Beacon Health System notifies data breach from worker snooping

A worker at Beacon Health System in South Bend, Ind., who for 3 years was accessing patient emergency department (ED) records without permission or a reason to analyze them, has been blamed for a breach of protected health information at the facility.

An audit by Beacon Health found the unwarranted access of patient information, which occurred from the time period of March 2014 to March 2017.

“While the worker might have had authorizations to view records in certain circumstances, the employee viewed patient records without a permissible reason,” the 3-hospital delivery system pointed out in a press release to local media.

“The worker refused taking or misusing any information, and we’ve no evidence that any data was used to commit fraud or otherwise misused,” the statement continued, demonstrating that the employee is no longer employed at Beacon Health System.

Compromised information involves patient names, Social Security numbers, ages, diagnoses, room numbers, acuity of sickness, chief complaints and some financial and insurance coverage information.

Beacon Heath System is reviewing training materials and putting in place new processes to decrease the likelihood of a similar tragedy occurring again. Affected individuals are being offered 1 year of identity monitoring and identity restoration services from Experian, and they are being asserted to monitor account statements and credit reports.

This is the 2nd major breach of protected health information for Beacon Health System, which operates 3 hospitals, home care services and a medical group practice. A hacking tragedy in May 2015 affected 306,789 people.

Beacon Health refused to give more information on the most recent tragedy, but sent the following statement about the incident:

“Beacon Health System’s Information Security and Privacy Team monitor worker access to records 24/7 and investigate potential issues for appropriateness on a daily basis. After an anomaly outside of Beacon’s routine monitoring was traced, upon further review, there was proof that records other than those that were required to complete this individual’s job duties were viewed. A third party forensic review validated that no data was electronically downloaded or transferred. Out of an abundance of caution, Beacon took the most conservative route to report the tragedy and notify those involved.”

 

Manufacturers, Healthcare providers fear attack likely on medical devices

Manufacturers, Healthcare providers fear attack likely on medical devices

The healthcare providers and the medical devices manufacturers that use these devices are primarily unprepared to defend against cyber attacks on their devices, in accordance to the outcomes of a recent survey on security preparedness.

The research by the Ponemon Institute indicates that both makers and users of medical devices are concerned about the likelihood that key medical equipment could be hacked. Two-thirds of device makers and 56% of healthcare providers say an attack on devices is likely during the next year, in accordance to the Ponemon survey.

The Ponemon Institute conducted the research for Synopsys, which sells a platform to handle security and quality problems in software development. The survey covered 242 device makers and 262 healthcare delivery organizations in the North America market.

Some 80% of device firms and healthcare respondents recognized the development of secure devices as a key challenge, asserting that devices remain vulnerable due to coding errors, lack of expertise on secure coding practices and pressure to meet product deadlines.

Despite those complications, fewer than 10% of respondents test devices at least yearly, with 53% of healthcare agencies and 43% of manufacturers report that they do no testing on devices, a finding that surprises Larry Ponemon, chair and founder of Ponemon Institute.

“I was blinded when we discovered that,” he contends. “I would have assumed (providers and manufacturers would have) testing; you would think there would be more due to the cyber threat, but that does not seem to be a driver for change.”

Ponemon puts the onus for change on healthcare organization management, not essentially on chief information officers and chief information security officers, who are attempting to do the right things but do  not have the resources or backing of senior leaders.

He claims that, when an attack happens, the CISO often is the fall guy and is fired, even though he or she may have been forcing for higher security. But the main mission for device makers and healthcare agency is to produce and distribute the product.

The survey discovered that one-third of all respondents reported that no person or function in their agency is primarily responsible for medical device security. Only half of device makers and 44% of healthcare organizations follow Food and Drug Administration guidance on mitigating device security risks.

The challenges that providers face with medical devices, which involve clinician mobile devices like smartphones, are overwhelming. Clinicians, Ponemon says, rely on their devices to efficiently serve sufferers, yet security protocols or architecture built in devices rarely adequately protects data. Security funding increases often occur merely after a serious attack, and encryption is not widely used with Internet of Thing devices.

Too often, Ponemon asserts, providers assume that security of pacemakers, insulin pumps and other devices brought into the hospital is the responsibility of the vendor.

“Healthcare doesn’t prioritize security as much as other industries,” he says. “Healthcare providers are thinking of patient safety, not security risks. We see pressures on healthcare providers to have products available to meet the needs of patients. Are we even capable of knowing if we have been hacked?”

Ponemon was glad to see the Food and Drug Administration recently issue guidance on cybersecurity, which he calls “pretty decent but not prescriptive—it does not tell you step-by-step what to do.” But he fears that following the guidance could be seen by device manufacturers and providers as just adding to existing costs.

“We’re living in a world where everything is a connected device. As we have more connected Internet of Things devices, risks increase. IOT devices are convenient to hack. In healthcare, this could kill people,” he claims.

The full report is available here.

 

University of Wisconsin Establishes Substance Abuse Adherence mHealth Application

Researchers from the University of Wisconsin’s Center for Health Enhancement Systems Studies (CHESS) established a mHealth app for substance abuse adherence mHealth application that is a finalist for an $100,000 grant award from the Harvard Innovation in American Government program.

The substance abuse adherence mHealth application, called A-CHESS, gives users a forum to talk to other recovering addicts, a panic button that notifies friends or family if the individual is having an urge to relapse, and a GPS locator to assist the recovering user stay away from risky areas such as bars.

“Deployed on randomized clinical trials, A-CHESS users are 65% more likely to remain sober after leaving an inpatient treatment service,” claimed David Gustafson, industrial and systems engineering emeritus research professor and the principal investigator at CHESS.

Since A-CHESS has possibility to make better the lives of millions struggling with substance abuse, the team was invited to present the app on at the Harvard Innovations in Government Competition on the day of May 17th.

A-CHESS, along with 6 other finalists, was opted among an entrant pool of 500 programs.

The award generates important national attention, as governments at state and local levels use the finalists’ concepts to drive positive change at all levels of society. Should the A-CHESS team receive the award, they could drastically improve the scope and capability of their app.

The developers of A-CHESS realized the smartphone is a strong medium in promoting adherence due to how accessible and functional apps can be for users.

“You require something like a smartphone app because individuals require getting into a treatment center to get help, but they require help afterwards too,” CHESS Deputy Director Fiona McTavish said.

Other characteristics in the substance abuse adherence mHealth application involve access to articles about addiction, games to distract users from negative thoughts, meditation music, quick tips and refusal skills, counselor messaging, questions that monitor their progress, and other GPS functions that let users know where recovery meetings are available.

Apps and mHealth present a distinctive opportunity to promote adherence, and positive self-care behaviors, as evidence by modern research.

Other behaviors that negatively impact the health, such as smoking, may soon be conveniently mitigated through intuitive smartphone interfaces and digital support.

Adherence apps also have possibility to improve access to care for several patients who may require care services outside of normal office hours, or those who can’t afford or access a provider when necessary.

“The current system is merely incapable of meeting the requirements of the people who are out there,” Gustafson said. “There is not enough staff — there will never be enough staff — so we needed to see what else could be done.”

 

EHR Market to Reach $33B by the year of 2025 - Research and Markets

Research and Markets has declared the addition of the "Electronic Health Records (EHR) Market Analysis By Product (Client Server-based, Web-based), By Type (Acute, Ambulatory, Post-Acute) By End-use (Hospitals, Ambulatory Care), And Segment Forecasts, 2014 - 2025" report to their offering. The global EHR market is hoped to reach USD 33.41 billion by the year of 2025. The government initiatives undertaken in support of EHR market adoption are most likely to accentuate the market growth.

The federal government launched Health Information Technology for Economic and Clinical Health (HITECH) Act in the year f 2009 for promoting usage of EHR amongst healthcare providers. The program involved provision of training and assistance for health information technology (IT) employees in case to set up EHRs in the hospitals.

The National Health Services (NHS), UK is planning to change the documentation procedure into digitized form completely by the year 2018. In the U.S., federal government has declared financial incentives for physicians planning to adopt EHR systems. Any average physician with at least 30 percent of his/her patients covered with Medicare is eligible for incentives worth USD 44,000.

Several region-specific initiatives are promoting eHealth services. For exmple, EUR-Lex offered eHealth action plan for the time period of 2012 - 2020, which states the strategies for deployment of eHealth services amongst European nations.

The EHR market in Asia Pacific is projected to showcase substantial growth over the forecast period owing to several developments across huge economies along with increased expenditure on healthcare IT. This regional market is anticipated to grow at a CAGR of 7 percent from the time period of 2017 to 2025.

Companies Mentioned 

• Cerner


• Allscripts


• McKesson Corporation


• GE Healthcare


• Epic Systems Corporation


• NextGen Healthcare


• Medical Information Technology, Inc.


• CureMD Healthcare


• Healthcare Management System (HMS)


• CPSI


• AdvancedMD, Inc.


• eClinicalWorks


• Computer Sciences Corporation (CSC)


• Greenway Health, LLC


• Practice Fusion, Inc.

Significant Topics Covered:

1 Methodology and Scope

2 Executive Summary

3 EHR Market Variables, Trends, & Scope

4 EHR Market: Product Estimates & Trend Analysis

5 EHR Market: Type Estimates & Trend Analysis

6 EHR Market: End-use Estimates & Trend Analysis

7 EHR Market: Regional Estimates & Trend Analysis, by Product, Type, & End-use

8 Competitive Landscape

For Further information about this report, please visit http://www.researchandmarkets.com/research/jhmvgg/electronic_health

 

Innovaccer Inc. Inaugurates New ACO Initiative to Help IPAs & Providers Transition

Innovaccer Inc., a Silicon Valley-based Healthcare analytics company has started a ‘no cost’ initiative to give assistance to Independent Physician Associations (IPAs) and other transforming provider agencies to transition into an Accountable Care Organization (ACOs)

The idea of value has become notable in the advancing healthcare. Care teams are developing room for improvement in care delivery to bring down the cost of care with a better quality of care. The complexity and competition linked with value-based reimbursement need IPAs and other provider agencies to remain flexible with strategically transforming healthcare.

Innovaccer Inc. will give a consultation on the complete roadmap encompassing:

– Participation options: ACOs can apply to engage in various Shared Savings Program tracks. As per the current situation and future aims, Innovaccer Inc. will assist provider organization to identify the most suitable option for themselves.

– Eligibility Criteria: Detailed information on all the clauses that is essential to be fulfilled to become an ACO.

– Health IT backbone: The type of IT backbone needed to assist the ACO succeeds and the investment needed to develop such IT infrastructure.

– Delivering and maintaining the quality of care: Value-Based performance analytics needed to track all payer contracts by quality and cost measures to recognize improvement opportunities and beat benchmarks.

– Expense control and Network utilization: Comprehending what are the huge cost drivers to identify leakages, manage costs in the network across all regions, facilities, and providers and increase network utilization.

“We’ve been working with IPA and ACO customers for a while now and have been delivering increasingly better clinical outcomes for them. We are happy to extend our resources and technical acumen to IPAs and other growing provider agencies to tackle the sharp learning curve to becoming a victorious ACO, with every requirement of this transition – right from understanding eligibility criteria and participation choices to improving physician communication and quality of care,” claims Abhinav Shashank, Co-founder and CEO at Innovaccer.

Innovaccer was recently elected by Mercy ACO, one of the largest value-focused agencies in the Mid-west as the technology partner to deliver value-based care. Innovaccer has also worked with several other key IPAs and ACOs towards improving clinical and financial outcomes, helped by Datashop – Innovaccer’s proprietary end-to-end value-based care solution.

 

Deficiency of access to health information said to restrict potential of machine learning technology

As machine learning technology sustains to advance at a rapid pace, providers are excited by the potential of this kind of artificial intelligence to predict which sufferers are most at risk for clinical events that need early intervention.

Although, these medical breakthroughs are being hampered by the deficiency of health data necessary to learn the complex patterns needed to positively affect patient care.

That is the consensus of healthcare stakeholders who gathered at Wednesday’s Machine Learning in Healthcare: Industry Applications conference in the Boston to discuss the technology’s promise and challenges.

Research released earlier this month by MarketsandMarkets projected that the healthcare artificial intelligence market is hoped to grow from $667.1 million in the year of 2016 to more than $7.9 billion by the year of 2022, a compound yearly growth rate of 53% over the forecast period. Machine learning technology is accelerating at a rate beyond Moore’s Law, with algorithms and models doubling in capability every 6 months.

Among the potential applications: medical imaging, drug discovery, diagnostics, precision medicine, as well as patient information and risk analysis. In fact, a study presented this week at the American Thoracic Society International Conference in Washington demonstrated that a machine-learning algorithm has the capability to recognize hospitalized patients at risk for severe sepsis and septic shock using information from electronic health records (EHRs).

In accordance to Russ Wilcox, partner of venture capital firm Pillar, machine learning technology is presently benefitting from a “trifecta” of technology trends—big data (a flood of digital information that doubles every 3 years), better hardware (optimized processors and storage) and smarter algorithms.

“90% of the world’s digital information is less than 2 years old, and (that trend) is accelerating even faster,” Wilcox told the Machine Learning conference.

Yet, in healthcare, he lamented the fact that much of the information is trapped in silos, which is stifling machine learning’s promising applications in medicine.

“So several of the other industries are way ahead of us in terms of considering about how to bring automation and digital tools to personalize our access” to data, stated John Brownstein, chief innovation officer at Boston Children’s Hospital, who summed up the issue in healthcare as being a deficiency of data accessibility and quality.

On the flip side, Brownstein pointed out that the large consumer technology companies have access to good quality information that enables automation and machine learning, resulting in a high level of personalization.

In the public sector, AI isn’t on the agenda of the Centers for Medicare and Medicare Services (CMS), even though the agency has increasingly been issuing updated healthcare data to improve transparency in the Medicare program and to provide more timely data for providers, researchers and beneficiaries, claims Niall Brennan, former chief data officer at CMS.

“While we did a ton of data work and re-centered and reengineered CMS as a more data-driven organization, I am afraid AI is so far off its radar screen that if you said AI to somebody at CMS they might consider you were talking about Allen Iverson,” said Brennan.

CMS is the greatest single U.S. health payer, generating enormous amounts of data. Although, as Brennan pointed out, it is primarily claims data, with the agency “missing nearly all of the clinical and genomic data.” Even so, he believes AI and machine learning technology could give CMS the capabilities to utilize data in new and creative ways and to generate actionable insights, he said.

Over the next 5 years, Brennan asserts that one of the key issues related to whether or not artificial intelligence and machine learning technology gain traction with huge public payers is “translating it into something tangible that will resonate with payers and lead them to consider them about realigning financial incentives” to make better the patient outcomes and reduce healthcare costs.

On the provider side, he made the case that the single most important driver for spurring the adoption of AI and machine learning technology is the transition from fee-for-service to value-based care “because it develops incredible incentives for providers to innovate and attempt to provide better care at lower costs.” At the similar time, Brennan cautioned against the hazards of “bolting innovative solutions on to a fee-for-service chassis.”

 

Apple Inc. plans to Bring Artificial Intelligence into Chips

Apple Inc. got an early beginning in artificial intelligence (AI) software with the 2011 introduction of Siri, a tool that lets users operate their smartphones with voice commands.

Now the electronics giant is bringing AI to chips.

Apple Inc. is working on a processor devoted particularly to AI-related tasks, in accordance with a person familiar with the matter. The chip, termed internally as the Apple Neural Engine, would make better the way the company’s devices handle tasks that would otherwise require human intelligence -- like facial recognition and speech recognition, claimed the person, who requested anonymity discussing a product that has not been made public. Apple Inc. refused to comment.

Engineers at Apple Inc. are racing to catch their peers at Amazon.com Inc. and Alphabet Inc. in the booming field of AI. While Siri gave Apple an early advantage in voice-recognition, competitors have since been more aggressive in deploying AI across their product lines, involving Amazon’s Echo and Google’s Home digital assistants. An AI-enabled processor would assist Cupertino, California-based Apple integrate more advanced capabilities into devices, specifically cars that drive themselves and gadgets that run augmented reality, the technology that superimposes graphics and other information onto a person’s view of the world.

“Two of the places that Apple is betting its future on require AI," claimed Gene Munster, former Apple analyst and co-founder of venture capital firm Loup Ventures. “At the core of augmented reality and self-driving cars is artificial intelligence.”

Improved Performance Apple devices presently manage complex artificial intelligence processes with 2 different chips: the main processor and the graphics chip. The new chip would let Apple offload those tasks onto a dedicated module designed particularly for demanding artificial intelligence processing, permitting Apple Inc. to improve battery performance.

Should Apple Inc. bring the chip out of testing and development, it would follow other semiconductor makers that have already launched dedicated AI chips. Qualcomm Inc.’s latest Snapdragon chip for smartphones has a module for handling artificial intelligence tasks, while Google declared its first chip, called the Tensor Processing Unit (TPU), in the year of 2016. That chip worked in Google’s data centers to power search results and image-recognition. At its I/O conference this year, Google declared a new version that will be available to clients of its cloud business. Nvidia Corp. also sells a similar chip to cloud customers.

The Apple AI chip is developed to make primary improvements to Apple’s hardware over time, and the company plans to instantly integrate the chip into many of its devices, involving the iPhone and iPad, in accordance to the person with knowledge of the matter. Apple has tested prototypes of future iPhones with the chip, the person said, adding that it is unclear if the component will be ready this year.

Apple’s operating systems and software features would integrate with devices that involve the chip. For instance, Apple has considered offloading facial recognition in the photos application, few parts of speech recognition, and the iPhone’s predictive keyboard to the chip, the person said. Apple also plans to offer developer access to the chip so third-party apps can also offload artificial intelligence-related tasks, the person stated.

Developer Conference Apple might select to discuss few of its latest advancements in AI at its annual developer’s conference in June. At the similar conference, Apple plans to launch iOS 11, its new operating system for iPhones and iPads, with an updated user-interface, individuals with knowledge of the matter said last month. The company is also said to discuss updated laptops with faster chips from Intel Corp.

An AI chip would join a growing list of processors that Apple has developed in-house. The company started designing its own main processors for the iPhone and iPad in the year of 2010 with the A4 chip. It has since issued dedicated processors to power the Apple Watch, the motion sensors across its products, the wireless components inside of its AirPods, and the fingerprint scanner in the MacBook Pro. The company has also tested a chip to run the low-power mode on Mac laptops.

In the year of 2015, Bloomberg reported that Apple’s culture of secrecy stymied the iPhone maker’s capability to attract top AI research talent. Since then, Apple has received multiple companies with deep ties to AI, has started issuing papers related to AI research, has joined a key research group and has made hires from the field. In the year of October 2016, Apple hired Russ Salakhutdinov from Carnegie Mellon University as its director of AI research.

 

Medical device theft at SSM Health Orthopedics affects the data of 836 patients

A medical device that records physiological information was stolen on the day of April 12 from SSM Health Orthopedics, which operates out of SSM Health-owned DePaul Hospital in St. Louis, potentially impacting the data of 836 sufferers.

The agency said the medical device, which looks similar to a laptop computer, contained in its memory certain physiological data as well as protected health information from sufferers who participated in a study between the time period of 2002 and 2017. The agency notified the sufferers that some of their protected health information has been compromised.

These sufferers had one of 2 electro diagnostic studies, called EMG or NCS, and the electromyography medical device recorded electrical activity in muscle tissue to assess health of the muscles and corresponding nerve cells. Compromised information involved first and last names, dates of birth, medical record numbers and chief complaints. No financial, address, phone or Social Security information was compromised. SSM Health privacy specialist Mackenzie Schlotz said in a letter sent to patients that the organization does not believe patients are at risk for identity theft deployed on the limited data on the device.

“It is likely that the intention of the theft was to steal the medical device, which resembles a laptop computer, and not health data,” Schlotz added. “There is no proof to recommend that the limited health information contained on the medical device has been misused in any manner.”

SSM Health Orthopedics has instituted new controls, and will conduct further training of staff and management on the managing of patient information.

The agency has 2 previous major data breaches listed on the HHS Office for Civil Rights breach web site. In the year of October 2013, the theft of a laptop at Janesville Hospital in Wisconsin affected 631 sufferers. In the year of October 2015, an unauthorized access to paper or films at SSM Health Cancer Care in Missouri affected 643 patients.

SSM Health Orthopedics refused to provide more information on the most recent incident, however it did corroborate the information it sent out to affected patients by letter.

 

Organizations informing data breaches faster to federal agencies

The Department of Health and Human Services’ OCR (Office for Civil Rights) is cracking down on providers that don’t report data breaches of protected health information in a basic timely manner. OCR in the month of March initiated to fine agencies that don’t notify federal agencies of breaches within sixty days as required. The effect has been dramatic—average reporting times for breaches were merely 45 days in the month of March and 59 in the month of April, compared with 478 days in February, in accordance to Protenus, a vendor that offers a cloud platform to monitor and secure the security of hospital electronic health records (EHRs).

“It is complex to know for sure with limited information, but we might recommend 2 reasons for this trend of reduced breach reporting time,” claims Robert Lord, co-founder and CEO at Protenus. “One potential reason is that initiating earlier this year, HHS has arguably stepped up enforcement on healthcare agencies that don’t report breaches within the required 60-day window. Organizations are informing data breaches faster to federal agencies.

“An extra potential reason is that healthcare agencies are becoming more diligent in their analysis and reporting of breaches, as awareness of the significance of reporting grows,” Lord continues. “While these tragedies are unfortunate, they can be utilized as a learning experience to educate other covered entities on best practices.”

The number of days between when a breach occurred and when it was discovered in the month of April ranged from almost instantly to 228 days. Organizations are informing data breaches faster to federal agencies.

In April, 16 hacking tragedies accounted for 47% of all breaches. Additionally, another 29% were caused by insiders; 15% involved lost or stolen information and 9% by unknown means. The total number of records breached in the April attacks for which Protenus has numbers includes 171,268 patients.

The kinds of breaches reported last month involve providers (79% of all incidents), health insurers (5.8%), business associates or vendors (5.8%) and other (8.8%). Data from the monthly Protenus Breach Barometer report comes from DataBreaches.net.

 

Cedars-Sinai Medical Center decrease unimportant care using EHR alerts

Cedars-Sinai Medical Center in Los Angeles has reduced unsuitable or unimportant care by integrating recommendations from the national Choosing Wisely initiative into its electronic health record (EHR) system.

Due to the integration, EHR alerts pop up on computer screens of physicians during sufferer visits at the 958-bed hospital and multi-specialty academic health science center, advising whether specific care choices are important because of patients’ specific medical conditions and medications.

Launched in the year of 2012 by the American Board of Internal Medicine Foundation and Consumer Reports, the Choosing Wisely initiative is based on guidance from dozens of medical specialty societies and has recognized almost 500 common diagnostic tests and processes that might not have clear benefit for patients and sometimes should be ignored.

In accordance to Scott Weingarten, MD, chief clinical transformation officer, Cedars-Sinai Medical Center started integrating Choosing Wisely suggestions into its Epic EHR in October 2013, giving doctors real-time information and sparking important conversations with sufferers about the appropriateness of certain tests and treatments.

“The learning effect or educational effect is that when physicians learn Choosing Wisely suggestions, they commonly don’t re-order the unnecessary test or treatment and then cancel, but instead they don’t order to begin with, once they recognize it is not important,” claims Weingarten.

To date, nearly 100 Choosing Wisely recommendations have been added to Cedars-Sinai’s EHR system, he points out, with sufferers of physicians who followed all the alerts experiencing fewer medical complications and leaving the hospital sooner.

“After decades of discussion and debate, physicians, nurses and others responsible for delivering care at the bedside are indicating that we can deal this issue of inappropriate care where the harms exceed the benefits,” states Weingarten. “By boosting sufferers and doctors, we can deliver higher quality care more efficiently, increasing the value of healthcare for those who require it most.”

Weingarten adds that when physicians completely adhered to all the EHR alerts, costs at Cedars-Sinai Medical Center reduced by hundreds of dollars per patient encounter. Overall, the health system ignored $6 million in healthcare spending in the first full year of Choosing Wisely implementation.

“The past year, Cedars-Sinai Health System acquired $1.63 million in savings from cancelled orders alone, where physicians didn’t re-order the unimportant test or treatment or substitute another unnecessary test or treatment,” in accordance to Weingarten. “This doesn’t involve extra savings from orders not placed, decreased labor costs like nursing time linked with inappropriate blood transfusions, or the cost associated with harm.”

Among the Choosing Wisely recommendations adopted by doctors at Cedars-Sinai Medical Center is to ignore prescribing benzodiazepines, like Ambien and Valium, in the elderly. “They can cause elderly sufferers to have falls and hip fractures,” claims Weingarten.

Harry Sax, MD, professor and executive vice chair of surgery, refers to a forthcoming study of inpatient care at Cedars-Sinai conducted with Advisory Board, a healthcare consulting and research firm.

“Our research recommends that sufferers of physicians who follow clinical decision support Choosing Wisely guidelines have fewer complications, lower costs and a shorter length of stay,” asserts Sax, who advises doctors on best medical practices at Cedars-Sinai. “Future work will concentrate on the characteristics of these physicians and which alerts have the greatest effects.”

Going forward, Weingarten says Cedars-Sinai Medical Center will continue to leverage such clinical decision support to make better the quality, safety and worth of care at the health system.

 

VA awards $19.6M contract for patient self-scheduling app system

In an attempt to decrease the wait times for medical care, the Department of Veterans Affairs has awarded health IT vendor Document Storage Systems a $19.6 million contract to give a mobile-based, commercial off-the-shelf patient self-scheduling app system as key part of a VA pilot program.

The Faster Care for Veterans Act of 2016 instructed the agency to inaugurate an 18-month pilot under which veterans could utilize a website or mobile app to schedule and confirm medical appointments at VA facilities. The law needs that the pilot be rolled out to at least 3 Veterans Integrated Service Networks.

The pilot of VA will leverage the DSS ForSite2020 scheduling software, which will be integrated with the Veterans Health Information Systems and Technology Architecture (VistA), enabling consumers to schedule and confirm primary care, specialty care and mental health appointments through a mobile device or computer. The app will enable sufferers to request, schedule, confirm, modify or cancel appointments 24 hour each day.

“The VA is making crucial improvements to veteran healthcare and will always look to leverage creative tools that will put more capabilities in the hands of Veterans,” stated VA Secretary David Shulkin, MD. “Patient Self-scheduling app system is widely used in the private sector and will assist to develop a better experience for veterans and their medical care providers.”

Presently, the agency is pursuing a dual-track modernization approach to its medical appointment scheduling by investing in commercial as well as VA-developed systems. In accordance to the VA’s Office of Veterans Access to Care, it is working to make better both external “veteran-facing” and internal “scheduler-facing” scheduling apps.

Besides the commercial veteran-facing Faster Care mobile app from DSS, the VA has deployed its internally developed Veterans Appointment Request (VAR) app to almost 100 sites nationally.

“VA’s Mobile Veterans Appointment Request app, presently available at 99 sites, also gives most of the primary capabilities required by the Faster Care for Veterans Act and is modeled after victorious mobile applications used for patient self-scheduling app system,” in accordance to an agency statement. “VA intends to sustain development of VAR to incorporate new capabilities.”

The Veterans Appointment Request app makes it possible for veterans to patient self-scheduling app system primary care appointments and request help in booking both primary care and mental health appointments at the VA facilities where they get care. In addition to scheduling appointments, the app is capable to trace appointment details and the status of requests, send messages about requested appointments and get notifications and cancel appointments.

 

Favorable CBO score provides empowerment to Medicare telehealth bill

Legislation developed to offers Medicare Advantage plans and accountable care organizations (ACOs) greater flexibility in giving Medicare telehealth bill services to sufferers with chronic conditions got a huge boost this week from the Congressional Budget Office, which provided the Senate bill a favorable score.

Initially, the CBO has expressed uncertainties that changing Medicare reimbursement policy regarding telemedicine could dramatically increase healthcare spending.

Although, on the day of Tuesday the office issued a preliminary cost estimate of the CHRONIC Care Act, which involves 4 provisions expanding telehealth coverage under Medicare: nationwide coverage for telestroke, home remote patient monitoring for dialysis therapy, enhanced telehealth coverage for accountable care organizations, and more flexibility for Medicare telehealth bill coverage under Medicare Advantage plans.

“We’re pleased with the reasonable and restricted costs linked with the expansion of Medicare reimbursement of telemedicine, as projected by the Congressional Budget Office,” claims Jonathan Linkous, CEO of the American Telemedicine Association, who is a longtime critic of Medicare restrictions on telehealth.

ATA stated that CBO’s cost estimate summarized that the Medicare telehealth bill wouldn’t increase or reduce Medicare spending. Specifically, the group pointed out that CBO stated in its analysis that expanding telehealth to the home for Medicare dialysis treatment would be budget neutral.

Linkous pointed out that CBO has “finally appreciated cost savings when telemedicine is executed through value-based programs such as Medicare Advantage,” adding that the ATA hopes that these estimates “will now provide Congress the courage to pass this bill and permit Medicare patients to get the benefits that telemedicine can provide.”

The Senate Finance Committee on Thursday held a scheduled mark-up of the CHRONIC Care Act, at which the legislation was unanimously passed by a roll call vote of 26-0. The bill now moves on to the Senate for passage.

In accordance to the ATA, this CBO analysis is the 1st time that the office has scored telemedicine legislation since the year of 2001. Critics of Medicare policy have often cited restrictions on reimbursement as key obstacles to ensuring access to telehealth services for sufferers with chronic conditions. Now, they see the CBO score as green-lighting the expansion of Medicare coverage of telemedicine.

 

Partners HealthCare & GE Healthcare merges for AI projects

Artificial intelligence (AI) is hoped to play an increasing role in healthcare delivery, but moving the application of predictive technology from the theory to reality has been a stumbling block. A latest partnership between Partners HealthCare and GE Healthcare is targeting at bridging this gap and bringing deep learning technology across the whole continuum of care.

Under a recently declared ten-year agreement between the Boston-based integrated delivery system and the health technology vendor, the partners expect to find ways to develop “new business models for applying AI to healthcare and establish products for extra medical specialties,” the announcement noted.

For instance, AI could be directed to solve issues in molecular pathology, genomics and population health.

The collaboration will occur through the newly developed Center for Clinical Data Science, a newly formed project of Massachusetts General Hospital and Brigham and Women’s Hospital.

The project will utilize multidisciplinary teams with broad access to data, computational infrastructure and clinical expertise. The initial concentration of the relationship will be on the development of applications that are intended to make better the clinician productivity and patient outcomes in diagnostic imaging.

“This is a significant moment for medicine,” stated David Torchiana, MD, CEO of Partners HealthCare. “Clinicians are inundated with data, and the patient experience suffers from inefficiencies in the healthcare industry. By merging the expertise at Mass General and Brigham and Women’s with the spirit of innovation at GE, this partnership has the resources and vision to increase the development and adoption of deep learning technology. Together, we can boost clinicians with the tools required to store, analyze and leverage the flood of information to more effectively deliver care to sufferers.”

Furthermore, the teams will co-develop an open platform on which Partners HealthCare, GE Healthcare and third-party developers can rapidly prototype, validate and share the applications with hospitals and clinics around the world.

 

Athenahealth takes a huge initiative for more HIT innovation

Ambulatory and hospital electronic health records (EHRs) vendor athenahealth is providing space in its San Francisco office for as many as 200 entrepreneurs to boost HIT innovation.

“By consolidating fresh talent, we can assist fast-track innovative solutions to market, making healthcare IT much more relevant, worthy and ‘shop-able’ for providers and their patients,” CEO Jonathan Bush stated in a statement.

The program is called MDP Labs and open to healthcare and technology entrepreneurs from seed-stage startups to mature companies, and athenahealth won’t take equity in the companies.

Internal research and development and business experts will assist the companies design programs, get feedback from athenahealth, its super-users and a network of advisors.

The program also gives access to athenahealth providers and beta programs. For more information, please visit here.

 

Public health labs to get assist sharing Zika virus test data electronically

Although almost all laboratories testing for the Zika virus is conducted at public health labs, most of these labs presently don’t have the capability to electronically exchange information like orders and test results.

Although, a joint project between the Office of the National Coordinator for Health Information Technology and the Centers for Disease Control and Prevention is trying to develop a national system for order entry and test reporting so that public health labs can interface with providers’ electronic health records (EHRs), replacing the current manual procedure between providers and labs.

The organizations are also partnering with the Association of Public Health Laboratories, in accordance to Michael Baker, an analyst in ONC’s Office of Policy.

“There is a huge distribution of Zika virus cases that have been laboratory confirmed. And, it is shocking that we do not have a way that this information can get around efficiently and completely, which could slow care,” stated Baker, who noted that in 2016 there were more than 5,000 cases of the mosquito-borne illness in the contiguous U.S. and more than 36,000 cases in the U.S. Territories.

So far, in the year of 2017, there are just 110 Zika cases in the U.S. But, the outbreak will ramp up as this year’s mosquito season progresses, and “the creation of this system is going to assist us track those cases better,” he added.

“We need to make sure that any Zika data that is developed gets into the right hands quickly and is seen by the right stakeholders at the right time,” claimed Michelle Meigs, senior informatics program manager at the Association of Public Health Laboratories. “The tools that are in place right now to handle that data and specimens throughout the testing lifecycle are really lacking.”

To facilitate electronic transmission and sharing of public health labs test data, Meigs offered that the project will leverage Health Level 7 International’s emerging Fast Healthcare Interoperability Resources (FHIR) standard and a web portal for providers. “We’re going to be looking at not just instituting the HL7 test order and results standard between the portal and the laboratory, but also hopefully from the EHR itself through the portal and to the laboratory,” she added.

Among the aims of the project, which is funded by the Department of Health and Human Services, is to make sure that public health labs get a standard pregnancy status with electronic lab orders. Because Zika can be passed to fetuses, possibly causing severe fetal birth defects, capturing pregnancy status and sharing the data with public health partners is crucial to documenting Zika infection in pregnant ladies and informing interventions.

“We need to be able to detect those cases and prioritize those testing regions so we know to inform the women, possibly, between providers and public health labs as fast as they can so they can work with their providers for monitoring,” said Baker.

Part of the HHS Ventures Fund, the CDC-ONC project was one of 5 entrepreneurial projects selected for growth-stage funding—$375,000 in total—to advance the department’s innovation agenda.

“This project would enable efficient data transmission and make better care for sufferers by transmitting orders and results in a faster and more efficient way,” states an HHS announcement. “Furthermore, this would develop the capacity of public health laboratories to respond and manage future changes in testing requirements guidance from public health authorities.”

Baker claimed that Florida and Texas have committed to be pilot sites for the project, as most of the U.S. Zika cases are located in those 2 states. “Once we get these pilots up and running, other states and other state public health labs will hopefully agree to take part in this,” he summarized.

 

Using video to elaborate test results to sufferers

Researchers at the institute of University of Illinois are in the initial stages of establishing a computer-generated physician or nurse that can elaborate test results to sufferers and next steps in treatment through patient portals available through an electronic health records (EHRs) system.

For now, the work is in the proof-of-concept stage, with researchers explaining the project in the March issue of the Journal of Biomedical Informatics. The work of showing test results to sufferers is being done at the institute of University of Illinois’ Beckman Institute for Advanced Science and Technology, and the Carle Foundation Hospital’s Research Institute.

While several sufferers today have access to their electronic health records (EHRs) when they log into their portal, they analyze a bunch of test results, often represented as numbers that can be complicated to understand, claims Dan Morrow, lead author and educational psychologist at the University of Illinois. “You see a table of numbers and scores but you do not get context on ranges and risks, and you don not know if a low score is normal or a high one is normal,” he explains. For now, the numbers are generally a basis for having a conversation with your doctor.

And for now, a computer-generated doctor has to wait as researchers take baby steps and develop up to that kind of technology. For starters, they are working on attempting to enhance the presentation of tests results whether get in the mail or through a portal, by color-coding scores. A low score for cholesterol, for example, would be green, a medium score would be yellow, and a high score would be red.

But work is underway to develop a more realistic patient-physician dialogue. A retired physician recorded scripts for the sufferer portal messages and other text required to develop the avatar clinician’s commentary. Multiple scripts have been established to emulate how various kinds of test results would be explained to sufferers.

Researchers also testing whether patients’ “gist memory,” which is fuzzy representations of an event, differs relying on whether the avatar speaks in a natural voice or a computer-generated voice.

As a 1st step, researchers brought older adults into the lab and had them go through various mock patient scenarios that affect the heart disease. Few of the adults, acting as patients and presented with mock test outcomes, would see a list of numbers or the similar numbers but color coded. Another group would see a video of a provider presenting results and told how they should think about the numbers, then assess how well the older adults understand and retain those outcomes.

The reality is that most individuals like information in a video but most physicians will not use video to explain results so the idea was to develop an avatar physician or nurse that appears in the video, in accordance to Morrow. “We need to emulate best practices in a real-life face-to-face atmosphere.”

The avatar clinician is programmed to display suitable facial expressions, gestures and other cues that promote patient understanding as if findings were being presented by a human.

Having got a grant to begin the project, the attempt recently got another grant to generate other clinician avatars, and now is seeking grants for pilot studies with patient portals next year.

If everything goes well, Morrow considers a first-generation product could be a reality in 2 or 3 years.

 

The Spring Accountable Care Organization Coalition Meeting: From Finding Worth to the Future of the Affordable Care Act

A day after the House Republicans gave vote to send the American Health Care Act to the Senate, Forbes opinion editor Avik Roy put it in context: the “behemoth” that is the health system of US has grown up over a half-century and merges with the worst characteristics of delivery systems from across the world—high charges, inefficiency, and deficiency of coverage. The Spring Accountable Care Organization Coalition Meeting: From Finding Worth to the Future of the Affordable Care Act.

“We’ve all the cost inefficiencies of a highly public system without any of the real coverage gains that you would hope from a truly government system,” stated Roy, speaking in Scottsdale, Ariz., at The American Journal of Managed Care® (AJMC®)’s spring meeting of the ACO and Emerging Healthcare Delivery Coalition,® May 4-5, 2017. The Spring Accountable Care Organization Coalition Meeting: From Finding Worth to the Future of the Affordable Care Act.

The address and appearance of Roy on a panel about the future of the Affordable Care Act (ACA) gave a high point in an information-packed conference, which also depicted:

• Keynote speaker Darius Lakdawalla, PhD, of the University of Southern California, who explained the challenge of measuring what matters to sufferers as the health system shifts to value-based payment structures.


• The AJMC® 2020 Panel Discussion series, which reflected the insights from health system leaders bringing legal services to Medicaid sufferers in post-Katrina New Orleans and another tackling how to get the most out of each sufferer visit, specifically among seniors, as well as the founder of a health IT organization committed to care transformation through precision medicine.


• Insights from ACO Coalition Chair Anthony Slonim, MD, DrPH, the CEO of Renown Health, and moderator Clifford Goodman, PhD, of The Lewin Group. “The significant takeaway from this meeting is that we’re making much progress,” Goodman claimed. “We’re making much progress in comprehending what value means and how we might bridge better understanding of value into decision making.”

The next ACO Coalition meeting is set for the time period of October 26-27, 2017, in Nashville, Tenn. For information, visit the Coalition website here.

 

Mentors must seek to strengthen weak regions of up-and-comers

Healthcare information technology leaders have myriad issues to solve in their daily lives, and those urgent demands often drown out the requirement to recognize others with leadership potential. Mentors must seek to strengthen weak regions of up-and-comers.

That has to change, asserts Rachel Hall, executive director of performance improvement at Ernst & Young, who has powerful opinions about the obligation of female leaders in healthcare IT to identify and mentor potential leaders. Mentors must seek to strengthen weak regions of up-and-comers.

“There is no secret box to what a potential leader looks like,” claims Hall, who’ll speak on this topic at next week’s Most Powerful Women in Healthcare IT event in Boston. The day-long conference will be held May 17 in the region of Boston.

To be effective in finding and supporting emerging leaders, executives need to “recognize those with capabilities and leadership and indicate them a path,” claims Hall, who is also one of the top 75 honorees opted by Health Data Management this year. For instance, Ernst & Young has a mentor program for females who are new mothers with the aim of supporting them so they can remain in the workforce during this period of changing requirements. Mentors must seek to strengthen weak regions of up-and-comers.

Seek out females who’ve a range of characteristics that bring value to an agency, involving assertiveness, influence, honesty, the capability to show a vision, as well as those who know what their own biases are and can work to overcome them, Hall will tell her peers. “Individuals think men are more assertive than women, but it is significant for us to be assertive as well.”

There are perceptions that can hold back females, and these must be brought to the surface, Hall considers. A specific woman in an organization, for example, may be ready for promotion, but there might be a perception that that she does not speak up in meetings. To counter that, a mentor should present a strategy to overcome what is holding her back, Hall claims. But it could be a double-edged sword—she may be attempting not to speak because she is being respectful of others, or she might not have a vision.

Hall will implore others to become passionate about growing female leaders and to force them. “It is the person-to-person interactions and the capability to bounce ideas off other individuals that has made my career fulfilling as I watch them grow in their careers,” she states.

 

Deep learning computer network excels at verification of breast cancer biopsy slides

Researchers have established a deep learning computer network that is highly precise and accurate in verifying whether invasive forms of breast cancer are present in whole biopsy slides.

A research team supervised by Case Western Reserve University published results of their research in Scientific Reports, detailing their deep learning computer network approach.

The research first involved training the network by downloading 400 biopsy images from several hospitals and then presenting the network with 200 images from The Cancer Genome Atlas and University Hospitals Cleveland Medical Center. Deep learning computer network excels at verification of breast cancer biopsy slides.

In accordance to Anant Madabushi, professor of biomedical engineering at Case Western Reserve and co-author of the study, the network scored 100% precision in determining the presence or absence of cancer on whole slides.

“This is a research with 600 patients, so it is fairly robust,” claims Madabushi, who also directs Case Western Reserve’s Center of Computational Imaging and Personalized Diagnostics. “And there were many human-machine comparisons done.”

In fact, compared with the analyses of 4 pathologists, the machine was more consistent and accurate, Madabushi asserts.

“Pathologists are highly busy, and we are talking about microscopic-level detail in these tissue slides. So, obviously, for them to go in and pick out every cell of cancer wasn’t tenable. There just was not enough time for them to be capable to sit down and manually do that,” adds Madabushi. “The network initiated to get more sophisticated, more granular and more accurate than the pathologists.”

Previous month, the Food and Drug Administration approved the marketing of the Philips IntelliSite Pathology Solution, the first whole slide imaging (WSI) system that enables review and interpretation of digital surgical pathology slides prepared from biopsied tissue. The system enables pathologists to read tissue slides digitally to make diagnoses, instead of looking straightly at a tissue sample mounted on a glass slide under a conventional light microscope.

In accordance to Madabushi, this is the first time the FDA has permitted the marketing of a WSI system for these purposes, which he says is a huge milestone for pathology. “A pathologist can look at an image of a slide on their computer monitor, and that is equivalent to the pathologist looking at a slide under their microscope,” he points out. “That means digital pathology—the digitization of slides—can now be utilized for primary diagnosis by a pathologist. That is a game changer.”

He considers that as pathologists increasingly adopt digital pathology there will be “an even greater need for software and analytics like the one we released in this paper.” Finally, Madabushi emphasizes that the FDA’s clearance of the Philips system “opens the door to an entire market for the analysis of digital pathology slide images.”

 

Cyberattack compels British hospitals to turn away sufferers

British hospitals emphasized individuals with non-emergency conditions to stay away after a cyber attack affected huge parts of the country’s National Health Service.

16 NHS organizations of British Hospitals were hit in the U.K. on the day of Friday, while a major number of Spanish companies were also attacked using ransomware. It is not still clear if the attacks were coordinated.

Security experts in the U.S. claimed that security and health care leaders are seeking to find solutions to stop the NHS outbreak from recurring here.

“The NHS has faced a huge cyber attack, we’re working with law enforcement and our advice will follow shortly,” Action Fraud, the central cyber-crime unit of U.K. said on Twitter. The National Cyber Security Center stated: “We’re aware of cyber tragedy and we’re working with NHS Digital and the National Crime Agency to investigate.”

British Hospitals in London, North West England and Central England have been impacted, in accordance to the BBC. Mid-Essex Clinical Commissioning Group, which runs British hospitals and ambulances in a place east of London, stated on Twitter that it had “an IT problem affecting some NHS computer systems,” adding “Please don’t attend Accident And Emergency unless it is an emergency.”

The affect on services isn’t a result of the ransomware itself, but because of the NHS Trusts shutting down systems to stop it from spreading, stated Brian Lord, a former deputy director of Government Communications Headquarters (GCHQ), the U.K.’s signals intelligence agency, who is now managing director of cybersecurity firm PGI Cyber. Lord, who explained an attack of this kind as "inevitable," said the impact was exacerbated because most NHS Trusts had "a poor understanding of network configuration, meaning everything has to shut down."

A screenshot of an apparent ransom message, sent to a hospital, demonstrated a demand for $300 in bitcoin for files that had been encrypted to be decrypted.

Employees across the NHS have since been sent emails from the health service’s IT teams warning not to open or click on suspicious attachments or links.

National Cryptologic Center of Spain, which is part of the intelligence agency of country, said on its website that there had been a “massive ransomware attack” against a huge number of Spanish agencies affecting Microsoft Windows operating system. El Mundo reported that the attackers sought a ransom in bitcoin.

“We are aware of reports and are looking into the situation,” claimed a Microsoft spokesperson.

Ransomware generally gets onto a computer when an individual unsuspectingly downloads a file that looks like a normal attachment or, alternatively, clicks on a web link. A hacker then can trigger the malware to freeze the computer, prompting a person to pay a ransom or lose all their files.

Hospitals have been a usual target because the culprits know how critical digital records are for treating sufferers.

Ransomware attacks have also been soaring. The number of such attacks increased 50% in the year of 2016, in accordance to an April report from Verizon Communications. These kinds of attacks account for 72% of all the malware incidents involving the healthcare industry in the year of 2016, in accordance to Verizon.

"The large-scale cyber-attack on our NHS today is a major wake-up call," stated Jamie Graves, chief executive officer of cyber-security company ZoneFox.

Andrew Barratt, managing principal of Coalfire, a company which gives cybersecurity risk assessments to the healthcare sector, said that severak NHS hospitals used personal computers with outdated Windows-based operating systems, which have makes them convenient to attack. He said several of these systems were too old to patch and that many NHS Trusts didn’t spend enough time on technical best practices and audits, leaving them susceptible to a variety of potential cyber attacks, involving ransomware.

 

Memorial Hermann Health System to pay $2.4M Fine for HIPAA violations

Memorial Hermann Health System in the region of Texas will pay a fine of $2.4 million and enter into a 2-year corrective action plan after revealing a sufferer’s protected health information without the patient’s authorization.

In the year of September 2015 a sufferer at a MHHS clinic presented a fraudulent identification card to office staff, which contacted police, and the sufferer was arrested.

MHHS released multiple press releases to fifteen media outlets on the incident and added the sufferer’s name in the title of the release; it also revealed the sufferer’s protected information during 3 meetings with an advocacy group, state representatives and a state senator, as well as on its website.

Moreover, the HHS Office for Civil Rights found during an investigation that the agency also failed to document in a timely manner the sanctioning of workforce members that revealed the patient’s name.

“Senior management should have known that revealing a sufferer’s name on the title of a press release was a clear privacy violation that would induce a swift OCR response,” OCR Director Roger Severino claimed in a statement. “This case reminds us that agency can readily cooperate with law enforcement without violating HIPAA, but that they must nevertheless sustain to secure patient privacy when making statements to the public and elsewhere.”

Among other requirements, the corrective action plan, available here, needs all MHHS facilities to attest their understanding of permissible uses and disclosures of protected health information, involving disclosures to the media.

Memorial Hermann Health System refused to comment.

 

NIST issues new guidance for protecting wireless infusion pumps

The NIST (National Institute of Standards and Technology) has released latest guidance on protecting wireless infusion pumps in hopes of hardening the devices against the cyber attacks.

The federal agency released the directions in collaboration with the National Cybersecurity Center of Excellence (NCCoE), which is a unit within NIST. The NCCoE has developed a plan indicating providers how to use standards-based commercially available technology to secure wireless infusion pumps, patient data and drug library dosing limits.

Various significant vendors collaborated with NIST on the report. They involve B.Braun, Baxter, BD, Cisco, Clearwater Compliance, DigiCert, Hospira, Intercede, MDISS, PFP, RAMPARTS, Smiths Medical, Symantec and TD Medical.

The plan involves a questionnaire-based risk assessment mapping security characteristics to available cyber security standards as well as to the requirements of HIPAA security rule to apply security controls for pumps and other data systems or networks to which they might connect.

“Finally, we demonstrate how biomedical, networking and cybersecurity engineers and IT experts can securely configure and deploy wireless infusion pumps to decrease cybersecurity risk,” NIST’s report asserts.

The new report depicts more than a year of work on infusion pump security by NIST, which called on technology companies in the year of January 2016 to mount a collaborative effort to make better the security of wireless pumps.

Federal organizations and watchdog groups raised awareness of the fact that wireless infusion pumps could be compromised by hackers, increasing risks for sufferers and also prompting uncertainties that the networks to which they are connected could be accessed through cyber attacks. Security on the devices generally is weak and can be conveniently manipulated by external agents.

“In specific, the wireless infusion pumps ecosystem (the pump, the network and the data stored in or on a pump) confront a range of threats involving unauthorized access to protected health information, changes to prescribed drug doses and interference with the function of pump,” the guidance states, referring a report of the Association for the Advancement of Medical Instrumentation.

However connecting infusion pumps to point-of-care medication systems and electronic health records (EHRs) can improve the healthcare delivery procedures, utilizing a medical device’s connectivity capabilities can pose increased threat, which could lead to operational or safety problems, NIST points out.

In general, wireless infusion pumps don’t interface with a lot of other information systems; they take data and push it to the pharmacy using an HL7 central server, and the data may also go into the electronic health record, says Tom Walsh, president of the Tom Walsh Consulting security practice. But because there are so many different vendors and varieties of pumps, it’s been difficult to devise one approach to protect them.

Part of the vulnerability stems from the fact that vendors often remotely access their devices in hospitals to troubleshoot them. “How do you know it’s the vendor in the device or someone hacking in?” Walsh asks. “The vendor may or may not collaborate with IT or biomedical.”

The full NIST guidance is available here. A model of a network infrastructure is here.

 

Care management program decreased healthcare charges in Pioneer ACO

Healthcare is going through a major transformation both in how care is delivered and how it is paid for across the country. These alternative payment models, like Accountable Care Organization (ACO) of Medicare, need health care delivery agencies to share in the financial risk linked with their patients' medical spending and motivate health care providers to think of alternative ways to get sufferers the care that they require. However ACOs seem to lower medical spending, there is less information on how these savings are really acquired. Today, researchers at Partners HealthCare published a study demonstrating that Partners Pioneer ACO not only decreases spending growth, but does this by reducing avoidable hospitalizations for sufferers with elevated but modifiable risks. The research appears in the month of May issue of the journal Health Affairs. Care management program reduced healthcare charges in Partners Pioneer ACO.

The research analyzed the impact of patient participation in the Pioneer ACO and its care management program on rates of emergency department (ED) visits, hospitalizations’ rates, and on overall Medicare spending. To measure the effect of ACO, and separately the care management effect, the researchers compared participation in the care management program to a similar group of sufferers who were eligible but hadn’t yet initiated the care management program.

"The significant finding was that the care management program seemed to be the mechanism through which the ACO was capable to acquire its benefits," stated John Hsu, MD, the study's first author and Director of Clinical Economics and Policy Analysis Program at the Mongan Institute for Health Policy at Massachusetts General Hospital, which is key part of Partners HealthCare. Sufferers in the care management program had lower rates of emergency department visits (94 percent of the rates of non-participants) and non-emergency visits (88 percent of the rates of non-participants), and an 8 percent decrease in hospitalizations. The longer the sufferer was in the program, the higher the reduction in hospitalizations.

"The decrease in utilization and spending are modest, but grow with sufferer participation in the program," claimed Eric Weil, MD, Chief Medical Officer of Primary Care in the Center for Population Health at Partners HealthCare, and one of the study authors. "The outcomes of the study recommend that focusing on sufferers with high risk is a key strategy and might explain the decrease in spending growth linked with ACOs."

In terms of cost savings, participation in the care management program was linked with a reduction in Medicare spending of $101 per participant each month, a decline of 6 percent. The whole ACO population, similar to comparable studies, reduced health care spending $14 each participant per month, a 2 percent decline.

"However the impacts of payment system changes are yet ongoing, this research reinforces the observation that altering care delivery takes time, but is worth the investment," stated Gregg Meyer, MD, Chief Clinical Officer at Partners HealthCare.

The care management program concentrates on chronically ill sufferers with several health problems, like diabetes, heart failure, and depression. Started at Massachusetts General Hospital in the year of 2006 as part of the Medicare Care Management for High Cost Beneficiaries Demonstration, the program now treats and handles the care for more than 12,000 complex, high risks adult and pediatric patients cared for at every Partners HealthCare primary care practice.

Sufferers are offered services by nurse care managers who work with physicians in the primary care office of patient. They establish custom treatment plans that deal any gaps in health care or social factors, like isolation and deficiency of family support. The care manager becomes the central, consistent point of contact for the sufferer. Other members of the care team involve social workers, community resources specialists, a pharmacist, and the patient's specialists. The care management group works with sufferers and their families in several settings involving the primary care office, at home, in the hospital, and in the emergency room (ER).

"The research indicates how one successful ACO was capable to acquire benefits, involving expansion from one hospital to the whole delivery system," stated Dr. Hsu. "This information can assist other health systems in the US as they contemplate entry into alternative payment models or make investment decisions to increase an existing ACO."

 

Incorrect Heart Rate mHealth Apps Pose Consumer issues

Almost a fifth of measurements recorded by heart rate mHealth apps for users can be incorrect by upwards of 20 beats each minute, compared to clinical monitoring, inn accordance to research from the European Society of Cardiology.

A group of researchers observed 4 different heart rate mhealth apps available on the App Store for iPhone 4 and 5, and discovered that these heart rate mhealth apps were appealing to consumers because of the ease-of-use and accessibility.

Not merely are the apps easily available, but can be tantalizing to consumers regardless of a significant likelihood to give false data.

“Heart rate mhealth apps come installed on several smartphones and once individuals see them it is human nature to use them and compare their outcomes with others,” stated study author Dr Christophe Wyss, a cardiologist at Heart Clinic Zurich, Switzerland.

But incorrect readings may lead to alarm in sufferers and prompt unimportant communications with providers.  “Consumers and interpreting physicians require being aware that the differences between apps are huge and there are no criteria to assess them,” cautioned Wyss.

In the research, the researchers assessed the precision of certain heart rate mHealth apps by comparing the results to the clinical gold standard measurements. Clinical monitoring utilizes an electrocardiogram (ECG), which measures the electrical activity of the heart using leads on the chest, and fingertip pulse.

The apps were broken into 2 subgroups: ones that made contact with the user and apps that were non-contact. Apps that made contact with the consumer were much more accurate than the non-contact apps, in accordance to the research team.

Although, even the user-contact apps delivered different results, as one of them was much better at recording heart rate in contrast to the other.

“The one contact app was remarkable, performing nearly like a medically approved pulse oximeter device, but the other app wasn’t accurate even though they use the similar technology,” claimed Dr Wyss.

The researchers attemped to find why the apps were different, but couldn’t even after reviewing camera technology (iPhone 4 versus iPhone 5), age, body temperature, or heart rate itself. The most likely answer includes proprietary information from the developer side of app production.

“The difference in performance between the contact apps is possibly down to the algorithm the app uses to measure heart rate which is commercially confidential,” stated Dr Wyss. “It means that merely because the underlying technology works in one app does not mean it works in another one and we cannot assume that all contact heart rate apps are precise.”

Non-contact apps performed worse than the contact apps overall. Problems in performance were very apparent when consumers had high heart rates and lower body temperatures, as the apps had a tendency to overestimate higher heart rates. The team considers that ease-of-use over accuracy incentivizes users to download the non-contact apps.

“While it is convenient to use the non-contact apps – you only look at your smartphone camera and it provides your heart rate – the number it gives is not as precise as when you’ve contact with your smartphone by putting your fingertip on the camera,” Wyss asserted.

Incorrect claims on heart rate apps have led some government officials to take action on the matter.  In the month of March, New York Attorney General Eric G. Schneiderman put sanctions on 3 heart rate mhealth apps that mislead consumers about in-app heart rate monitoring.

“Mobile health apps can benefit users if they function as advertised, don’t make misleading claims and protect sensitive user information,” Schneiderman claimed in a press release. “Although, my office won’t hesitate to take action against developers that disseminate unfounded data that is both false and potentially harmful to everyday consumers.”

Users who use heart monitoring apps should be aware that the tools might not present precise data, Wyss added, and shouldn’t use mHealth applications as a replacement for clinical monitoring of cardiac conditions.

 

Artificial Intelligence seen as Third Great Revolution bringing services to the masses

Artificial intelligence (AI) is being explained as the third great revolution in the field of business, following the Industrial Revolution and the Information Revolution. And if few industry observers are correct, it’ll have a transformative impacts on consumers, business and government markets around the globe.

In accordance to the report “Bot.Me: A revolutionary partnership: How AI is pushing man and machine closer together” from PwC, “AI has the possibility to become the great equalizer. Access to services that were conventionally reserved for a privileged few can be extended to the masses.”

The effects of that on business can’t be understated, as artificial intelligence has the possibility to open up major new markets or expand on existing markets. That means agencies that embrace artificial intelligence will have distinct competitive advantage, the study points out.

“As humans, there is a lot we are not good at,” claims AI developer Kaza Razat, quoted in the PwC study. “When we are making machines that are better at certain things than we are, it is still an extension of us. From an evolution standpoint, there are places where we have reached the end of our capacity.”

Still, artificial intelligence (AI) is merely as good as the data it uses the research stresses. That places greater emphasis on problems related to data quality and data governance.

Where artificial intelligence is hoped to have particularly dramatic impact is in areas around cybersecurity, privacy, cancer research and the treatment of other diseases, the study claims.

“With the huge amount of DNA data being recorded today, AI could revolutionize personalized healthcare by observing that data; wearables and ingestibles could monitor and correct human behavior to maximize life expectancy and increase wellbeing. We are already seen AI victoriously recognize autism in babies with 81% accuracy, and skin cancer with 91% accuracy.”

The study polled almost 2,500 consumers and business leaders on where they considered AI will have the most immediate impact. Their responses:

• 66% said treating cancer and other diseases


• 68% said cybersecurity and privacy


• 61% said personal financial security and fraud protection


• 62% said clean energy


• 58% said global education


• 56% said economic growth


• 56% said global health and well-being


• 50% said climate change


• 38% said income inequality


• 31% said gender inequality

More than 40% of consumers “believe AI will expand access to medical, financial, legal and transportation services to those with lower incomes,” the study claims.

 

Prescription databases to play a vital role in decreasing opioid abuse

In the battles against rampant opioid abuse, physicians have a strong weapon in their arsenal—state prescription databases that detect all prescriptions written for these addictive drugs.

Nearly every state has executed Prescription Drug Monitoring Programs (PDMPs), which record opioid prescribing history of a patient. By leveraging these prescription databases, doctors can access information to make an informed decision about whether sufferers are opioid abusers.

PDMPs gather and share data on prescriptions for controlled substances to flag suspicious prescribing and utilization. Although, not all states need providers to access these kinds of prescription databases prior to writing or filling a prescription.

Researchers have discovered that “must access” PDMPs, which need physicians to consult them before writing prescriptions, primarily reduced opioid misuse in Medicare Part D, based on the review of 3.5 million patient records between the time period of 2007 and 2013. At the same time, their research demonstrated that PDMPs without such compulsory provisions have no effect on curbing opioid abuse.

Regrettably, when provider access isn’t mandatory, data indicates that only small numbers of providers create PDMP logins and actually request patient histories.

“A great instance is Kentucky, which passed a ‘must access’ requirement in the year of 2012 and saw the share of controlled substance prescribers who had developed a login rise from about a third to more than 95%,” claims Colleen Carey, assistant professor of policy analysis and management in the College of Human Ecology at Cornell University.

In accordance to Carey, a healthcare economist, one of the ways states can get providers to start using PDMPs is to pass laws that need physicians to check these databases for their sufferers’ previous prescriptions. She points out that New York has the nation’s toughest laws with those requirements.

“New York (is the) strictest state needing doctors to check the opioid history of ‘every patient, every time,’ which is stronger than any other state,” she claims.

Carey and Thomas Buchmueller, a professor in the Ross School of Business at the institute of University of Michigan, co-authored a paper detailing their findings which are to be released in an upcoming issue of the American Economic Journal: Economic Policy.

“Our results recommend that PDMPs that don’t require provider participation are not effective in decreasing questionable or unsuitable use of prescription opioids,” summarize Carey and Buchmueller. “We do find evidence that ‘must access’ PDMPs have the desired impact of curbing certain kinds of extreme utilization. Particularly, such policies decrease several measures of excessive quantity and shopping behavior. The strongest laws, which cover all ingredients and settings of care and don’t require providers to be suspicious, have larger effects on utilization than weaker laws, but even ‘limited’ and ‘discretionary’ laws lower rates of shopping behavior.”

Doctor shopping is explained as seeing multiple providers to procure prescription medications illicitly. In their research on “must access” PDMPs, Carey and Buchmueller found that Medicare opioid users who got prescriptions from 5 or more physicians—a common indication of doctor shopping—dropped by 8%, while the percentage of those who got opioids from 5 or more pharmacies was reduced by 16%.

Nevertheless, the researchers also analyze that the “passage of a ‘must access’ PDMP might prompt people to cross state lines in search of less-regulated prescribers and pharmacies.”

 

Senate bill expands the use of telehealth services, remote patient monitoring for Medicare Beneficiaries

6 senators of U.S. have launched legislation seeking to remove hurdles to the use of telehealth services and remote patient monitoring for Medicare beneficiaries.

Sens. Brian Schatz (D-Hawaii), John Thune (R-S.D.), Roger Wicker (R-Miss.), Benjamin Cardin (D-Maryland), Thad Cochran (R-Miss.), and Mark Warner (D-Va.) launched the bipartisan Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act of 2017.

“Telehealth is the future of healthcare. It expands access to care, lowers charges and assists more people stay healthy,” stated Schatz. “Our bipartisan bill will assist change the way sufferers get the care they need, improving the healthcare system for both patients and healthcare providers.”

The CONNECT for Health Act builds on the provisions of another recently launched Senate bill—the CHRONIC Care Act—which targets to improve health outcomes for Medicare beneficiaries living with chronic ailments by, among other provisions, expanding access to telehealth services.

For its part, the CONNECT for Health Act calls for:

• Expansion of telehealth services in accountable care organizations (ACOs) and Medicare Advantage, as well as for home dialysis and telestroke services for purposes of evaluating acute stroke


• Broadening the utilization of remote patient monitoring for certain high-risk, high-cost sufferers


• Bolstering telehealth services and remote patient monitoring services in rural health clinics, federally qualified health centers, Native American sites, and permitting global and bundled payments


• Developing direct authority for the Secretary of the Department of Health and Human Services to lift existing restrictions on telehealth when certain quality and cost-effectiveness criteria are met


• Expanding the utilization of telemental health by providing the HHS secretary the authority to lift restrictions for few mental health services

The legislation has been endorsed by more than 50 agencies, involving ACT|The App Association, American Telemedicine Association (ATA), College of Healthcare Information Management Executives and the Healthcare Information and Management Systems Society (HIMSS).

“The CONNECT for Health Act gives a carefully crafted approach to star assisting countless American Medicare recipients realize the benefits of connected health technology,” claimed Morgan Reed, executive director of The App Association. “By lifting arduous limitations on the use of telehealth and motivating Medicare physicians to use creative remote monitoring technologies, responsible and secure connected health solutions might be introduced more broadly throughout the continuum of care to make better the patient health outcomes.”

“Medicare beneficiaries deserve access to telehealth services already available within nearly every other health program involving Medicaid, Veterans Health, private insurance policies and most recently TRICARE,” stated Jonathan Linkous, CEO of the ATA. “This bill might be their best hope for this Congress.”

Likewise, HIMSS appreciated the bill and pledged their support for its reforms.

“We consider that the CONNECT for Health Act will modernize healthcare delivery for Medicare beneficiaries by removing obstacles to the use of telehealth and other healthcare technologies like remote patient monitoring, resulting in higher access to high-quality care, improved continuity of care and better value for sufferers and the Medicare program,” stated HIMSS in a written statement.

 

Harvard Medical School, mPulse Mobile Partners to Improve Medicaid Chronic Care

A new mHealth agreement between Harvard Medical School and mPulse Mobile targets to study the impacts of two-way text messaging on the self-care habits of Medicaid beneficiaries.

Through two distinctive programs, researchers from the Department of Health Care Policy at Harvard will evaluate how text messaging can help newly enrolled Medicaid members with a requirement to enroll in a supplemental chronic care management program.

The first program involves the utilization of interactive text messages that prompt members to sign up for GCHP’s asthma disease management program. This is to see if mHealth intervention has a positive impact at initial point-of-enrollment in Medicaid.

A second program will particularly analyze if tailored text dialogues can affect primary care provider selection, utilization of preventive care services and screenings, and incidence of chronic illness.

Both text messaging programs are funded and supported by the California Health Care Foundation Innovation Fund, and will be available to Medicaid members under the Gold Coast Health Plan (GCHP).

Chronic diseases are immensely problematic, as they comprise 86% of US healthcare charges. An mHealth approach to chronic disease management at this scale could assist other agencies build similar strategies that deliver chronic care to huge populations.

Harvard Medical School researchers consider that the mPulse Mobile technology can assist with much needed improvements in how providers and other stakeholders engage with Medicaid members and their chronic disease management.

“There is a huge requirement for innovation in care delivery and how we can engage patients outside of just the office visit,” stated program researcher and associate professor of healthcare policy and medicine, Harvard Medical School, Ateev Mehrotra, MD, MPH.

“I have spent much of my career studying the capability of different interventions to drive advancements in population health management, and I am excited about the possibility for mPulse Mobile to engage people in their health using tailored and interactive text messaging to make better outcomes and lower charges.”

The companies see language as an obstacle for several newly enrolled beneficiaries to get proper screening and diagnoses for chronic conditions. An analysis of tailored text messaging aims to determine how language hurdles affect a member’s capability to actively seek out chronic care.

“We give members targeted strategies for assisting manage chronic conditions, working with them to acquire their best possible health,” claimed Nancy R. Wharfield, MD, associate chief medical officer, Gold Coast Health Plan.

The partnership depicts an opportunity to advance care delivery across other populations that struggle with access to care.

“Harvard’s interest in studying the efficacy of these programs further validates the requirement for innovative mobile solutions that reach members and drive engagement, specifically with underserved populations,” stated Chris Nicholson, CEO, mPulse Mobile.

“We are thrilled to work with Harvard and our customer Gold Coast Health Plan on this research and sustain proving text messaging’s positive effect on health outcomes.”

 

ONC initiating Patient Matching Algorithm Challenge Next Month

Identifying that the misidentification of sufferers remains a difficult issue for healthcare agencies, the Office of the National Coordinator for Health Information Technology is planning to start its Patient Matching Algorithm Challenge early next month.

“There is a lot of work going on with patient matching in the industry,” claims Steve Posnack, director of the ONC Office of Standards and Technology. “But with all the matching that is gone on, there are some benchmarks that are publicly available … about how well the algorithms that individuals are using to do sufferer matching should perform.”

Posnack explains patient matching as the procedure of comparing different demographic elements from different health information technology systems to evaluate if they refer to the same patient. He also appreciates the potentially negative effect that mismatching can have on patient safety.

The target of ONC’s Patient Matching Algorithm Challenge is to shine “a little bit of sunlight and transparency around what the benchmarks should be and how well the present tools are performing (and to) see if there are other tools and algorithms out there that could do a great job potentially than what is presently in use,” Posnack asserts.

The fial goal of the challenge is to “spur the establishment of innovative new algorithms, benchmark current performance and assist the industry coalesce around common metrics for success,” in accordance to Posnack.

Participants in the challenge, which officially initiates in early June, will be offered a dataset and will have their answers evaluated and scored against a master key. These participants will be offered as many as 100 run-throughs to see how well they can match the sufferers in the dataset.

ONC will award as many as 6 cash prizes totaling $75,000. The huge prize category will engage 3 prizes for the highest “F-Score”—a combination of best precision and recall. Additionally, best in category prizes will be awarded for “best precision” (least mismatched patients), “best recall” (least missed matches) and “best first F-Score run.”

Previously this year, the ECRI Institute ranked the top 10 patient safety concerns in the year of 2017 for healthcare agencies, with patient identification errors ranking 6th overall.

Posnack points out that the College of Health Information Management Executives has initiated and is currently conducting a $1 million National Patient ID Challenge designed to establish a solution that ensures 100% accuracy of every patient’s health data to decrease the preventable medical errors.

He explains ONC’s Patient Matching Algorithm Challenge as being complementary to the CHIME’s National Patient ID Challenge, with finalists in the innovation round to be declared on May 12 and an ultimate winner declared in the month of November.

“We’ve a great relationship with CHIME and have surely been in touch with them related to their challenge,” adds Posnack. “But, we are approaching patient matching from a different angle. We are actually trying to spotlight how the algorithms perform and the benchmarks that we can develop from an industry perspective.”

ONC will conduct 3 informational webinars—May 10, 17 and 24—to give additional details about the challenge and participant requirements.

“We expect our challenge will get the attention of experts from other industries that deal with individual matching, like the financial and airline industries,” Posnack summarizes.

 

Mayo Clinic leverages analytics to reduce test overutilization

To assist its providers know what laboratory tests to order and when, the Mayo Clinic is utilizing analytics to decrease the test overutilization and unnecessary healthcare charges.

Inefficient clinical laboratory test utilization cannot merely increase costs but can negatively affect the patient safety and quality of care, in accordance to Daniel Boettcher, senior programmer and analyst at the Mayo Clinic’s laboratory in Rochester, Minnesota.

Although, the Mayo Clinic has embraced clinical laboratory test utilization management to trace provider ordering patterns to recognize areas where performance can be improved and to stop providers from ordering tests that do not benefit patient outcomes.

That is where analytics come into play—assisting to decrease the unnecessary testing and improve utilization management by suggesting approaches for diagnoses of particular diseases, guiding selection of the correct tests, and helping in the treatment and monitoring of patient care.

“Over the last 4 years or so, we have been working to transform the way we give analytics services to the laboratories here,” claims Boettcher.

Instead of building a laboratory-focused analytics platform in-house, the Mayo Clinic decided to partner with an outside vendor, due to the work demands that such a project would place on its in-house IT team of analysts, developers and programmers, as well as the complications engaged in such a project. Mayo Medical Laboratories and Mayo’s Department of Laboratory Medicine and Pathology (DLMP), one of the world’s greatest clinical laboratories conducting more than 27 million tests yearly, opted healthcare analytics company Viewics to serve as their analytics platform.

Among other capabilities, the Viewics Utilization Management solution observes physician peer-to-peer test ordering patterns; offers peer-to-peer utilization reports to physicians; and recognizes the most costly tests and those providers with the highest send-out rates.

“With self-service reporting, we’re really putting the data in the hands of the users,” analyzes Boettcher. “They have straight access to it. Nobody is in their way.”

Additionally, the software assists to manage laboratory test utilization problem areas, like removing clinically obsolete tests, decreasing clinically duplicative testing, and identifying and changing tests with confusing or similar codes.

For those hospitals and health systems searching to implement and use analytics to drive organizational initiatives, Boettcher asserts that developing an analytics-driven culture is critical in which the data flowing into an agency is transformed into information that can be used to make actionable decisions.

Boettcher points out that “getting information into the system requires being managed just as carefully—if not more carefully—than getting information out of the system.” He makes the case that “if we do not get good quality information put into the system, we cannot get good quality information out of the system.”

“At the Mayo Clinic, it meant taking a strategic approach to developing a culture of analytics,” he summarizes, adding that it is about “ingraining into the laboratory staff and their procedures the value of analytics so that it is part of their everyday, regular workflow and operations.”

 

Data center market suffers as more agencies choose cloud computing

Cloud computing sustains to take a bite out of the data center market, as latest projections from Gartner Inc. indicate barely any spending growth for the year.

Worldwide IT (information technology) spending on the data center system segment is anticipated to grow by only 0.3% this year, Gartner says. Despite that low number, it is better news that previous year, which actually saw negative growth.

“We’re seeing a shift in who is purchasing servers and who they are buying them from,” elaborated John-David Lovelock, research vice president at Gartner. “Enterprises are shifting away from buying servers from the traditional vendors and instead renting server power in the cloud computing from companies like Amazon, Google and Microsoft. This has developed a reduction in spending on servers which is affecting the overall data center system segment.”

Of the 5 spending areas studied by Gartner, only communication services had a lower projection for 2017 year, at negative 0.3% growth. Spending on devices is projected to see a 1.7% increase and enterprise software is hoped to lead at a 5.5% increase.

Worldwide IT spending is projected to total $3.5 trillion in the year of 2017, which reflects a 1.4% increase from 2016, in accordance to Gartner. Heading into 2017 Gartner had originally projected a 2.7% spending increase. The research firm adjusted its projection down because of the rising significance of the U.S. dollar against foreign currencies.