 other VA offices in New Hampshire HIE are getting ready to enable providers in their regions to exchange data electronically with the VA.

Along with the connections will come educational steps to explain to providers the benefits of electronic connectivity with VA and workflow changes they will require making. The benefits involve improved patient safety and data security, and putting data in providers’ hands quicker, while no longer depending on faxes.

One reason the connectivity came together was because the timing was correct, Loughlin elaborates. Linking with VA wasn’t a priority because providers were concentrated on achieving meaningful use of electronic health records (EHRs), and VA was not ready for Direct during that period, anyway. With meaningful use winding down, VA’s outreach to Manchester was the impetus to get Direct secure messing rolling, with assistance from a Manchester VA board member who was a veteran and served as a patient advocate.

Providers will have the choice of getting PDF files, discrete data elements, a summary of care or a progress note, deployed on the workflows of providers, the technical capability of their staffs or the capabilities of the providers’ vendors.

Direct connectivity is just one piece of improved sharing of health information in New Hampshire, Loughlin contends, as the industry waits for more modern and advanced capabilities like the CommonWell, CareQuality and FHIR interoperability initiatives to mature. “There is no single solution, so we’re attempting to maximize the advantages of all of the solutions,” he further adds.

 

Latest connections and platform expands Rochester RHIO

Rochester RHIO, a health information exchange facilitating 1.4 million consumers in thirteen upstate counties in the city of New York, has become the last of 8 regional HIEs to build links to the Statewide Health Information Network for New York, known as SHIN-NY.

The RHIO, which has been operating for ten years, has focused on developing, expanding and maintaining its business while linking to other regional HIEs in the upstate region, because that is where 90% of its business comes from, claims Jill Eisenstein, executive director.

The agency also recently completed a major platform migration, expanding its ability to send queries to downstate RHIOs, including SHIN-NY, to which it made more than 600 queries in the past month.

The new platform hosts an enterprise master patient index to recognize and reconcile duplicate patient records and an interface engine. It also supports clinical alerts to let physicians know when sufferers have been admitted to a hospital or discharged, and broadens support for HL7 CCD and CCA document exchange standards.

Virtual Physical Therapy Assists to Enhance Home Health Care

Reflexion Health introduces VERA to empower patients and improve outcomes.

The explosion of creation in technology is vitally transforming the way healthcare is administered and handled around the world. From diagnosis to treatment and chronic condition management, telehealth has become a reality. And in the wake of an ever-changing healthcare landscape, meaningful care is on the rise. There is also increasing pressure to deal excessive healthcare spending and inefficient care pathways to decrease costs and improve results.

One of the newest fields to be handled through innovative technology is physical therapy. Previous year, a pilot program was made by researchers from the University of Texas at Dallas to connect wounded veterans with physical therapy through real-time video, 3D computer-generated worlds, and force-feedback “haptic” devices that could reestablish a physical therapist session between sufferers and therapists remotely over high-speed networks, as Live Science reported.

Now, Reflexion Health, a digital healthcare company committed to transforming traditional medicine, has developed VERA™, a virtual exercise rehabilitation assistant that remotely brings physical therapy to the home, empowering sufferers and providers to save time, steps, and money.

The Act would offer professional development Services to rural providers

The U.S. Senate on a 97-0 vote has approved the Expanding Capacity for Health Outcomes Act to expand Project ECHO, a step to offer professional development services and other support to healthcare rural providers in remote and underserved regions.

Project ECHO is modeled after a step at the institute of University of New Mexico that connects rural patients to rural providers through telemedicine. Project ECHO previously concentrated on care for patients with hepatitis C.

Under the legislation, which moves to the U.S. House that has a companion bill, Project ECHO now will extend across the rural areas of nation to serve a wide variety of healthcare requirements. Senators Orrin Hatch (R-UT) and Brian Schatz (D-HI) sponsored the bill.

Project ECHO will utilize videoconferencing technology to link specialists with rural primary care providers or rural providers. Weekly “teleECHO clinics” will combine didactic teaching (ways to better manage work) with mentoring and case-based learning, in accordance to a statement from Hatch.

These clinics, or lectures, could cover such areas as treatments for several diseases, offering behavioral health treatment in rural areas, and making improvements in public health interventions like HIV and tuberculosis.

The aim, in accordance to Hatch, is to increase expert knowledge among rural providers while giving a network of assistance, helping the provider retention rate, decreasing isolation and offering more access to specialists.

The legislation needs the Department of Health and Human Services to assess if Project ECHO improves the quality of care, and calls for the Government Accountability Office to assess increased efficiencies and cost savings via the program.

“We are now one step closer to supporting new ways to train health providers and deliver health care,” Sen. Schatz stated in a statement. “Technology is modifying and changing the way medical professionals connect with each other and their sufferers. Our bill capitalizes on this technology to give health experts in hard-to-reach areas the specialized training they need and assist them to reach more patients.

 

Northwell Health, Siemens teams up for population health effectiveness research

Northwell Health and Siemens Healthineers have teamed up in a research partnership targeted at gauging clinical effectiveness and performing research utilizing analytics-based population health evidence.
Siemens will provide funding and research support over the next 4 years to Northwell's Imaging Clinical Effectiveness and Outcomes Research Program, or iCEOR. It will also commit full-time workers to work with Northwell Health on its population health management initiatives.
This partnership is first-of-its-kind for both Siemens and Northwell Health, stated August Calhoun, senior vice president of services, Siemens Healthineers North America. The aim, he said, is to collaborate on research that could "potentially define care pathways for several populations in the future."

Workers Ready for Wearable devices at Work, Study concludes

Jiff data indicates that there is great promise for the inclusion of wearable devices in the workplace.

In a recent study, workers at 14 large employers demonstrated that they are ready for wearables at work, according to data from Jiff. And while doctors perceive they are on board with the wearables movement, sufferers aren’t so sure.

In fact, a latest Nielsen survey discovered while 40% of physicians said they have suggested wearables to their patients, less than 5% of patients say that their doctor has recommended the technology to them. One way to bridge this gap is through workplace adoption and support of the devices.

Almost one-half of employees have participated in a well-being activity or wellness program in the last year, in accordance to the survey, while almost two-thirds of employees said employers should actively motivate employees to live a healthy lifestyle. And nearly one in 3 employers surveyed offered a wellness program that incorporated wearables; another 23% considering a wearable program in the future.

With consumer health and wellness representing a $135 billion market, it’s not surprising consumers are open to employer support in their attempts to attain improved health. Yet the real value of wearables devices in making better the healthcare outcomes is still not completely proven. One recent study found wearable devices did not assist patients to achieve better results in a weight loss intervention program.

Secure Mobile Communication permits shift in practice’s care model

Getting in contact with the physicians of Direct Care Clinic of Northwest Arkansas is convenient—they are only a text or email away. Secure mobile communication with sufferers has become a key source of communication that permits the Rogers, Ark.-based practice to serve patients and provide them personalized care.

The physicians of the practice would not have it any other way.

“This is the way primary care should be done,” claims Dan Weeden, MD, one of the 2 physicians in the practice. “It is a good way to do primary care.”

Weeden and Joel Frankhauser, MD, have modified the practice’s approach, in part enabled by new IT systems. It is changed electronic health records (EHRs) systems, deployed a smartphone app and adopted the secure mobile communication or messaging software to enable better communication.

Direct Care now provides direct primary care to over 700 patients who pay a set amount each month—less than $50—for entire treatment and services. That is moderately different model than concierge service, under which a person or family pays an annual fee for care. And it is a far cry from the conventional fee-for-service model the practice employed before the change, when it treated more than 2,000 patients.

Before the switch, the practice utilized an EHR from Epic, and followed the conventional way of filing claims with insurers, which paid varying amounts for care. In making the switch, it is shifted to the InLight EHR system from Amazing Charts, which has better enabled the shift to direct primary care, assisting it offer the more consistent monthly fee approach.

Weeden claims that the new approach has opened up communication with sufferers, who might need an often visit but frequently just want a rapid answer to a medical query. This year, the practice sought a secure mobile communication or secure messaging application that could be integrated into the InLight EHR and discovered Twistle, which enables sufferers to use smartphones to send messages to the practice.

The app brings ease to the practice and patients, in accordance to Weeden. It mitigates the need for office visits and provides patients peace of mind while, at the similar time, quickly alerting clinicians to potential issues.

Patients who’ve the free Twistle app on their phone can send messages to the practice that go into nurse and physician computers as well as their smartphones.

Direct Care chose Twistle secure messaging because it is HIPAA compliant, but Weeden worries that few other doctors using the direct primary care model don’t follow HIPAA “and it’s imperative that they do so,” he states.

 

People Need mHealth Convenience, But Payers Are not Ready

8 in ten consumers would rather see their doctor online than in person, the mHealth convenience survey claims. But insurers are not prepared to make that an easy procedure.

A new study finds that people overwhelmingly prefer online interactions with their doctor over in-person visits, and they will even risk the security of their health information for the mhealth convenience.

In all, 8 out of every ten people surveyed by West Monroe Partners prefer real-time contact through a portal or mHealth app over a visit to the doctor’s office. And 31% have used an mHealth app in the last 2 years to talk to their doctor about a particular medical condition.

In accordance to the survey of more than 1,300 consumers, 86% are using their healthcare provider’s online portal, and two-thirds of those people whose doctors do not have a portal what their doctors to make that leap. The public claim for mHealth is even higher: 91% of those surveyed would use a mHealth app if they could.

The shift in people’s thinking is not lost on doctors.

“Healthcare providers are realizing the affect of digital communication channels and are beginning to adapt,” Will Hinde, senior director of healthcare for West Monroe Partners, claims in the report. “We are initiating to see more providers incorporate the digital experience with their office visit, by moving to more online scheduling of appointments, paperless office interactions, following up through e-mail, portals, and mobile apps and taking measures towards higher cost and quality transparency.”

The issue to mHealth convenience adoption comes not from those providing healthcare, but those holding the purse strings.

In accordance to the survey, 85% of payers are not sure their company has the technology in place to meet the needs of consumer, and 54% are not sure they have the procedures to create a mobile, consumer-centric platform.

Part of the challenge lies in what payers think their members want. Several currently offer awards, like gift cards, and redeemable points to prompt members to share their health data online. But with less than 50% of consumers surveyed saying they trust their doctor with their personal health information, those rewards are not cutting it.

“Provided the volume, scale, and visibility of healthcare-based cyberattacks, it is no surprise less than half of consumers (48%) entirely trust their provider with their personal data,” the study points out. “This deficiency of trust poses an important business hurdle for the roughly 70% of healthcare insurers presently offering rewards programs built around consumers sharing data collected from their health tracking devices and apps – which can assist insurers to provide more individualized care. Confronted with a customer base that is reticent to share personal health information, these insurers can seek their rewards programs stagnating, with customer retention, loyalty, and actionable data collection suffering as an outcome.”

In accordance to the survey, consumers will share their health information with doctors if the rewards are more meaningful – that means better rates, better service or convenient access to doctors.

The West Monroe Partners survey recommends that consumers are demanding mHealth convenience or easier online access to their doctors, and they will even forego a minor bit of privacy and security in exchange for cost savings. But healthcare providers are shifting too slowly to provide them that convenience, and the payer industry is even farther behind.

 

1 Million Google accounts hacked Via Android malware

More than one million Google accounts – involving authentication tokens – have been compromised by the Android malware strain called as Gooligan, security firm Check Point reported on the day of Wednesday.

Hackers can utilize the stolen credentials to gain access to Gmail and Google Photos, Docs, Drive, Play and GSuite. Moreover, the cybercriminals can generate revenue by installing apps from Google Play and rating the apps on behalf of the user. Hackers also profit from the adware installed by Gooligan.

1^st spotted in the wild in the year of 2014, this most recent campaign that started in August has infected about 13,000 devices per day by targeting Android 4 and 5 devices. Checkpoint officials estimate that accounts for almost 74% of Android users.

Presently, Gooligan installs 30,000 apps a day on breached devices – or two million fraudulent apps since the campaign started.

The researchers also discovered Gooligan in several legitimate-looking third-party app stores, but users also downloaded the app straightly from malicious links found in phishing messages.

Check Point researchers contacted Google's security team with their findings, and the firm is providing a free online tool that lets users determine if their account is part of the breach.

Four more regional Zika cases Reported in Miami-Dade

State health officials said on the day of Wednesday that they have discovered four more locally transmitted cases of the mosquito-borne Zika virus in Miami-Dade County, while 2 "travel-related" cases were reported in the Orlando place.

The 4 cases in Miami-Dade brought the total of locally transmitted cases in the state to 244, in accordance to the Florida Department of Health website.

Investigators were attempting to determine where exposure occurred in the 4 cases. Meanwhile, one travel-related case was reported in Orange County, while another was reported in Osceola County.

In such cases, individuals are infected elsewhere and then bring Zika into the state.

In all, Florida has had 1,219 reported cases of Zika, in accordance to the department.

National Report: Towards a healthier nation; No Health without Mental Health

The Americans’ health is deteriorating rapidly because of chronic diseases like diabetes, high blood pressure and heart disease. The debate over health care has resulted in the Affordable Care Act (ACA), which has given health insurance to 20-million more Americans than 4 years ago. But is the access to health care making better the mental health of the nation? The Chicago School of Professional Psychology is issuing a latest report which is a compendium of research supporting the requirement to treat clients with a holistic approach that enables mental and physical health.

Toward a Healthier Nation: No Health Without Mental Health is a basic national report on the status of mental health. It investigates 3 promising approaches embedded in the ACA. Each place has the potential to be "a game changer" in how mental and physical health problems are dealt. The report depicts the strategies to stop common mental health concerns, like depression, from escalating into health-threatening issues. The report outlines how the use of inter-professional teams from physical and psychological perspectives, as well as technological innovations, gives an extra layer of day-to-day support.

The research was conducted by psychology experts who have witnessed the harsh realities of the failure to care for the whole person during office visits, in hospitals, schools, prisons, and on the streets of our communities. This 3-part report discusses the critical need to deal mental and physical health problems as one process. The report is created to advance the way psychology and medicine are considered and practiced. Toward a Healthier Nation: No Health Without Mental Health, also calls for more mental health experts who can deal the increasing cultural diversity in the U.S.

House of Representatives set to vote today on 21st Century Cures bill

After 2 years of legislative wrangling, the House of Representatives is all ready to vote today on the 21^st Century Cures Act bill involving various health IT provisions created to deal the issues of electronic health record usability, interoperability, and data blocking.

Speaking on the floor of the Senate yesterday in advance of today’s House vote, Sen. Lamar Alexander (R-Tenn.) applauded the legislation’s $6.3 billion in appropriations to support the Obama administration’s Cancer Moonshot ($1.8 billion), Brain Research through Advancing Innovative Neuro technologies ($1.6 billion), and Precision Medicine Initiative ($1.4 billion). The bill finds to speed the approval of latest medicines and medical devices, among other provisions.

Alexander, chairman of the Senate health committee, also termed out the 21st Century Cures bill’s attempts to make better the health IT. Noting that the federal government has spent more than $30 billion on incentives to get providers to accept electronic health records (EHRs), he charged that EHR systems are a “mess” and desperately require fixing.

“Various portions of the bill concentrate on 2 critical areas where improvement is required to better leverage health IT and EHRs to their full potential,” claims Ben Moscovitch, manager of HIT at The Pew Charitable Trusts. “Those 2 areas are enhanced interoperability and improved usability and patient safety.”

Radiologists ready to utilize criteria for imaging orders

Much concerns and minor industry awareness surround a latest program that will need physicians ordering outpatient radiological processes for Medicare beneficiaries to justify ahead of time that the imaging orders are important.

The reimbursement approach targets to have physicians refer to industry-developed appropriateness criteria before ordering advanced—and costly—imaging processes for sufferers, utilizing clinical decision support modules that will be tied into agencies’ electronic health records systems (EHRs).

The program, one of the provisions of the Protecting Access to Medicare Act of 2014 year, will go into effect on the day of Jan. 1, 2018, but several specifics of how the program will work are yet in development, claimed presenters at a session during the annual meeting of the Radiological Society of North America.

The utilization of criteria is hoped to be applied to imaging orders for outpatients for 8 types of studies, termed priority clinical places—coronary artery disease, suspected pulmonary embolism, headache, hip pain, low back pain, shoulder pain, cancer of the lung, and cervical or neck pain, claims Joseph Hutter, MD, a lieutenant commander in the U.S. Public Health Service.

The program will have important impacts on ordering physicians, radiological experts and healthcare agencies, which will require adding imaging-specific modules to their EHR systems and adjusting workflows. Additionally, it could affect the payments for radiology experts in the year of 2018 and force a minor percentage of physicians who regularly override appropriateness criteria to seek pre-authorization for studies starting in the year of 2020.

Criteria to justify contemporary radiological processes for those clinical reasons have been hammered out by RSNA and other professional agencies, presenters claim. Before physicians imaging orders tests, they will require using a clinical decision support module, hoped to be embedded in their EHR systems.

The program has been established through a partnership between the Centers for Medicare and Medicaid Services (CMS) and various professional radiological groups as a way to make sure that imaging services like MRI, CT and nuclear medicine scans meet suitable use criteria. The intent of the attempt is to decrease duplicate or unimportant procedures, states Curtis Langlotz, MD, professor of radiology at the Stanford University Medical Center.

Ordering physicians can select to override the decision on appropriateness given by the module, but outcomes will be compiled over time to assess how regularly physicians comply, or do not comply, with appropriate use criteria, Langlotz claims. By the year of 2020, the top 5% of physicians overriding CDSM decisions will be believed to be outliers and will require having orders for advanced radiological processes subject to pre-authorization.

When the program begins in the year of 2018, it’ll have an instant impact on radiology professionals. Physicians that utilize CDSMs to assess the appropriateness of processes will get a code from the module, which radiologists will require submitting on claims sent for payment to Medicare. Radiologists that do not submit the code to CMS will not be paid, Hutter states.

 

UMass agrees to pay fine of $650,000 for exposing electronic health records

The University of Massachusetts Amherst (UMass) has accepted to pay the federal government a fine of $650,000 to settle a 3-year-old healthcare privacy violation of exposing electronic health records that resulted from a malware infection. That’s why it has agreed to pay fine of $650,000 for exposing electronic health records.

In the year of June 2013, the center of university for language, speech and hearing reported a malware infection to the U.S. Department of Health and Human Services Office for Civil Rights that resulted in the unauthorized disclosure of the personal health and financial data of over 1,670 people. The malware infection had resulted in the unauthorized exposure of a host of sensitive information involving sufferer names, addresses, Social Security numbers, and dates of birth, health insurance information, diagnoses and procedure codes.

Few details about the malware attack are vague, like how many unauthorized users had access to the sufferer information and for how long. The University of Massachusetts Amherst claims that the information breach happened due to a Trojan horse attack, a kind of malware that is mostly disguised as legitimate software.

The federal government levied the fine in huge measure because at the time period the University of Massachusetts Amherst did not have a firewall in place securing the electronic health records at its center for language, speech and hearing. “UMass failed to execute technical security measures at the Center to guard against unauthorized access to electronic protected health information transmitted over an electronic communications network by ensuring that firewalls were in place,” in accordance to a statement from the Office for Civil Rights, the branch of the federal government that enforces The Health Insurance Portability and Accountability Act of 1996, or HIPAA, a law that targets to ensure the confidentiality of sufferer medical records.

The Office for Civil Rights determined that in hindsight University of Massachusetts Amherst should have implemented a better job ensuring that the center for language, speech and hearing was part of a protective electronic health network that complied with HIPAA and had adequate firewalls in place to stop the unauthorized approach. The federal government also fined the University for not performing a precise and thorough risk analysis until the month of September 2015 and was enabled of exposing electronic health records.

In addition to the monetary settlement, the UMass has accepted to a corrective action plan that needs it to perform an enterprise-wide risk analysis and establish and implement a risk management plan, claims the Office for Civil Rights.

The UMass also has been needed to revise its policies and processes and train its staff on the HIPAA safeguards being put in place. “HIPAA’s security needs are a significant tool for securing both patient information and business operations against threats like malware,” claims Office for Civil Rights director Jocelyn Samuels.

 

Mayo Clinic utilizes emergency telemedicine for newborn resuscitations interventions

The Mayo Clinic is utilizing emergency video telemedicine to effectively help community hospitals less familiar with modern newborn resuscitation interventions during high-risk, complex deliveries.

Mayo’s Division of Neonatal Medicine previously provided newborn telemedicine consultations to 6 of its health system sites, where regional care teams used wireless tablets running HIPAA-compliant video conferencing software from Vidyo to interact with neonatologists at Mayo in Rochester, Minn. Video consults are now conducted at all ten of Mayo’s health system sites that deliver babies in the Rochester region.

The technology integrates neonatologists to “visually assess the babies and co-handle them together with local care teams more efficiently utilizing video and better communication,” claims Jennifer Fang, MD, a Mayo Clinic fellow in neonatal-perinatal medicine. “With telemedicine now, we are capable to bring our neonatologists to the bedside remotely to really assist guide to these local care teams with complex deliveries.”

Business associate breach struck healthcare industry

More hospitals are claiming that they have suffered a breach of protected health information after a worker working for a contractor was discovered to have downloaded a range of sufferer demographic data without authorization.

Information the employee downloaded to a flash drive involved the patient names, birth dates, addresses, phone numbers, diagnoses, medications, as well as sufferer identification numbers and physician names, among other data.

Healthcare agencies are seeking out about the breach from Ambucor Health Solutions, a business associate that provides contracted cardiac and labor monitoring services. The number of impacted providers and patients isn’t still publicly known.

Although, agencies that have notified patients of the breach involve Carolina Cardiology Consultants in Greenville, S.C.; New Mexico Heart Institute in Albuquerque; Conemaugh Physician Group Cardiology in Johnstown, Penn.; Berkshire Medical Center in Pittsfield, Mass.; and Cleveland Clinic Akron General, among others.

A representative of Ambucor wasn’t instantly available for comment.

While noting that no information seems to have been misused, Ambucor is providing affected sufferers 1 year of identity theft protection. The vendor is a subsidiary of ScottCare Corp.

Massachusetts Digital Health Council to Advise on State Health IT Growth

The Massachusetts Digital Health Council will advise the Governor and his administration in how to use health IT to improve care and job growth.

Massachusetts Governor Charlie Baker declared the state’s Digital Health Council recently during its 1^st meeting last week at the Massachusetts General Hospital Museum of Medical History and Innovation..

An offshot of the state’s Digital Health Initiative, the Council is a public-private coalition of industry experts planning to advise the Baker Administration on the state’s health IT use. These experts involve technology, healthcare delivery, insurance, medical device, life science, academic, and government experts.

The Digital Health Council will work to assist steer the state’s Digital Health Initiative, which Governor Baker announced in the year of January 2016. The Council will work with information developed from the Initiative to make a 3-year growth plan, and will sustain to support programs to carry out the plan and report yearly on its progress.