Plastic Surgery of South Dakota is providing about 10,200 current and former patients a year of credit and identity protection services amid concerns that their information was accessed during a mid-February ransomware attack.
The agency removed the ransomware from its information systems and decrypted data, then brought in security experts to determine if any data was accessed by unauthorized users. While the majority of records were not accessed, the practice was unable to rule out whether a smaller subset of sufferer records had been breached.
To date, although, there is no proof of any actual or attempted misuse of data, the practice noted in a patient notification letter. Information that could have been compromised includes patients’ names, driver’s license numbers, Social Security numbers, state identification numbers, credit and debit card information, medical conditions and diagnosis information, lab results, addresses, dates of birth and health insurance data.
Plastic Surgery of South Dakota is further recommending a range of steps for affected individuals to take to protect themselves, including monitoring credit reports and explanations of benefits; getting free credit reports from the three major credit bureaus; placing fraud alerts on credit files and placing a security freeze on credit reports, which prohibits release of information from the reports absent consumer authorization.
The practice refused to give further details about the incident beyond a patient notification letter.
Monday, July 31, 2017
Friday, July 28, 2017
Anthem Blue Cross selects solution to help genetic testing
Anthem Blue Cross has initiated a genetic testing solution aimed at encouraging suitable, safe, and affordable testing and counseling for patients.
The Anthem Blue Cross program is developed and administered by national specialty benefits management leader, AIM Specialty Health, which offers an automated system that guides the decision-making process.
Anthem’s Genetic Testing Solution promotes appropriate use and provides education that addresses the clinical and financial complexities of genetic testing. Through a combination of clinical review of testing requests and coordination with genetic testing laboratories, providers and members can draw upon verified resources to support clinical decision making.
Anthem’s program has been in place since the day of July 1 and is being first used with its completely insured and self-insured members; national account members will be added in the year of 2018.
“More than 70,000 genetic testing products are presently on the market, and an average of 10 new products is introduced every day,” says Razia Hashmi, MD, Anthem’s medical director for commercial business. “Stakeholders across the healthcare system are increasingly challenged to manage the pace of change.”
With an international market for such testing estimated at $10.3 billion market by the year of 2024, the healthcare insurance and the industry in general is being thrust into an ongoing debate about how to handle the increasing array of complicated and costly tests.
Anthem considers the testing solution will improve the efficiency of the healthcare system for laboratories, doctors’ offices and insurers by moving from a manual, labor-intensive and post-service process to a real-time automated system that can deliver prior authorizations to doctors as they are sitting with their patients. The company also considers it’ll decrease the likelihood of errors in filling out paperwork, which adds to labor and time.
For several tests, using the solution can cut down the average time for submitting and processing an insurance claim from days to minutes because the prior authorization review provides specific CPT code data to the insurer to facilitate the claim processing, Anthem Blue Cross and AIM Specialty say.
The Anthem Blue Cross program is developed and administered by national specialty benefits management leader, AIM Specialty Health, which offers an automated system that guides the decision-making process.
Anthem’s Genetic Testing Solution promotes appropriate use and provides education that addresses the clinical and financial complexities of genetic testing. Through a combination of clinical review of testing requests and coordination with genetic testing laboratories, providers and members can draw upon verified resources to support clinical decision making.
Anthem’s program has been in place since the day of July 1 and is being first used with its completely insured and self-insured members; national account members will be added in the year of 2018.
“More than 70,000 genetic testing products are presently on the market, and an average of 10 new products is introduced every day,” says Razia Hashmi, MD, Anthem’s medical director for commercial business. “Stakeholders across the healthcare system are increasingly challenged to manage the pace of change.”
With an international market for such testing estimated at $10.3 billion market by the year of 2024, the healthcare insurance and the industry in general is being thrust into an ongoing debate about how to handle the increasing array of complicated and costly tests.
Anthem considers the testing solution will improve the efficiency of the healthcare system for laboratories, doctors’ offices and insurers by moving from a manual, labor-intensive and post-service process to a real-time automated system that can deliver prior authorizations to doctors as they are sitting with their patients. The company also considers it’ll decrease the likelihood of errors in filling out paperwork, which adds to labor and time.
For several tests, using the solution can cut down the average time for submitting and processing an insurance claim from days to minutes because the prior authorization review provides specific CPT code data to the insurer to facilitate the claim processing, Anthem Blue Cross and AIM Specialty say.
Thursday, July 27, 2017
Web-Based tool puts cancer sufferers at the center of their care
A web-based tool designed for clinical collaboration has been shown to be beneficial in facilitating care management communication between patients with advanced cancer and their clinicians.
The internally developed platform, termed as Loop, was put to the test in a feasibility randomized controlled trial at Sinai Health System’s Temmy Latner Center for Palliative Care in Toronto and the University of Toronto’s Princess Margaret Cancer Center.
Loop, a secure web-based tool, enables sufferers and caregivers to communicate asynchronously with multiple members of the care team including physicians, nurses and allied health professionals. Particularly, it links sufferers and caregivers to providers in a virtual space where communication can be facilitated outside of appointments and across care settings.
Results of the feasibility trial involving 24 advanced-stage cancer patients, recruited to both the intervention and control arms, and their care teams were recently published in the Journal for Medical Internet Research. The study found that it was feasible to implement Loop in clinical practice and that the tool may have the potential to improve continuity of care.
“We conducted a pilot randomized controlled trial in a population of patients with advanced cancer, as prototypical of a population with complex care needs,” write the authors. “Our objective was to evaluate the feasibility of integrating a tool like Loop into current care processes and to capture preliminary measures of the effect of Loop on continuity of care, quality of care, symptom distress, and healthcare utilization.”
“It is not about the diagnosis of the patient—it’s much more about patients with complex care needs that would benefit from an intervention like this,” says Amna Husain, MD, project leader at the Temmy Latner Center for Palliative Care.
The notion behind Loop is to put patients at the center of their care, making them an integral member of their care team with better access to information, according to Husain. To facilitate this engagement, the platform was developed with an intuitive, easy-to-use web interface to enable messaging between patient, providers and caregivers on a desktop computer or mobile device after logging in with an email address and password, she notes.
Loop, web-based tool, is a communication tool meant to connect people across organizations, teams and disciplines, Husain adds. However, she is quick to add that messages can only be read and posted by care team members using the tool if they are involved in a patient’s care.
“The messages are threaded in conversations and can be searched using various filters,” states the JMIR article. “In addition to posting messages, users may label posts with user-defined ‘tags’ and an ‘Attention To’ feature that specifies individuals to be alerted to a post by a generic email.”
The research discovered that participants in the trial were able to understand and use the core functionality of Loop, namely to post and read messages.
“We further observed that sufferers viewed their Loop more often than they posted, compared with healthcare providers, who posted nearly as often as they viewed a Loop,” conclude the authors. “This could be interpreted as showing that patients were more proactive tool users, while healthcare providers are more likely to wait for notifications before logging in.”
Overall, researchers discovered that use of the platform suggests that “some coordination tasks were improved but further strategies to build collaboration among team members may be needed.”
“The power of a communication web-based tool is when you are able to enable collaboration across a team, rather than just one-on-one communication between a patient and provider or a provider and another provider,” adds Husain, who claims a larger follow-up study for Loop is planned.
The internally developed platform, termed as Loop, was put to the test in a feasibility randomized controlled trial at Sinai Health System’s Temmy Latner Center for Palliative Care in Toronto and the University of Toronto’s Princess Margaret Cancer Center.
Loop, a secure web-based tool, enables sufferers and caregivers to communicate asynchronously with multiple members of the care team including physicians, nurses and allied health professionals. Particularly, it links sufferers and caregivers to providers in a virtual space where communication can be facilitated outside of appointments and across care settings.
Results of the feasibility trial involving 24 advanced-stage cancer patients, recruited to both the intervention and control arms, and their care teams were recently published in the Journal for Medical Internet Research. The study found that it was feasible to implement Loop in clinical practice and that the tool may have the potential to improve continuity of care.
“We conducted a pilot randomized controlled trial in a population of patients with advanced cancer, as prototypical of a population with complex care needs,” write the authors. “Our objective was to evaluate the feasibility of integrating a tool like Loop into current care processes and to capture preliminary measures of the effect of Loop on continuity of care, quality of care, symptom distress, and healthcare utilization.”
“It is not about the diagnosis of the patient—it’s much more about patients with complex care needs that would benefit from an intervention like this,” says Amna Husain, MD, project leader at the Temmy Latner Center for Palliative Care.
The notion behind Loop is to put patients at the center of their care, making them an integral member of their care team with better access to information, according to Husain. To facilitate this engagement, the platform was developed with an intuitive, easy-to-use web interface to enable messaging between patient, providers and caregivers on a desktop computer or mobile device after logging in with an email address and password, she notes.
Loop, web-based tool, is a communication tool meant to connect people across organizations, teams and disciplines, Husain adds. However, she is quick to add that messages can only be read and posted by care team members using the tool if they are involved in a patient’s care.
“The messages are threaded in conversations and can be searched using various filters,” states the JMIR article. “In addition to posting messages, users may label posts with user-defined ‘tags’ and an ‘Attention To’ feature that specifies individuals to be alerted to a post by a generic email.”
The research discovered that participants in the trial were able to understand and use the core functionality of Loop, namely to post and read messages.
“We further observed that sufferers viewed their Loop more often than they posted, compared with healthcare providers, who posted nearly as often as they viewed a Loop,” conclude the authors. “This could be interpreted as showing that patients were more proactive tool users, while healthcare providers are more likely to wait for notifications before logging in.”
Overall, researchers discovered that use of the platform suggests that “some coordination tasks were improved but further strategies to build collaboration among team members may be needed.”
“The power of a communication web-based tool is when you are able to enable collaboration across a team, rather than just one-on-one communication between a patient and provider or a provider and another provider,” adds Husain, who claims a larger follow-up study for Loop is planned.
Wednesday, July 26, 2017
Sutter Health to assist small hospitals by Using virtual PCs
Sutter Health is in the initial stages of providing smaller hospitals a virtual personal computer infrastructure that will enabling an agency’s users to move from one machine to another throughout a facility, or access data from a mobile device of their choice, like a tablet.
The program, likely to be named Healthcare Workspace, is envisioned to make information more secure while enabling convenient and fast access from anywhere, with the service handling software updates and ensuring participating providers sustain to be compliant with regulations.
The hospitals would amuse the financial savings through reduced acquisition charges and use of desktop computers, while consumers would still have access to their personal computer—now mobile—anywhere and at any time.
“The virtual desktop follows you, so you do not have your own PC but a virtual PC,” elaborates Wes Wright, chief technology officer at Sutter Health. Citrix will run the virtual desktops that will operate on a Cisco network.
If a user does not use the virtual desktop for four hours, it automatically logs out. If during a shift a virtual desktop user unknowingly picked up a virus, when the shift is done the virus goes away because the virtual desktop goes away.
The target audience for virtual desktops is hospitals with 100 beds or fewer that can’t afford virtualized desktop infrastructure or find the suitable IT talent for using the technology.
Sutter Health has opted IT consulting and deployment firm Entisys 360 as the valued-added reseller that will market and run the base applications. Wright believes Citrix and Microsoft also likely will market the product, as well as some health care, operational and security consultancies.
Wright warns that much of the project sustains to be in the planning stage, although October is currently pegged as a soft launch. Sutter Health has initiated reaching out to smaller hospitals and gauging their interest, which Wright says is high.
A monthly subscription fee has yet to be evaluated; when it is set, marketing will start through Sutter’s physician services unit. As part of the package, Sutter Health also will offer virtual call centers.
The program, likely to be named Healthcare Workspace, is envisioned to make information more secure while enabling convenient and fast access from anywhere, with the service handling software updates and ensuring participating providers sustain to be compliant with regulations.
The hospitals would amuse the financial savings through reduced acquisition charges and use of desktop computers, while consumers would still have access to their personal computer—now mobile—anywhere and at any time.
“The virtual desktop follows you, so you do not have your own PC but a virtual PC,” elaborates Wes Wright, chief technology officer at Sutter Health. Citrix will run the virtual desktops that will operate on a Cisco network.
If a user does not use the virtual desktop for four hours, it automatically logs out. If during a shift a virtual desktop user unknowingly picked up a virus, when the shift is done the virus goes away because the virtual desktop goes away.
The target audience for virtual desktops is hospitals with 100 beds or fewer that can’t afford virtualized desktop infrastructure or find the suitable IT talent for using the technology.
Sutter Health has opted IT consulting and deployment firm Entisys 360 as the valued-added reseller that will market and run the base applications. Wright believes Citrix and Microsoft also likely will market the product, as well as some health care, operational and security consultancies.
Wright warns that much of the project sustains to be in the planning stage, although October is currently pegged as a soft launch. Sutter Health has initiated reaching out to smaller hospitals and gauging their interest, which Wright says is high.
A monthly subscription fee has yet to be evaluated; when it is set, marketing will start through Sutter’s physician services unit. As part of the package, Sutter Health also will offer virtual call centers.
Tuesday, July 25, 2017
Tewksbury Hospital in Massachusetts terminates worker after long-term snooping
A worker at Tewksbury Hospital in Massachusetts was discovered to be occasionally snooping in sufferers’ electronic medical records without clinical justification.
The inappropriate access of medical records occurred from the year of 2003 until it was discovered this past spring. Now, the facility—one of four hospitals in the Massachusetts Department of Public Health serving complex chronically ill adult sufferers and psychiatric patients—has notified more than 1,100 affected people.
Tewksbury Hospital officials say they learned of the breach in April, when a former patient expressed concern that their medical record might have been inappropriately accessed. Compromised data involved names, addresses, and dates of birth, gender, diagnoses and medical treatments. Less than half of the records involved viewing of Social Security numbers, according to the hospital.
The state’s department of health has terminated the worker.
“To decrease the chance of future tragedies like this occurring, we are reviewing our policies regarding access to the electronic medical records system,” Tewksbury executives noted in a statement. “We’re also reassessing how we review our workforce members’ use of the electronic medical records system and will be reviewing the training we provide to all workforce members regarding the privacy and security of confidential information.”
Tewksbury Hospital is advising affected people to notify credit reporting agencies, order a credit report and review it for signs of fraud, and request a security freeze to prevent the opening of new accounts using the compromised information.
In its notification to sufferers, Tewksbury Hospital is not offering credit monitoring or identity theft protection services. Currently, there is no indication that information has been accessed or misused, in accordance with a spokesperson for the hospital.
The hospital refused to give additional details about the incident, and did not comment on why the inappropriate access had gone undetected for fourteen years.
The inappropriate access of medical records occurred from the year of 2003 until it was discovered this past spring. Now, the facility—one of four hospitals in the Massachusetts Department of Public Health serving complex chronically ill adult sufferers and psychiatric patients—has notified more than 1,100 affected people.
Tewksbury Hospital officials say they learned of the breach in April, when a former patient expressed concern that their medical record might have been inappropriately accessed. Compromised data involved names, addresses, and dates of birth, gender, diagnoses and medical treatments. Less than half of the records involved viewing of Social Security numbers, according to the hospital.
The state’s department of health has terminated the worker.
“To decrease the chance of future tragedies like this occurring, we are reviewing our policies regarding access to the electronic medical records system,” Tewksbury executives noted in a statement. “We’re also reassessing how we review our workforce members’ use of the electronic medical records system and will be reviewing the training we provide to all workforce members regarding the privacy and security of confidential information.”
Tewksbury Hospital is advising affected people to notify credit reporting agencies, order a credit report and review it for signs of fraud, and request a security freeze to prevent the opening of new accounts using the compromised information.
In its notification to sufferers, Tewksbury Hospital is not offering credit monitoring or identity theft protection services. Currently, there is no indication that information has been accessed or misused, in accordance with a spokesperson for the hospital.
The hospital refused to give additional details about the incident, and did not comment on why the inappropriate access had gone undetected for fourteen years.
Monday, July 24, 2017
Information Technology confidence, spending up across various industries
Improvements and stability in business information technology confidence across a range of industries involving healthcare, will drive stronger IT spending growth this year, in accordance to a new study by International Data Corp.
Professional services firms, involving cloud service providers, will increase their information technology confidence spending by 6% in the year of 2017, while IT budgets in the financial services sector will rise by more than 5%, the IDC research predicts.
By the year of 2021, IT spending will reach $2.7 trillion, with the largest contributions coming from consumers, banks, manufacturers, and telecommunications providers.
Cloud service providers are anticipated to resume data center investment growth in the second half of 2017, after a brief slowdown, and this will drive server and storage spending by professional services firms to almost 9 percent growth this year.
Enterprise buyers are also poised for a server upgrade cycle this year, IDC claimed, driving positive growth in spending across vertical industries. Enterprise software spending remains strong, led by professional services (up 9%), followed by banking, securities and investment services, retail and healthcare (all up 8 percent).
Total annual software spending will surpass $600 billion by 2021, with the largest contributions coming from manufacturing, banking and professional services, the report stated.
"The banking industry indicates highly positive indicators for spending plans, with key projects focused on big data and analytics," said Jessica Goepfert, program director for customer insights and analysis at IDC. "Nearly all of the major banks around the world have highlighted that their [big data analytics] deployments are now a critical part of their competitive strategies. This is particularly the case on the retail banking side, as the banks establish their omnichannel strategies, seek to understand and respond to their customers' behavior, and build strategies for excellence in customer experience."
Professional services firms, involving cloud service providers, will increase their information technology confidence spending by 6% in the year of 2017, while IT budgets in the financial services sector will rise by more than 5%, the IDC research predicts.
By the year of 2021, IT spending will reach $2.7 trillion, with the largest contributions coming from consumers, banks, manufacturers, and telecommunications providers.
Cloud service providers are anticipated to resume data center investment growth in the second half of 2017, after a brief slowdown, and this will drive server and storage spending by professional services firms to almost 9 percent growth this year.
Enterprise buyers are also poised for a server upgrade cycle this year, IDC claimed, driving positive growth in spending across vertical industries. Enterprise software spending remains strong, led by professional services (up 9%), followed by banking, securities and investment services, retail and healthcare (all up 8 percent).
Total annual software spending will surpass $600 billion by 2021, with the largest contributions coming from manufacturing, banking and professional services, the report stated.
"The banking industry indicates highly positive indicators for spending plans, with key projects focused on big data and analytics," said Jessica Goepfert, program director for customer insights and analysis at IDC. "Nearly all of the major banks around the world have highlighted that their [big data analytics] deployments are now a critical part of their competitive strategies. This is particularly the case on the retail banking side, as the banks establish their omnichannel strategies, seek to understand and respond to their customers' behavior, and build strategies for excellence in customer experience."
Friday, July 21, 2017
ONC plan to be supported by Groups to measure interoperability
Industry groups basically support a measurement framework for healthcareinteroperability standards proposed by the Office of the National Coordinator for Health Information Technology or ONC plan, although they differ on whether a voluntary industry-based measure reporting system is the best path forward.
Release in April, ONC’s draft framework is meant to help developers, health information exchange organizations and providers move toward a set of industry-wide measures to assess the implementation and use of interoperability standards. The agency’s public comment period on the framework ended on Monday.
Both the American Medical Informatics Association and Health IT Now submitted comments to ONC plan supporting the development of a framework for reaching consensus on such measures, which they see as critical for measuring progress being made on achieving nationwide interoperability.
“We consider that several significant policy queries would be informed by data collected as part of such a measurement framework, as well as provide a window into our progress toward nationwide interoperability,” states AMIA CEO Doug Fridsma in his organization’s letter to the agency. “For example, as the industry moves from local coding for laboratory results to LOINC, away from a legacy set of standards based on the Consolidated Clinical Document Architecture (CCDA) towards a Fast Health Interoperability Resources (FHIR)-based ecosystem, it will be important to understand the details of this transition.”
Likewise, in its letter to ONC, Health IT Now points out that the Medicare Access and CHIP Reauthorization Act (MACRA) requires widespread interoperability by the day of Dec. 31, 2018.
“Measuring interoperability is essential to comprehend how much progress is being made against this goal,” writes HITN Executive Director Joel White. “Measurement can thus be a tool to help advance interoperable systems, information exchange, and the use of data in improving care.”
Presently, quantifiable data regarding the implementation and utilization of standards is often not readily available or regularly tracked. In its proposed framework, ONC identifies two key measurement areas: tracking whether interoperability standards are contained in health IT products and services, and the use of standards—including customization of the standards—by end users such as providers.
While AMIA explains the agency’s draft framework as “thoughtful” and rightly recognizing current gaps, challenges and opportunities, Fridsma in his letter underscores the need to have the “benefits of measurement outweigh the costs,” particularly with measure reporting becoming more automated.
“As the work moves forward, we emphasize ONC to be very mindful of the potential burdens associated with additional measurement and to carefully balance the burdens of measurement with expected benefits,” contends Fridsma. “As the field moves from surveys to more automated reporting, we urge ONC plan to focus on guidance to industry on what may be used in voluntary and optional automated data collection before there is any definitive shift from surveys to automated collection. It is essential that measurement not become an end in-and-of-itself and that we recognize the charges to clinicians, developers and others in developing and implementing automated solutions.”
At the same time, on the query of whether a voluntary, industry-based measure reporting system is the best means to implement ONC’s framework, Fridsma says that AMIA does not anticipate that widespread industry participation will occur based on a strictly volunteer basis.
“Ideally, the reporting system creates a high ratio of value/burden,” in accordance with the Fridsma. “Moreover, if reporting is convenient, then we expect higher rates of participation with a decreased need for strong incentives. However, if the accumulation of value is not shared among those being measured, or reporting is not easy, we anticipate that incentives will be necessary to encourage participation in the reporting system and we suggest a focus on positive incentives.”
Although, HITN’s White makes the case that a voluntary, industry-based measure reporting system is the best way to implement the framework, as opposed to a mandated reporting system, adding that the “barriers to interoperability can best be solved by private-market developed standards and initiatives” given that “government involvement in the quest to reach interoperability has mostly fallen flat and, in some cases, impeded progress.”
White also highlights the fact that—like ONC—the National Quality Forum has proposed its own interoperability measurement framework.
“ONC plan has been working to establish the Proposed Interoperability Standards Measurement Framework and the NQF’s Interoperability Committee (with funding from HHS) has been working independently to establish interoperability measurement frameworks,” he concludes. “NQF and ONC plan should clarify their roles in this process to avoid confusion about the several frameworks and their interaction moving forward.”
Release in April, ONC’s draft framework is meant to help developers, health information exchange organizations and providers move toward a set of industry-wide measures to assess the implementation and use of interoperability standards. The agency’s public comment period on the framework ended on Monday.
Both the American Medical Informatics Association and Health IT Now submitted comments to ONC plan supporting the development of a framework for reaching consensus on such measures, which they see as critical for measuring progress being made on achieving nationwide interoperability.
“We consider that several significant policy queries would be informed by data collected as part of such a measurement framework, as well as provide a window into our progress toward nationwide interoperability,” states AMIA CEO Doug Fridsma in his organization’s letter to the agency. “For example, as the industry moves from local coding for laboratory results to LOINC, away from a legacy set of standards based on the Consolidated Clinical Document Architecture (CCDA) towards a Fast Health Interoperability Resources (FHIR)-based ecosystem, it will be important to understand the details of this transition.”
Likewise, in its letter to ONC, Health IT Now points out that the Medicare Access and CHIP Reauthorization Act (MACRA) requires widespread interoperability by the day of Dec. 31, 2018.
“Measuring interoperability is essential to comprehend how much progress is being made against this goal,” writes HITN Executive Director Joel White. “Measurement can thus be a tool to help advance interoperable systems, information exchange, and the use of data in improving care.”
Presently, quantifiable data regarding the implementation and utilization of standards is often not readily available or regularly tracked. In its proposed framework, ONC identifies two key measurement areas: tracking whether interoperability standards are contained in health IT products and services, and the use of standards—including customization of the standards—by end users such as providers.
While AMIA explains the agency’s draft framework as “thoughtful” and rightly recognizing current gaps, challenges and opportunities, Fridsma in his letter underscores the need to have the “benefits of measurement outweigh the costs,” particularly with measure reporting becoming more automated.
“As the work moves forward, we emphasize ONC to be very mindful of the potential burdens associated with additional measurement and to carefully balance the burdens of measurement with expected benefits,” contends Fridsma. “As the field moves from surveys to more automated reporting, we urge ONC plan to focus on guidance to industry on what may be used in voluntary and optional automated data collection before there is any definitive shift from surveys to automated collection. It is essential that measurement not become an end in-and-of-itself and that we recognize the charges to clinicians, developers and others in developing and implementing automated solutions.”
At the same time, on the query of whether a voluntary, industry-based measure reporting system is the best means to implement ONC’s framework, Fridsma says that AMIA does not anticipate that widespread industry participation will occur based on a strictly volunteer basis.
“Ideally, the reporting system creates a high ratio of value/burden,” in accordance with the Fridsma. “Moreover, if reporting is convenient, then we expect higher rates of participation with a decreased need for strong incentives. However, if the accumulation of value is not shared among those being measured, or reporting is not easy, we anticipate that incentives will be necessary to encourage participation in the reporting system and we suggest a focus on positive incentives.”
Although, HITN’s White makes the case that a voluntary, industry-based measure reporting system is the best way to implement the framework, as opposed to a mandated reporting system, adding that the “barriers to interoperability can best be solved by private-market developed standards and initiatives” given that “government involvement in the quest to reach interoperability has mostly fallen flat and, in some cases, impeded progress.”
White also highlights the fact that—like ONC—the National Quality Forum has proposed its own interoperability measurement framework.
“ONC plan has been working to establish the Proposed Interoperability Standards Measurement Framework and the NQF’s Interoperability Committee (with funding from HHS) has been working independently to establish interoperability measurement frameworks,” he concludes. “NQF and ONC plan should clarify their roles in this process to avoid confusion about the several frameworks and their interaction moving forward.”
Thursday, July 20, 2017
OIG decides to inquire $15B in meaningful use payments
The Department of Health and Human Services Office of Inspector General will analyze the accuracy of $14.6 billion in meaningful use payments made to hospitals by Medicare between 2011 and 2016. Initially this year, the OIG estimated physicians were wrongfully paid $729 million under meaningful use payments.
Medicare incentive payments were authorized over a 5-year period to hospitals that adopted electronic health record (EHR) technology. From January 1, 2011, through December 31, 2016, the Centers for Medicare and Medicaid Services made Medicare EHR incentive payments to hospitals totaling $14.6 billion, the OIG stated.
The Government Accountability Office recognized wrong incentive payments as the primary risk to the Medicare EHR incentive program. An OIG report described the obstacles that CMS faces in overseeing the Medicare EHR incentive program. In addition, previous OIG reviews of Medicaid EHR incentive payments found that state agencies overpaid hospitals by $66.7 million and would in the future overpay these hospitals an additional $13.2 million, the OIG claimed.
“These overpayments resulted from inaccuracies in the hospitals’ calculations of total incentive payments,” the OIG said. “We will review the hospitals’ incentive payment calculations to identify potential overpayments that the hospitals would have received as a result of the inaccuracies.”
On another front, the OIG will be analyzing the precision of telemedicine payments under Medicare.
Medicare Part B covers expenses for telehealth services on the telehealth list when those services are delivered via an interactive telecommunications system, provided few conditions are met. To support rural access to care, Medicare pays for telehealth services provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner situated at a distant site.
Medicare incentive payments were authorized over a 5-year period to hospitals that adopted electronic health record (EHR) technology. From January 1, 2011, through December 31, 2016, the Centers for Medicare and Medicaid Services made Medicare EHR incentive payments to hospitals totaling $14.6 billion, the OIG stated.
The Government Accountability Office recognized wrong incentive payments as the primary risk to the Medicare EHR incentive program. An OIG report described the obstacles that CMS faces in overseeing the Medicare EHR incentive program. In addition, previous OIG reviews of Medicaid EHR incentive payments found that state agencies overpaid hospitals by $66.7 million and would in the future overpay these hospitals an additional $13.2 million, the OIG claimed.
“These overpayments resulted from inaccuracies in the hospitals’ calculations of total incentive payments,” the OIG said. “We will review the hospitals’ incentive payment calculations to identify potential overpayments that the hospitals would have received as a result of the inaccuracies.”
On another front, the OIG will be analyzing the precision of telemedicine payments under Medicare.
Medicare Part B covers expenses for telehealth services on the telehealth list when those services are delivered via an interactive telecommunications system, provided few conditions are met. To support rural access to care, Medicare pays for telehealth services provided through live, interactive videoconferencing between a beneficiary located at a rural originating site and a practitioner situated at a distant site.
Wednesday, July 19, 2017
Kalamazoo County looking for mosquitoes carrying Zika virus
Kalamazoo County is keeping an eye out for mosquitoes known to carry the Zika virus until the end of summer season.
The Kalamazoo County Health & Community Services Department is engaging in a mosquito surveillance program to ensure insects carrying the virus aren’t in West Michigan.
Traps were set at 5 areas throughout the county in June searching for the Asian tiger mosquito, the species most known to carry the virus.
According to a department release, southern Michigan is in the trail of potential migration of the insect. Although, none have been found to this point.
In addition to trapping the mosquitoes, County is identifying what type of insects it is capturing to the Centers for Disease Control and giving citizens information on preventing mosquito bites, diseases and habitat control.
For further information, contact the County Health & Community Services Department-Environmental Health Unite at 269.373.5210.
The Kalamazoo County Health & Community Services Department is engaging in a mosquito surveillance program to ensure insects carrying the virus aren’t in West Michigan.
Traps were set at 5 areas throughout the county in June searching for the Asian tiger mosquito, the species most known to carry the virus.
According to a department release, southern Michigan is in the trail of potential migration of the insect. Although, none have been found to this point.
In addition to trapping the mosquitoes, County is identifying what type of insects it is capturing to the Centers for Disease Control and giving citizens information on preventing mosquito bites, diseases and habitat control.
For further information, contact the County Health & Community Services Department-Environmental Health Unite at 269.373.5210.
Tuesday, July 18, 2017
IBT, Scripps Acquire $6.6 Million to Establish Pan-Ebolavirus Vaccine
A collaboration between Integrated BioTherapeutics (IBT) and The Scripps Research Institute (TSRI) has been granted a $6.6 million, 5-year grant by the National Institutes of Health’s (NIH) National Institute of Allergy and Infectious Diseases (NIAID) to develop a vaccine that secures against ebolavirus.
"This award will enable us to deal a pressing global public health need, namely a single vaccine that can secure against all ebolaviruses,” stated IBT’s CSO, M. Javad Aman, Ph.D., who is co-principal investigator for the collaboration. “To meet this challenge, we have assembled a unique team of experts in immunogen design, structural biology, vaccine development, and animal models of filovirus infection.”
Filoviruses, involving Ebolavirus, Sudan ebolavirus, Bundibugyo ebolavirus, and Marburg marburgvirus, cause hemorrhagic fever in humans, and infection is lethal in 40% to 90% of cases. The most recent Ebolavirus outbreak in West Africa was caused by the Zaire ebolavirus (EBOV) and led to 29,000 infections and more than 100,000 deaths. A single glycoprotein reflected on the filovirus surface mediates infection and is the primary target for vaccine development.
Structural differences in surface glycoproteins between viruses mean that current EBOV vaccine development programs are not generally not designed to protect against other filoviruses, but the team at IBT and TSRI has identified broadly neutralizing antibodies that may secure against all ebolaviruses.
The NIAID-funded project will use the EBOV glycoprotein as a foundation for the rational design of pan-Ebolavirus vaccine candidates that can elicit broadly protective immune responses targeting structural sites that are shared between the different viral glycoproteins. The aim is to develop and test immunogens that can be progressed into advanced preclinical studies. IBT says it then projects moving the most promising candidates into the clinic.
"A novel aspect of the program will be the use of state-of-the-art imaging and computational approaches,” stated co-principal investigator Erica Ollmann Saphire, Ph.D., at TSRI. “This design work will help us craft a vaccine to steer the immune response in the right directions."
"We’re excited to participate in this collaboration and to test novel immunogen design strategies for their ability to focus antibody responses to conserved epitopes on ebolaviruses,” added William Schief, Ph.D., who is also a TSRI co-principal investigator for the program. “This’ll be a fantastic test for structure-based vaccine design, and it may give us insights on how to make vaccines for other more variable viruses.”
The collaboration will also include investigators at the Albert Einstein College of Medicine (Bronx, NY) the US Army Medical Research Institute of Infectious Diseases (USAMIID; Frederick, MD), the Public Health Agency of Canada (Winnipeg, Manitoba), and the Sanford Burnham Prebys Medical Discovery Institute in La Jolla, CA.
IBT is concentrated on the discovery and development of vaccines and therapeutics for emerging bacterial and viral infectious diseases, including pan-filovirus immunotherapeutics and vaccines. The firm works closely with U.S. government agencies including the NIAID, National Cancer Institute, Department of Defense, and USAMRIID.
Just previous month, IBT reported that its partnership with the Albert Einstein College of Medicine received Phase II of a small business technology transfer (STTR) grant from the NIAID to continue the development of bispecific antibodies targeting multiple broadly neutralizing epitopes on filovirus glycoproteins. During Phase I of the program the partners generated a lead candidate that was shown to provide protection against Ebolavirus and Sudan ebolavirus, and neutralize all ebolaviruses. Phase II of the project will encompass antibody manufacture in CHO cells and evaluation in nonhuman primates.
In May, IBT reported publication in the journal Cell of nonhuman primate studies demonstrating the ability of an antibody candidate designated CA45 to block cells from infection by EBOV, Sudan ebolavirus, and Bundibugyo ebolavirus.
"This award will enable us to deal a pressing global public health need, namely a single vaccine that can secure against all ebolaviruses,” stated IBT’s CSO, M. Javad Aman, Ph.D., who is co-principal investigator for the collaboration. “To meet this challenge, we have assembled a unique team of experts in immunogen design, structural biology, vaccine development, and animal models of filovirus infection.”
Filoviruses, involving Ebolavirus, Sudan ebolavirus, Bundibugyo ebolavirus, and Marburg marburgvirus, cause hemorrhagic fever in humans, and infection is lethal in 40% to 90% of cases. The most recent Ebolavirus outbreak in West Africa was caused by the Zaire ebolavirus (EBOV) and led to 29,000 infections and more than 100,000 deaths. A single glycoprotein reflected on the filovirus surface mediates infection and is the primary target for vaccine development.
Structural differences in surface glycoproteins between viruses mean that current EBOV vaccine development programs are not generally not designed to protect against other filoviruses, but the team at IBT and TSRI has identified broadly neutralizing antibodies that may secure against all ebolaviruses.
The NIAID-funded project will use the EBOV glycoprotein as a foundation for the rational design of pan-Ebolavirus vaccine candidates that can elicit broadly protective immune responses targeting structural sites that are shared between the different viral glycoproteins. The aim is to develop and test immunogens that can be progressed into advanced preclinical studies. IBT says it then projects moving the most promising candidates into the clinic.
"A novel aspect of the program will be the use of state-of-the-art imaging and computational approaches,” stated co-principal investigator Erica Ollmann Saphire, Ph.D., at TSRI. “This design work will help us craft a vaccine to steer the immune response in the right directions."
"We’re excited to participate in this collaboration and to test novel immunogen design strategies for their ability to focus antibody responses to conserved epitopes on ebolaviruses,” added William Schief, Ph.D., who is also a TSRI co-principal investigator for the program. “This’ll be a fantastic test for structure-based vaccine design, and it may give us insights on how to make vaccines for other more variable viruses.”
The collaboration will also include investigators at the Albert Einstein College of Medicine (Bronx, NY) the US Army Medical Research Institute of Infectious Diseases (USAMIID; Frederick, MD), the Public Health Agency of Canada (Winnipeg, Manitoba), and the Sanford Burnham Prebys Medical Discovery Institute in La Jolla, CA.
IBT is concentrated on the discovery and development of vaccines and therapeutics for emerging bacterial and viral infectious diseases, including pan-filovirus immunotherapeutics and vaccines. The firm works closely with U.S. government agencies including the NIAID, National Cancer Institute, Department of Defense, and USAMRIID.
Just previous month, IBT reported that its partnership with the Albert Einstein College of Medicine received Phase II of a small business technology transfer (STTR) grant from the NIAID to continue the development of bispecific antibodies targeting multiple broadly neutralizing epitopes on filovirus glycoproteins. During Phase I of the program the partners generated a lead candidate that was shown to provide protection against Ebolavirus and Sudan ebolavirus, and neutralize all ebolaviruses. Phase II of the project will encompass antibody manufacture in CHO cells and evaluation in nonhuman primates.
In May, IBT reported publication in the journal Cell of nonhuman primate studies demonstrating the ability of an antibody candidate designated CA45 to block cells from infection by EBOV, Sudan ebolavirus, and Bundibugyo ebolavirus.
Monday, July 17, 2017
Drchrono evolves FHIR support into its electronic health record
EHR vendor drchrono has declared that its electronic health record (EHR), practice management and revenue cycle products now support the Fast Healthcare Interoperability Resources specification.
With FHIR, drchrono claimed that it’s enabling ten million sufferers to access to their healthcare information through the FHIR API through the company’s inpatient electronic health record.
The new application programming interface is developed to support the Precision Medicine Sync for Science Initiative and fulfills one of the requirements of Meaningful Use Stage 3 to enable a patient electronic health record API, the vendor stated.
Drchrono’s Patient API also offers users the ability to control their own data and share the data with others throughout the continuum of care. Any developer through the personal health record FHIR API can build applications on top of drchrono so researchers and other physicians with the patient’s approval can view that person’s data.
Most developers know what APIs are, they know the modern technology stacks, but they do not necessarily know what HL7 or X12 are, the company stated.
FHIR, on the other hand, enables developers to move into healthcare and start building new apps as quickly as possible using concepts from other modern technology practices, he said.
The healthcare system increasingly needs a patient to play more of a part to ensure they are getting the right care in the right setting at the right time.
“Increasingly, more of our healthcare system’s burden is on sufferers, when it comes to higher deductibles, the requirement for second opinions, the need to understand what preventive services are available to them,” said Aneesh Chopra, the former U.S. CTO and CEO of CareJourney. “That shift to more responsibility is concurrent with the need to have more information so you can get better at that step.”
With FHIR, drchrono claimed that it’s enabling ten million sufferers to access to their healthcare information through the FHIR API through the company’s inpatient electronic health record.
The new application programming interface is developed to support the Precision Medicine Sync for Science Initiative and fulfills one of the requirements of Meaningful Use Stage 3 to enable a patient electronic health record API, the vendor stated.
Drchrono’s Patient API also offers users the ability to control their own data and share the data with others throughout the continuum of care. Any developer through the personal health record FHIR API can build applications on top of drchrono so researchers and other physicians with the patient’s approval can view that person’s data.
Most developers know what APIs are, they know the modern technology stacks, but they do not necessarily know what HL7 or X12 are, the company stated.
FHIR, on the other hand, enables developers to move into healthcare and start building new apps as quickly as possible using concepts from other modern technology practices, he said.
The healthcare system increasingly needs a patient to play more of a part to ensure they are getting the right care in the right setting at the right time.
“Increasingly, more of our healthcare system’s burden is on sufferers, when it comes to higher deductibles, the requirement for second opinions, the need to understand what preventive services are available to them,” said Aneesh Chopra, the former U.S. CTO and CEO of CareJourney. “That shift to more responsibility is concurrent with the need to have more information so you can get better at that step.”
Friday, July 14, 2017
Hospitals can anticipate financial burden from new EHRs installs
Hospitals installing new EHRs or electronic health record systems should anticipate a sizable cash drain as the procedure disrupts business and adds technology and training expense, Moody's Investors Service claimed in a report this week.
During the first year of new EHRs installations, the median decline in operating cash flow for hospital systems is 10 percent with a 6 percent falloff in days cash on hand, Moody's said after examining system installs over the past several years. EHR installations can cost anywhere from several million dollars for a small, stand-alone hospital to a half-billion dollars for larger systems.
Moody's discovered in looking at 39 recent launches that the installs can disrupt billing and patient throughput.
"Implementing new EHRs or electronic medical record systems carries significant financial risk for hospitals because the systems are vital to the provision of care and billing," the report said.
Though disruptive in the first year of execution, the damage to operating performance commonly dissipates after the first year as staff and clinicians become proficient in the technology, Moody's said.
An EHR is the electronic nervous system of a hospital or clinic, allowing staff to onboard patients, track care, view clinical workflow and bill for services. It also increasingly contains information that can help systems and hospitals gather information useful toward meeting new payment models.
Vanderbilt University Medical Center in Nashville has been preparing for more than a year for the Nov. 2 launch of its new Epic EHR across the entire academic health system.
Vanderbilt decides to have 1,000 third-party consultants and trainers on hand in the first week to minimize disruptions and help employees through the switch, Vanderbilt EHR project leader Dr. Kevin Johnson said in a May interview. He likened the transition to "changing a jet engine in midflight."
Vanderbilt has budgeted $214 million for the conversion.
UMass Memorial Health Care is going live with its own Epic rollout later this year. Already, the preparation is hitting the bottom line of the Worcester, Mass.-based system.
During the first year of new EHRs installations, the median decline in operating cash flow for hospital systems is 10 percent with a 6 percent falloff in days cash on hand, Moody's said after examining system installs over the past several years. EHR installations can cost anywhere from several million dollars for a small, stand-alone hospital to a half-billion dollars for larger systems.
Moody's discovered in looking at 39 recent launches that the installs can disrupt billing and patient throughput.
"Implementing new EHRs or electronic medical record systems carries significant financial risk for hospitals because the systems are vital to the provision of care and billing," the report said.
Though disruptive in the first year of execution, the damage to operating performance commonly dissipates after the first year as staff and clinicians become proficient in the technology, Moody's said.
An EHR is the electronic nervous system of a hospital or clinic, allowing staff to onboard patients, track care, view clinical workflow and bill for services. It also increasingly contains information that can help systems and hospitals gather information useful toward meeting new payment models.
Vanderbilt University Medical Center in Nashville has been preparing for more than a year for the Nov. 2 launch of its new Epic EHR across the entire academic health system.
Vanderbilt decides to have 1,000 third-party consultants and trainers on hand in the first week to minimize disruptions and help employees through the switch, Vanderbilt EHR project leader Dr. Kevin Johnson said in a May interview. He likened the transition to "changing a jet engine in midflight."
Vanderbilt has budgeted $214 million for the conversion.
UMass Memorial Health Care is going live with its own Epic rollout later this year. Already, the preparation is hitting the bottom line of the Worcester, Mass.-based system.
Monday, July 10, 2017
Survey: Physicians are not ready for Quality Payment Program
A recent survey of 1,000 physicians discovered that most respondents aren’t ready for the Quality Payment Program (QPP).
The survey, conducted by the American Medical Association and KPMG, indicates that respondents give mixed views on their comfort level with the program, the proposed rules of which were recently issued for review by the industry.
Physicians this year are measuring and reporting certain quality measures while also indicating proficient use of electronic health records (EHRs) in the MIPS program that is part of MACRA. Physicians can acquire extra points and thus receive higher reimbursement rates beginning in the year of 2019.
Instead of entering the MIPS program, physicians can be part of an Advanced Alternative Payment Model, which will need them to take on risk and receive a 5 percent bonus for meeting certain thresholds that reward doctors for delivering high-quality and cost-efficient care.
In the AMA survey, 70% of respondents report they have started preparations to meet QPP requirements, and about 90% of those believe they will meet the 2017 reporting requirements.
Although, the survey discovered that just 51% were somewhat knowledgeable about MACRA and the Quality Payment Program, and only 8 percent reported that they were very knowledgeable about QPP.
Prior reporting experience through the PQRS and EHR meaningful use programs appears to have contributed to readiness for QPP, survey results demonstrated. However, only one in four physicians say they are well-prepared for QPP.
“Although, even those who feel prepared do not completely understand the financial ramifications of the program,” in accordance with the AMA and KPMG, which conducted the study for the AMA. “In short, they may be prepared to ‘check the box’ of reporting requirements but they lack the long-term strategic financial vision to succeed in 2018 and beyond.” Survey findings are available here.
The survey, conducted by the American Medical Association and KPMG, indicates that respondents give mixed views on their comfort level with the program, the proposed rules of which were recently issued for review by the industry.
Physicians this year are measuring and reporting certain quality measures while also indicating proficient use of electronic health records (EHRs) in the MIPS program that is part of MACRA. Physicians can acquire extra points and thus receive higher reimbursement rates beginning in the year of 2019.
Instead of entering the MIPS program, physicians can be part of an Advanced Alternative Payment Model, which will need them to take on risk and receive a 5 percent bonus for meeting certain thresholds that reward doctors for delivering high-quality and cost-efficient care.
In the AMA survey, 70% of respondents report they have started preparations to meet QPP requirements, and about 90% of those believe they will meet the 2017 reporting requirements.
Although, the survey discovered that just 51% were somewhat knowledgeable about MACRA and the Quality Payment Program, and only 8 percent reported that they were very knowledgeable about QPP.
Prior reporting experience through the PQRS and EHR meaningful use programs appears to have contributed to readiness for QPP, survey results demonstrated. However, only one in four physicians say they are well-prepared for QPP.
“Although, even those who feel prepared do not completely understand the financial ramifications of the program,” in accordance with the AMA and KPMG, which conducted the study for the AMA. “In short, they may be prepared to ‘check the box’ of reporting requirements but they lack the long-term strategic financial vision to succeed in 2018 and beyond.” Survey findings are available here.
Sunday, July 9, 2017
Hacking of Medical devices increasing as a next huge threat
Medical devices, involving those that are implanted within patients, are increasingly likely to be targeted by hackers and could pose a nightmare scenario if providers do not take measures to improve their defenses.
“The issue with security is that hackers always follow the path of least resistance,” claims Sam Rehman, the chief technology officer at security vendor Arxan, which serves multiple industries and has a large footprint in healthcare.
Like several other security vendors, Rehman says providers require conducting a comprehensive risk assessment and fixing vulnerabilities. In healthcare, medical devices security is a hot topic and for great reason, because providers mostly have hundreds if not thousands of devices in their facilities.
But providers also require increasing security levels for devices that are implanted in patients, and that is because several of those devices have wireless capabilities that enable hackers to interfere with them, Rehman says.
For instance, physicians can utilize hand-held medical devices to wirelessly collect data and even update an implant, for example to change device settings on insulin pumps, pacemakers and other devices. Although, a hacker in a hospital can do the same thing, which represents a potential risk to patient safety, Rehman cautions.
Many hackers might not need to intentionally cause harm, but others will do what someone pays them to do, which could involve causing injury to patients. Rehman says monetary motivation, particularly through blackmail, could rise as a potential risk.
Such hacking could involve efforts to affect the share price of a device manufacturer. Rehman says stock price manipulation could provide another financial motive for hacking. For imstance, if one person can make money by paying another person to cause harm, the instigator can make money when a company’s stock price falls.
A scenario similar to this has already occurred. Previously this year, the Food and Drug Administration confirmed cybersecurity vulnerabilities in St. Jude Medical’s implantable cardiac devices and its Merlin@home transmitter. The vulnerabilities were originally declared by an investment group that threatened to make money by selling its stock short.
St. Jude Medical devices, the FDA stated, could be hacked by outsiders, leading to injury or death, and St. Jude’s share price quickly dropped by 10% as the company scrambled to make fixes. “If someone can make money, this absolutely will happen,” Rehman assumes.
“The issue with security is that hackers always follow the path of least resistance,” claims Sam Rehman, the chief technology officer at security vendor Arxan, which serves multiple industries and has a large footprint in healthcare.
Like several other security vendors, Rehman says providers require conducting a comprehensive risk assessment and fixing vulnerabilities. In healthcare, medical devices security is a hot topic and for great reason, because providers mostly have hundreds if not thousands of devices in their facilities.
But providers also require increasing security levels for devices that are implanted in patients, and that is because several of those devices have wireless capabilities that enable hackers to interfere with them, Rehman says.
For instance, physicians can utilize hand-held medical devices to wirelessly collect data and even update an implant, for example to change device settings on insulin pumps, pacemakers and other devices. Although, a hacker in a hospital can do the same thing, which represents a potential risk to patient safety, Rehman cautions.
Many hackers might not need to intentionally cause harm, but others will do what someone pays them to do, which could involve causing injury to patients. Rehman says monetary motivation, particularly through blackmail, could rise as a potential risk.
Such hacking could involve efforts to affect the share price of a device manufacturer. Rehman says stock price manipulation could provide another financial motive for hacking. For imstance, if one person can make money by paying another person to cause harm, the instigator can make money when a company’s stock price falls.
A scenario similar to this has already occurred. Previously this year, the Food and Drug Administration confirmed cybersecurity vulnerabilities in St. Jude Medical’s implantable cardiac devices and its Merlin@home transmitter. The vulnerabilities were originally declared by an investment group that threatened to make money by selling its stock short.
St. Jude Medical devices, the FDA stated, could be hacked by outsiders, leading to injury or death, and St. Jude’s share price quickly dropped by 10% as the company scrambled to make fixes. “If someone can make money, this absolutely will happen,” Rehman assumes.
Friday, July 7, 2017
Seven Regional HIEs complete data exchange contracts
Seven regional HIEs or health information exchanges in the upper Midwest are increasing the number of patient records they are sharing through a collaborative that spans 5 states.
Since last fall, the HIEs have been working to complete technical connections, as well as settling on suitable legal agreements to permit data exchange, executives claim.
Additionally, the participating agencies are working to implement a virtual integrated record that would enable physicians outside of the 5 states covered by the HIEs to access patient records. The virtual access initiative gives a model that could be replicated by other HIEs to more immensely share information that clinicians require in the course of treatment.
Participating Seven regional HIEs include:
Last October, the HIEs agreed to exchange patient data among themselves. The initiative, termed as the Heartland Project, got a $270,000 grant from the Department of Health and Human Services, with funds being shared among all seven entities; in addition, the money is assisting to develop a governance structure for the Heartland Project.
This past fall, Great Lakes Health Connect, a health information exchange in the State of Michigan since the year of 2010, was the last HIE to join the project. Since the month of April, Great Lakes has got 10,057 admit/discharge/transfer messages and has sent 57,690 such messages to partnering HIEs.
“Heartland Project is seven regional HIEs working among ourselves with the aim of broadening beyond our regions when patients go outside these areas,” says Doug Dietzman, executive director at Great Lakes Health Connect.
With the utilization of the virtual integrated patient record, if a Michigan resident receives care in another state, an admit/discharge/transfer message is transmitted to Great Lakes Health Connect, which then notifies the patient’s primary care physician. This enables better continuity of care and better communication among clinicians
With all participating seven regional HIEs now live on the system, the exchanges now are developing a query process for Continuity of Care Documents, with hopes that CCDs can be exchanged by year-end.
The new 7-HIE data exchange service has been named the Patient-Centered Data Home, which will enable data to be forwarded to a physician to support a complete medical record, Dietzman says.
As technical work progressed in recent months to link the HIEs, so did work to establish policies and methods governing the actual exchange of data across the region. It took 3 or 4 months of work to develop a trust framework for how information will be shared and how participants will manage the information once they have it, Dietzman says.
One big challenge was handling identities, which was managed by running admit/discharge/transfer messages through a master patient index (MPI), and each HIE has its own technology vendors, so they also have their own MPIs and a unique identifier for each patient.
The long-term intent of Heartland Project is to be a model for other HIE initiatives, Dietzman says, but how to do that is not yet clear, he appreciates. But the ultimate aim is quite bigger—to tie all HIEs at some point across the nation.
Since last fall, the HIEs have been working to complete technical connections, as well as settling on suitable legal agreements to permit data exchange, executives claim.
Additionally, the participating agencies are working to implement a virtual integrated record that would enable physicians outside of the 5 states covered by the HIEs to access patient records. The virtual access initiative gives a model that could be replicated by other HIEs to more immensely share information that clinicians require in the course of treatment.
Participating Seven regional HIEs include:
- Indiana Health Information Exchange, Indianapolis.
- Michiana Health Information Network, South Bend, Ind.
- HealthLINC, Bloomington, Ind.
- East Tennessee Health Information Exchange, Nashville.
- The Kentucky Health Information Exchange, Frankfort.
- The Health Collaborative, Cincinnati.
- Great Lakes Health Connect, Grand Rapids, Mich.
Last October, the HIEs agreed to exchange patient data among themselves. The initiative, termed as the Heartland Project, got a $270,000 grant from the Department of Health and Human Services, with funds being shared among all seven entities; in addition, the money is assisting to develop a governance structure for the Heartland Project.
This past fall, Great Lakes Health Connect, a health information exchange in the State of Michigan since the year of 2010, was the last HIE to join the project. Since the month of April, Great Lakes has got 10,057 admit/discharge/transfer messages and has sent 57,690 such messages to partnering HIEs.
“Heartland Project is seven regional HIEs working among ourselves with the aim of broadening beyond our regions when patients go outside these areas,” says Doug Dietzman, executive director at Great Lakes Health Connect.
With the utilization of the virtual integrated patient record, if a Michigan resident receives care in another state, an admit/discharge/transfer message is transmitted to Great Lakes Health Connect, which then notifies the patient’s primary care physician. This enables better continuity of care and better communication among clinicians
With all participating seven regional HIEs now live on the system, the exchanges now are developing a query process for Continuity of Care Documents, with hopes that CCDs can be exchanged by year-end.
The new 7-HIE data exchange service has been named the Patient-Centered Data Home, which will enable data to be forwarded to a physician to support a complete medical record, Dietzman says.
As technical work progressed in recent months to link the HIEs, so did work to establish policies and methods governing the actual exchange of data across the region. It took 3 or 4 months of work to develop a trust framework for how information will be shared and how participants will manage the information once they have it, Dietzman says.
One big challenge was handling identities, which was managed by running admit/discharge/transfer messages through a master patient index (MPI), and each HIE has its own technology vendors, so they also have their own MPIs and a unique identifier for each patient.
The long-term intent of Heartland Project is to be a model for other HIE initiatives, Dietzman says, but how to do that is not yet clear, he appreciates. But the ultimate aim is quite bigger—to tie all HIEs at some point across the nation.
Wednesday, July 5, 2017
The use of electronic health records interrupts the doctor-patient connection
The utilization of electronic health records during the patient encounters has the potential to negatively affect the doctor-patient connection, in accordance with a study that used a qualitative analysis of comments from hospital- and office-based physicians.
Researchers at the institute of Brown University and Healthcentric Advisors conducted the analysis of comments, which were submitted in response to a Rhode Island Health Information Technology Survey, conducted in 2014 by the state’s Department of Health—744 doctors gave feedback about their EHR use and how it impacts the doctor-patient connection.
“We were actually struck by the difference between how the inpatient physicians view their EHRs and how it affects their actions, in contrast with those in the office space,” claims Rebekah Gardner, MD, an associate professor of medicine at Brown University’s Warren Alpert Medical School and a senior medical scientist with Healthcentric Advisors. Result of the research was recently published in the Journal of Innovation in Health Informatics.
Researchers discovered that hospital-based physicians commented most frequently that they spend less time with sufferers because they have to spend more time on computers for documentation. By contrast, office-based physicians commented most frequently on EHRs worsening the quality of the doctor-patient connection.
“However hospital-based physicians report benefits ranging from better information access to improved patient education and communication, unintended negative consequences are more frequent themes,” the researchers wrote.
The research discovered other responses differed across settings. “When comparing themes across settings, hospital-based physicians more frequently comment on the use of EHRs to feel more prepared for the clinical encounter, while office-based physicians more frequently comment on alteration of workflow and the depersonalization of relationships.”
At the similar time, the authors point out that comments from physicians that were “generally positive and comments that detailed the sufferer’s perspective comprised the least commonly observed themes for both (hospital and office) settings.”
In accordance with the Gardner, the study demonstrates the requirement for different solutions to make better how EHRs are used in inpatient versus office-based settings, given the different ways in which doctors in those environments perform their jobs.
She points out those hospital-based physicians frequently use computers situated outside of patient rooms, while office-based physicians increasingly bring laptops into exam rooms.
Outpatient doctors “will be documenting and going through the EHR while they are sitting there talking to the sufferer, so it is literally sitting there between them, distracting the physician from making eye contact and taking their attention away from the patient,” states Gardner, who suggests that doctors “honor the golden minute” when they first enter an exam room—not turning on their computer, giving patients their undivided attention and engaging them in conversation to develop doctor-patient connection.
She also suggests that after the computer is turned on, physicians should turn the screen in such a way that patients can view it. Doctors should “narrate” what they are doing in the EHR to be more inclusive of the documentation process, in accordance with Gardner.
On the other hand, Gardner claims inpatient physicians “who take care of patients on hospital floors, in the ICU and ER, when they are in the room with a patient, the computer often is not there—they are going outside of the room and documenting later.” As an outcome, researchers report that when doctors use computers for EHR documentation in inpatient settings, it limits time spent directly interacting with patients.
“With our inpatient findings, it actually speaks to the volume of documentation that is required and clunky EHR user interfaces,” states Gardner, who calls for making these interfaces more intuitive as well as decreasing the documentation burden on physicians.
Gardner and her colleagues appreciate that one of the limitations of the survey is that it was administered in a single state. Although, they contend that the large sample size, high response rate, range of represented specialties and array of EHR vendors might reduce this limitation.
Researchers at the institute of Brown University and Healthcentric Advisors conducted the analysis of comments, which were submitted in response to a Rhode Island Health Information Technology Survey, conducted in 2014 by the state’s Department of Health—744 doctors gave feedback about their EHR use and how it impacts the doctor-patient connection.
“We were actually struck by the difference between how the inpatient physicians view their EHRs and how it affects their actions, in contrast with those in the office space,” claims Rebekah Gardner, MD, an associate professor of medicine at Brown University’s Warren Alpert Medical School and a senior medical scientist with Healthcentric Advisors. Result of the research was recently published in the Journal of Innovation in Health Informatics.
Researchers discovered that hospital-based physicians commented most frequently that they spend less time with sufferers because they have to spend more time on computers for documentation. By contrast, office-based physicians commented most frequently on EHRs worsening the quality of the doctor-patient connection.
“However hospital-based physicians report benefits ranging from better information access to improved patient education and communication, unintended negative consequences are more frequent themes,” the researchers wrote.
The research discovered other responses differed across settings. “When comparing themes across settings, hospital-based physicians more frequently comment on the use of EHRs to feel more prepared for the clinical encounter, while office-based physicians more frequently comment on alteration of workflow and the depersonalization of relationships.”
At the similar time, the authors point out that comments from physicians that were “generally positive and comments that detailed the sufferer’s perspective comprised the least commonly observed themes for both (hospital and office) settings.”
In accordance with the Gardner, the study demonstrates the requirement for different solutions to make better how EHRs are used in inpatient versus office-based settings, given the different ways in which doctors in those environments perform their jobs.
She points out those hospital-based physicians frequently use computers situated outside of patient rooms, while office-based physicians increasingly bring laptops into exam rooms.
Outpatient doctors “will be documenting and going through the EHR while they are sitting there talking to the sufferer, so it is literally sitting there between them, distracting the physician from making eye contact and taking their attention away from the patient,” states Gardner, who suggests that doctors “honor the golden minute” when they first enter an exam room—not turning on their computer, giving patients their undivided attention and engaging them in conversation to develop doctor-patient connection.
She also suggests that after the computer is turned on, physicians should turn the screen in such a way that patients can view it. Doctors should “narrate” what they are doing in the EHR to be more inclusive of the documentation process, in accordance with Gardner.
On the other hand, Gardner claims inpatient physicians “who take care of patients on hospital floors, in the ICU and ER, when they are in the room with a patient, the computer often is not there—they are going outside of the room and documenting later.” As an outcome, researchers report that when doctors use computers for EHR documentation in inpatient settings, it limits time spent directly interacting with patients.
“With our inpatient findings, it actually speaks to the volume of documentation that is required and clunky EHR user interfaces,” states Gardner, who calls for making these interfaces more intuitive as well as decreasing the documentation burden on physicians.
Gardner and her colleagues appreciate that one of the limitations of the survey is that it was administered in a single state. Although, they contend that the large sample size, high response rate, range of represented specialties and array of EHR vendors might reduce this limitation.
Tuesday, July 4, 2017
CHIME provides new certification program for industry executives
The College of Healthcare Information Management Executives (CHIME) is launching a new certification program that seeks to appreciate the expertise of executives who work for companies that give products or services to the healthcare industry.
The Ann Arbor, Mich.-based professional organization has initiated the CHIME Foundation Certified Healthcare Executive program (CFCHE) for information technology experts who are not CIOs, but are at a senior level and have other achievements in the HIT industry.
Experts who may seek the new designation may be consultants, implementers, sales representatives or in other roles, claims Keith Fraidenburg, executive vice president and COO at CHIME.
CHIME considers the new designation will facilitate interactions within the healthcare IT industry, he states. For instance, when a CIO or other technology professional discusses technology with a person with a CFCHE designation, the CIO will know the other person has passed a tough exam and has studied the challenges confronting CIOs, other healthcare leaders and payers, along with other IT experts outside a healthcare organization, Fraidenburg says.
CHIME has experience developing professional designations for the healthcare IT industry. In the year of 2009 it started a new certification program for IT executives called the Certified Healthcare CIO (CHCIO) program. Currently, more than 350 CHIME members have studied for and acquired the CHCIO title. Becoming a CHCIO is a demonstration of knowledge, skill and competency earned over various years and is the CIO equivalent of being a “black belt,” Fraidenburg asserts.
For CHIME’s newest program, after an individual has registered to participate in the CFCHE certification program, a candidate will get an extensive list of reading materials, and will take a sample exam that is not like the real exam but written in the similar way as the CIO exam to ascertain where the candidate did well and where he or she requires improving.
The Ann Arbor, Mich.-based professional organization has initiated the CHIME Foundation Certified Healthcare Executive program (CFCHE) for information technology experts who are not CIOs, but are at a senior level and have other achievements in the HIT industry.
Experts who may seek the new designation may be consultants, implementers, sales representatives or in other roles, claims Keith Fraidenburg, executive vice president and COO at CHIME.
CHIME considers the new designation will facilitate interactions within the healthcare IT industry, he states. For instance, when a CIO or other technology professional discusses technology with a person with a CFCHE designation, the CIO will know the other person has passed a tough exam and has studied the challenges confronting CIOs, other healthcare leaders and payers, along with other IT experts outside a healthcare organization, Fraidenburg says.
CHIME has experience developing professional designations for the healthcare IT industry. In the year of 2009 it started a new certification program for IT executives called the Certified Healthcare CIO (CHCIO) program. Currently, more than 350 CHIME members have studied for and acquired the CHCIO title. Becoming a CHCIO is a demonstration of knowledge, skill and competency earned over various years and is the CIO equivalent of being a “black belt,” Fraidenburg asserts.
For CHIME’s newest program, after an individual has registered to participate in the CFCHE certification program, a candidate will get an extensive list of reading materials, and will take a sample exam that is not like the real exam but written in the similar way as the CIO exam to ascertain where the candidate did well and where he or she requires improving.
Monday, July 3, 2017
A Creative Tool assists cystic fibrosis patients to actively engage in their own care
A computerized decision-making tool has been demonstrated to be effective in assisting cystic fibrosis patients engage with clinicians as active participants in their own care.
Established by researchers at the University of Cincinnati, the shared decision-making tool takes into account sufferers’ preferences for measures of lung function and health, as well as evidence-based treatment to help cystic fibrosis patients in prioritizing home treatments.
Cystic fibrosis patients must undertake time-consuming and sometimes complex home therapies, claims Mark Eckman, MD, Posey Professor of Clinical Medicine and director of the UC Division of General Internal Medicine.
Although, by factoring personalized data into a computational framework, the tool assigns weights to patient preferences and personal aims for some of these treatments—combined with quantitative data on treatment efficacy, costs and time estimates—resulting in a score for each treatment option, he asserts.
“A personalized report is generated based on patient input, but also the model internally is informed by information from clinical trials and medical literature in terms of the efficacy of the different treatments,” stated Eckman. “That report then is utilized in a shared decision-making visit to facilitate a conversation between the patient and the clinician.”
Eckman and Patricia Joseph, MD, director of the Adult Cystic Fibrosis Program at UC Medical Center, assissted conducted a field study of 21 cystic fibrosis patients to determine the tool’s acceptability, understandability and ease of use. They and their co-authors recently issued an article in the journal Medical Decision Making Policy & Practice discussing results of the initial evaluation of the tool.
“Our field study of 21 sufferers with cystic fibrosis discovered that patients uniformly believed the shared decision-making exercise helped them establish personalized priorities for home therapies and activities,” they summarized.
“Use of the tool helped them clarify their personal values for the relative significance of home treatment goals and assisted them feel better prepared to discuss home treatment options with their doctors,” they report. “Perhaps most important, using the (CF-Shared Decision Making Tool) made them feel that they were contributing to making decisions in their care.”
Presently, the system leverages a Microsoft Excel spreadsheet based on a paper pamphlet that patients fill out, and clinicians must manually populate into a computerized model to generate a personalized report. Going forward, Eckman says researchers want to make the tool available through a computer tablet so patients can input their own data and automatically generate results. “This could also be put up on a sufferer portal,” he adds. “That is where we want to go. But, right now, the current model and interactions are a bit clunky.”
Drawing from the success of the limited field study, researchers expect to conduct a randomized clinical trial to evaluate whether the tool makes better the patient adherence to home treatments and clinical outcomes.
Established by researchers at the University of Cincinnati, the shared decision-making tool takes into account sufferers’ preferences for measures of lung function and health, as well as evidence-based treatment to help cystic fibrosis patients in prioritizing home treatments.
Cystic fibrosis patients must undertake time-consuming and sometimes complex home therapies, claims Mark Eckman, MD, Posey Professor of Clinical Medicine and director of the UC Division of General Internal Medicine.
Although, by factoring personalized data into a computational framework, the tool assigns weights to patient preferences and personal aims for some of these treatments—combined with quantitative data on treatment efficacy, costs and time estimates—resulting in a score for each treatment option, he asserts.
“A personalized report is generated based on patient input, but also the model internally is informed by information from clinical trials and medical literature in terms of the efficacy of the different treatments,” stated Eckman. “That report then is utilized in a shared decision-making visit to facilitate a conversation between the patient and the clinician.”
Eckman and Patricia Joseph, MD, director of the Adult Cystic Fibrosis Program at UC Medical Center, assissted conducted a field study of 21 cystic fibrosis patients to determine the tool’s acceptability, understandability and ease of use. They and their co-authors recently issued an article in the journal Medical Decision Making Policy & Practice discussing results of the initial evaluation of the tool.
“Our field study of 21 sufferers with cystic fibrosis discovered that patients uniformly believed the shared decision-making exercise helped them establish personalized priorities for home therapies and activities,” they summarized.
“Use of the tool helped them clarify their personal values for the relative significance of home treatment goals and assisted them feel better prepared to discuss home treatment options with their doctors,” they report. “Perhaps most important, using the (CF-Shared Decision Making Tool) made them feel that they were contributing to making decisions in their care.”
Presently, the system leverages a Microsoft Excel spreadsheet based on a paper pamphlet that patients fill out, and clinicians must manually populate into a computerized model to generate a personalized report. Going forward, Eckman says researchers want to make the tool available through a computer tablet so patients can input their own data and automatically generate results. “This could also be put up on a sufferer portal,” he adds. “That is where we want to go. But, right now, the current model and interactions are a bit clunky.”
Drawing from the success of the limited field study, researchers expect to conduct a randomized clinical trial to evaluate whether the tool makes better the patient adherence to home treatments and clinical outcomes.
Sunday, July 2, 2017
Ransomware attacks Cleveland Medical, affects info of 22,000 sufferers
Cleveland Medical Associates is providing about 22,000 sufferers identity protection services after a ransomware attack against the practice.
The five-clinician practice is giving a year of protective services through Equifax to both current and former sufferers whose information may have been affected.
Cleveland Medical Associates refused to give more details about the tragedy and also did not provide any extra statements about the attack.
The breach was discovered the morning of April 17. In response, the practice executed a new medical records system and engaged forensic specialists to verify the extent to which information was affected. The practice believes the motive for the attack was extortion and that access to patient health information wasn’t an end result of the attack.
“Based upon our inquiry, there is no evidence that your protected health information was taken from our system or misused as result of the incident,” the practice told patients in a notification letter. “Because we were not able to determine with reasonable certainty whether or not there was an unauthorized access of your information, however, we’re offering you with notification of this incident.”
Protected health information that could have been compromised involves patient names, addresses, demographics, telephone numbers, email addresses, clinical information, insurance billings and Social Security numbers.
The Equifax protection package offers credit monitoring, as much as $25,000 in identity theft insurance and automatic fraud alerts of changes to a credit report.
The five-clinician practice is giving a year of protective services through Equifax to both current and former sufferers whose information may have been affected.
Cleveland Medical Associates refused to give more details about the tragedy and also did not provide any extra statements about the attack.
The breach was discovered the morning of April 17. In response, the practice executed a new medical records system and engaged forensic specialists to verify the extent to which information was affected. The practice believes the motive for the attack was extortion and that access to patient health information wasn’t an end result of the attack.
“Based upon our inquiry, there is no evidence that your protected health information was taken from our system or misused as result of the incident,” the practice told patients in a notification letter. “Because we were not able to determine with reasonable certainty whether or not there was an unauthorized access of your information, however, we’re offering you with notification of this incident.”
Protected health information that could have been compromised involves patient names, addresses, demographics, telephone numbers, email addresses, clinical information, insurance billings and Social Security numbers.
The Equifax protection package offers credit monitoring, as much as $25,000 in identity theft insurance and automatic fraud alerts of changes to a credit report.
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