Why practices are confronting difficulties to exchange patient records

Medical record administrators are sustaining to have difficulties exchanging patient records with other providers.

Data exchange of patient records is specifically difficult when getting providers are not on the same electronic health records (EHRs) as the sender, in accordance to results of a survey conducted in the month of January by Black Book Research, which discovered that more than 40% of responding administrators admitted to record exchange challenges.

Those mixed outcomes come even though vendors of EHRs are reconfiguring systems to better enable data exchange. The survey also measured how well respondents’ electronic health records (EHRs) vendors are optimizing EHRs, including the use of the emerging FHIR interoperability standard, to better support HIE.

“As inpatient agencies execute optimized EHR software that uses FHIR to advance interoperability and HIE, the whole provider network gains the data exchanging functionality to better serve sufferers,” claims Doug Brown, managing partner at Black Book. “Physician groups continue to lack the financial and technical expertise to adopt complex EHRs which are necessary to attain higher reimbursements by public and private payers.”

• 70% of responding hospitals do not use patient records information outside of their own EHR because information from external providers isn’t made available in the EHR workflow.


• 22% of records administrators say transferred patient information isn’t presented in a usable format.


• 21% of hospital-based physicians say the data they view can’t be trusted for precision when sent between disparate information systems.

In all, more than 80% of independent physicians in the survey aren’t confident of having the technology and skills to manage the financial risk of quality payment programs.

Black Book also inquired how providers feel about their EHR vendor. Those ranked greatest are: Evident CPSI for hospitals with fewer than hundred beds; Cerner for community hospitals with 101-250 beds; Allscripts for facilities with more than 250 beds; and Cerner for hospital chains and integrated delivery systems.

 

Behavioral health provider turns EHR to prepare for accountable care

HealthWest, a community mental health organization serving Muskegon County in west Michigan, recently opted its 4th electronic health record (EHR) system, a shift predicated on better supporting sufferers and the staff during the era of value-based and accountable care.

The agency used its earlier EHR for more than 5 years, but the state of Michigan has changed its behavioral health procedures, and HealthWest required extra functionality that involves better connectivity with medical providers to support accountable care, claims David McElfish, chief information officer.

“The aim is to have an integrated medical and behavioral health record and exchange data with primary care physicians throughout the county,” he further adds. “The result in the end is offering better care to our clients.”

HealthWest engaged in a 6-month vendor selection procedure and recently settled on the Cx360 EHR from Core Solutions. Clinicians and staff liked an interface on the latest records system that gives data views on all clients or just one client, provides more relevant data on lookup screens, is more intuitive and has more convenient workflow, in accordance to McElfish.

Other vendor candidates didn’t give a managed care module that involved electronic billing and claims management, and would not permit HealthWest’s in-house information technology team to establish add-on screens for reporting purposes.

HealthWest also needed a sufferer portal, seamless eligibility verification checks and appointment schedules viewable on mobile devices, since most staff members work in the community. Moreover, HealthWest has been working to automate more procedures so that data moves in real time, another initiative that Cx360 could support.

When it came down to a final pick among 2 products with comparable price tags, it was the extra offerings and greater flexibility that Core Solutions offered that sealed the deal.

“As HealthWest progressed, there was no way to continue to have manual procedures,” McElfish concludes. “We required functionality to get local provider claims electronically instead of on paper.”

An implementation kick-off meeting is planned for the day of February 22. HealthWest previously was looking to go live in the month of October, but uncertainties that the timetable may be too aggressive makes a January 2018 go-live look more likely, McElfish claims.

 

Two providers take decidedly different approaches with sufferers after breaches

2 more healthcare agencies have reported cyber attacks that resulted in unauthorized access to patient information, but the two providers took decidedly different approaches in offering protective services to affected people after breaches.

Princeton Pain Management in Plainsboro, N.J., discovered on the day of Nov. 28, 2016, that a third party gained unauthorized access to its computer system, and the data at risk included some 4,668 patients.

Compromised health information involved names, telephone numbers, addresses, dates of birth, Social Security or Medicare numbers, driver license or government identification numbers, insurance information, and diagnostic and treatment information.

Despite the sensitivity of much of the data included in the breach, the agency’s announcement didn’t involve an offer of credit or identity protection services after breaches.

Princeton Pain Management, which used its declaration to provide sufferers with information on how to secure themselves, didn’t respond to a request for extra information on the tragedy or its response.

Six-hospital Verity Health System in California is notifying more than 9,000 people after protected health information was accessed by an unauthorized person. On the day of Jan. 6, 2017, the agency tracked the hack of its Verity Medical Foundation-San Jose Medical Group web site that is no longer being used. Access was discovered to have originated between the time period of October 2015 and January 2017.

Compromised patient information involved the dates of birth, names, medical record numbers, home addresses, email addresses, phone numbers and the last four digits of credit card numbers. Social Security numbers and complete credit card information wasn’t being compromised, the organization says.

Verity Health System is providing 1 year of credit monitoring services. The organization didn’t respond to a request for extra information on the breach or remediation attempts.

 

PCHA, IHE emphasizes to work on info exchange

Two industry agencies—one that is fairly new, and another that is been in operation for many years—say they plan to work together this year on joint initiatives to make better ways that IT systems share health information or info exchange.

The Personal Connected Health Alliance (PCHA) and Integrating the Healthcare Enterprise (IHE) say they plan to pursue 3 initiatives in attempts to make better and simplify interoperability. PCHA and IHE signed a joint liaison contract in the year of 2016, and this latest declaration builds off of that, executives say.

PCHA is a not-for-profit agency developed by the Healthcare Information and Management Systems Society to support technology that enables personal connected health. IHE, which has been in existence for nearly 2 decades, is an initiative by healthcare professionals and the industry to make better the way healthcare computer systems share information and info exchange.

The agencies will further their collaboration on future IHE Profiles and Continua Design Guidelines development, to make sure the combined deployment of fully interoperable systems. The 2 groups will also cooperate on conformity testing and certification, aligning their respective tools and procedures. Ultimately, PCHA and IHE are “devoted to advancing communication, education and interoperability demonstrations to eradicate confusion among providers, vendors and standards bodies,” executives claim.

Standards-based exchange of healthcare information among facilities, health information agencies and government agencies is identified as significant in improving care. IHE's Profiles and PCHAlliance's Continua Design Guidelines are both standards-based, open specifications that have been developed to be deployed together, and make sure that device data—whether captured by the sufferer or in a care delivery setting—flows into electronic health records (EHRs) in the similar format and coded content.

Continua Design Guidelines are identified as an international standard for personal health systems and comprise a reference architecture, implementation tools and services.

IHE Profiles give a common language for purchasers and vendors to meet the integration requirements of healthcare sites and the integration capabilities of HIT products.

"PCHAlliance and IHE share the similar vision. That is, we consider that health info exchange is possible throughout the worldwide healthcare ecosystem and, together, we can support latest innovations and develop solutions to make better health outcomes, enhance understanding and assist to make big data possible," stated Michael Kirwan, vice president, Personal Connected Health Alliance. "We’re looking forward to expanding our collaboration and working closely to further extend interoperability in healthcare."

Pennsylvania Superior Court finds UPMC not responsible for data breach

The Pennsylvania Superior Court has ruled that the institute of University of Pittsburgh Medical Center has no duty under state law to secure employee information and dismissed a class action lawsuit against the delivery system.

The ruling, which is in reaction to a February 2014 tragedy that instantly affected all of UPMC’s 62,000 present and former employees, has ramifications not just for healthcare agencies, but for all businesses in the state, observers claims.

Data compromised in the breach involve names, dates of birth, Social Security numbers, tax information, addresses, and salary and bank information. In the year of April, 2014, UPMC confirmed compromised data for as many as 27,000 workers with at least 788 employees becoming victims of tax fraud, and a month later confirmed all workers were compromised, in accordance to the Pennsylvania Superior Court filings.

Attorneys for the employees argued in the Pennsylvania Superior Court that UPMC had a legal duty to secure employee information and that the organization didn’t properly encrypt data, develop firewalls and implement appropriate user authentication protocols.

A trial court ruled that UPMC didn’t owe a duty of reasonable care in gathering and storing employee information. The Superior Court agreed, pointing put the pervasiveness of electronic storage of information with an obvious social utility to promote efficiency. Moreover, the Pennsylvania Superior Court in its opinion said the mere duty that Pennsylvania’s legislature has enforced on companies in the state is notification of a data breach, and it is not for the courts to change the direction of the legislature because public policy is a matter for the legislature.

“While a data breach (and its ensuring harm) is basically foreseeable, we don’t consider that this possibility outweighs the social utility of electronically storing employee information,” the Pennsylvania Superior Court pointed out in its decision. “In the modern era, more and more data is stored electronically and the days of keeping documents in file cabinets are long gone. Without doubt, workers and consumers alike derive substantial benefits from efficiencies resulting from the transfer and storage of electronic data.”

The Superior Court doubled down on its assertions, saying a judicially created duty of care is not required to incentivize companies to secure their confidential information. “We find it unimportant to need employers to incur potentially significant charges to increase security measures when there is no true way to stop data breaches altogether. Employers strive to run their businesses efficiently, and they have an incentive to secure employee information and stop these types of occurrences.”

Appellants, the court ruled, didn’t provide their information to UPMC for the consideration of its safe keeping but for employment purposes. The full ruling is available here.

 

Beacon Health System ACO Expands Relationship with Koan Health for Value-Based Analytics

The federally recognized accountable care organization (ACO) owned by Beacon Health System in South Bend, Ind. — has expanded its relationship with Dallas-based Koan Health. Koan will now give comprehensive healthcare analytics, risk management and performance improvement services for several CHA ACO and Beacon initiatives.

"CHA ACO and Beacon are innovators in the region of Indiana," pointed out Jeff Hayes, Koan Health executive vice president. "We are excited to assist them strengthen results in all of their value-based attempts."

Through the contract, CHA ACO and Beacon will have approach to proprietary analytic tools and consulting services of Koan Health that observe and target areas for improvement in population health and particular episodes of care.

“Analytics of Koan Health are much more flexible, transparent and detailed in contrast to any of the competition's," stated Diane Maas, Beacon Health vice president. "And their responsiveness and service make them true partners."

Koan will support the Beacon team in setting, monitoring and achieving performance improvement aims in 2 strategic areas:

• Accountable care relationships (Employee ACO and Medicare Shared Savings Program) with almost 30,000 covered lives and over $300 million in yearly expenditures.


• Episode-of-care relationships (Medicare Bundled Payments for Care Improvement Initiative and Comprehensive Care for Joint Replacement Model) with nearly 700 episodes and $15 million in yearly expenditures.

"Our analytics develop a deep link between clinical and financial performance," claimed DT Nguyen, Koan Health chief executive officer. "Our experience with accountable care and bundled payments enables us to assist organizations to coordinate improvement across all of their public, private and employee programs."

Value-based arrangements are part of a continual revolution in health care delivery and financing. Government and private payers seek to control charges by reimbursing providers deployed on clinical and financial results—rather than on the number of services they deliver.

Precise predictive analytics, like those given by Koan Health, are a critical tool in comprehending current performance, setting improvement goals, designing interventions and measuring outcomes.

 

Indiana University School of Medicine startup launches EHR-embedded pediatric software

Digital Health Solutions, a startup initiated by 2 Indiana University School of Medicine professionals, is commercializing software it said will assist pediatricians better target care for their sufferers. The Indiana University School of Medicine startup launches EHR-embedded pediatric software.

The tool, known as Child Health Improvement through Computer Automation, or CHICA, augments electronic health records (EHRs) to assist physicians better assess sufferer risks, identify issues earlier and better document care quality. It was established by DHS President Stephen Downs, MD, section director of Children's Health Service Research at IU, and Tammy Dugan, senior software developer at IU and chief technology officer of Digital Health Solutions. The Indiana University School of Medicine startup launches EHR-embedded pediatric software.

The pediatric population "does not get as much attention due to the reimbursement structures in hospitals," Dugan claimed in a statement.

By licensing CHICA via the Indiana University Research and Technology Corp., the target is to give pediatricians tools that can assist improve care for children.

The technology works by first screening families in office waiting rooms through an electronic tablet that inquires twenty queries.

"Deployed on the responses of family, the software uses its prioritization procedure to opt the most significant issues for the physician to address during the visit," Downs added. "The family can give information on a broad range of topics, involving general preventive counseling, asthma, attention deficit hyperactivity disorder, autism, domestic violence, iron deficiency, lead exposure, maternal depression, tuberculosis and more. It also permits physicians to alert sufferers to problems that might otherwise be overlooked."

When physicians access a sufferer’s EHR, the embedded link connects them with CHICA. The Indiana University School of Medicine startup launches EHR-embedded pediatric software.

"Once the doctors have checked all the boxes, demonstrating how they responded to the alerts, the data is submitted as a block of text to EHR software that can then be incorporated into the note of provider, thereby streamlining clinical documentation," stated Dugan.

"Payers of health care are searching for ways for providers to indicate superior-quality care," Downs said. "The system captures data that improves and indicates the quality of care, which could be used to make better reimbursement. It also gathers patient-reported information that cannot be captured any other way."

 

Microcephaly case links Directly to deadly Zika Virus

The Health Secretariat has confirmed about the very first microcephaly case in a newborn infant in Mexico, one that is linked straightly to the deadly Zika virus.

The premature baby passed away during childbirth in the month of November in the state of Oaxaca.

The National Institute of Perinatology in the city of Mexico confirmed that the microcephaly case diagnosis, and discovered traces of the Zika virus in the amniotic fluid, along with congenital deformities.

The Health Secretariat claimed in a press release that between the time period of November 2015 and January 2017 it confirmed 7,634 cases of Zika infections, 4,252 of which were pregnant females. Of those, 588 have given birth.

The health agency cautioned that it was possible there would be more cases.

The secretariat repeated its suggestions to ignore contracting the Zika virus by using long-sleeved shirts and pants and mosquito repellent; turning pails and bottles upside down, and accurately discarding those no longer in use; keeping water containers clean and covered; and keeping doors and windows closed or secured with mosquito nets.

Pregnant females should certainly attend their prenatal appointments and, along with the general public, seek medical consultation in case of suffering any of the symptoms.

The deadly Zika virus is like a mild form of dengue fever transmitted by the same mosquito, and is normally treated by rest. It can’t be stopped by drugs or vaccines.

Official figures demonstrated that last July there were 667 cases of Zika infections, and that 287 of them were pregnant females.

 

Several agencies lack effective direction on cybersecurity

Despite all the attention now concentrated on cybersecurity, a major number of agencies say they aren’t sure they know the most effective protection strategy to combat and tackle these kinds of attacks.

This deficiency of knowledge and protection “is putting businesses across the globe at threat of grinding to a halt,” in accordance to the new Corporate IT Security Risks survey from Kaspersky Lab.

The study discovered that 39% of agencies appreciate that they are not confident that they have precise IT security safeguards for cybersecurity in place.

“DDoS attacks in specific can rapidly incapacitate a targeted business’s workflow, bringing business-critical procedures to a stop,” the study pointed out. Although, the research discovered that 16% of businesses aren’t protected from DDoS attacks at all, and 49% depend on built-in hardware for protection.

“This isn’t effective against the increasing number of large-scale attacks and ‘smart’ DDoS attacks which are difficult to filter with standard methods,” the report added.

In several cases, agencies assume that they are already secured for cybersecurity from these kinds of attacks, but that confidence is mostly misplaced.

Some 40% of the agencies surveyed fail to put measures in place because they consider that their Internet service provider (ISP) will give protection. The survey discovered that 30% believe that their data center or infrastructure partners will secure them.

“The reality is that these agencies mostly secure businesses from large-scale or standard attacks, while ‘smart’ attacks, such as those utilizing encryption or imitating user behavior, need an expert approach,” the study elaborates.

Perhaps most surprisingly, the survey discovered that almost a third of agencies fail to take action because they consider they are unlikely to be targeted by DDoS attacks. Some 12% even appreciate that they consider that a small amount of downtime because of DDoS would not cause a major problem for the company.

“The reality is that any company can be targeted because such attacks are convenient for cybercriminals to launch. What is more, the potential cost of a single attack can be in the millions,” in accordance to the report.

“As we have seen with the recent attacks, DDoS is immensely disruptive, and on the rise,” claims Kirill Ilganaev, head of Kaspersky DDoS protection at Kaspersky Lab. “When hackers launch a DDoS attack, the damage can be devastating for the business that is being targeted because it disables a online presence of company. As an outcome business workflow comes to a halt, mission-critical processes can’t be completed and reputations can be ruined.”

“Online services and IT infrastructure are merely too significant to leave unguarded,” Ilganaev sustains. “That is why specialized DDoS protection solution should be considered an important part of any effective protection strategy in business today.”

EHR analysis: Childbirth complications can raise autism spectrum disorder risks

An analysis of data from electronic health records (EHRs) of almost 600,000 kids born in Kaiser Permanente hospitals in the region of southern California between the time period of 1991 and 2009 has discovered a link between complications soon before or during birth and a higher risk of a child establishing an autism spectrum disorder (ASD).

The research indicates the power of using EHRs to give data for medical research that could affect care delivery and lay the groundwork for additional analysis.

Of the 594,638 records analyzed, 6,255 kids were diagnosed with autism spectrum disorder; of those, 37% experienced perinatal complications, in accordance to the study, released in the American Journal of Perinatology.

These kids with complications during birth had a 10% higher risk of autism spectrum disorder, and that number increased to 22% if complications began before labor. In all, kids exposed to complications before and during birth had a 44% higher risk.

Complications with the highest risk of ASD involved birth asphyxia, premature separation of the placenta from the uterus, preeclampsia, breech/transverse fetal presentation, fetal dystocia/abnormal size or position, and a prolapsed/exposed umbilical cord, in accordance to study results.

“Our study recommends that kids exposed to certain perinatal complications, particularly birth asphyxia and preeclampsia, were more likely to be diagnosed with ASD than those who weren’t exposed, even after adjusting for factors like gestational age at birth and a mother’s age, race and education,” lead author Darios Getahun, MD, claims.

2 other Kaiser studies in the time period of 2014 and 2015 found siblings have fourteen times higher risk of establishing ASD if an older sibling has it, and children with mothers that developed gestational diabetes by the 26^th week of pregnancy also confronted increased risk.

The most recent study is available here.