Tag: Health iT

Doctors turn to free eConsult platforms to reduce diagnostic errors, study finds

 

 

Dive Brief:

  • As providers step up efforts to reduce medical errors and misdiagnoses, more physicians are availing virtual consultation tools to get second opinions, a study in npj Digital Medicine shows.
  • Researchers looked at physician use of WebMD’s free online Medscape Consult between November 2015 and October 2017. During that time, 310,563 physicians accessed the platform — 37,706 of them “active users” who generated a total of 117,346 posts (7,834 original contacts and 109,512 responses).
  • The No. 1 specialty area identified by eConsult users as their primary practice area was internal medicine, at 26.9%. Pediatrics, cardiology, obstetrics and gynecology and dermatology rounded out the top five most frequent specialties. The median time to first response was 90 minutes.

 

Dive Insight:

The researchers stress that Medscape Consult is not the only online doctor-to-doctor engagement platform. Other crowdsourced platforms include Sermo, Human Diagnosis Project and QuantiaMD. There are also apps like HealthTap and CrowdMed that allow consumers to consult doctors or other health professionals about symptoms and diagnoses.

“Artificial intelligence has been advocated as the definitive pathway for reducing misdiagnosis. But our findings suggest the potential for collective human intelligence, which is algorithm-free and performed rapidly on a voluntary basis, to emerge as a competitive or complementary strategy,” the authors write. “While there are certainly more refinements and study of this platform required, we have demonstrated an extraordinary reach and potential for a multispecialty, crowdsourced, global virtual consultation platform at scale for physicians in search of diagnostic input.”

The global study, conducted by Scripps Research Institute and WebMD, shows the growing popularity of eConsults with physicians everywhere. While younger doctors made up the bulk of initial queries, the majority of responses (more than 60%) were from physicians aged 61 and older, suggesting “older physicians feel comfortable with and support this type of virtual engagement,” the authors write.

A study in JAMA earlier this year found eConsult can significantly improve access to specialists and reduce specialty work for primary care physicians. But it warned also of new workload challenges for eConsult users, such as increased administrative burden, added clinical responsibility and restructured specialty care delivery.

For eConsult to thrive, stakeholders need to realign expectations and improve communications between primary care doctors and specialists, a 2017 New England Journal of Medicine case study at NYC Health + Hospitals concluded. eConsults can also lead to changes in workflow, such as more scheduling shifting from primary care to specialist, which could trigger changes in dedicated staff, according to the study.

Patient-matching tools viable but nowhere near perfect, Pew says

 

 

Dive Brief:

  • No solution currently exists that could achieve perfect or near perfect match rates across EHR systems for all patients, according to a report released Tuesday by the Pew Charitable Trusts. However, actions can be taken to better link records, to the benefit of patients and providers.
  • In the short term, Pew recommends clarifying government funding restrictions for unique identifiers, agreeing on standardized demographics, assessing privacy ramifications, continuing to research (and adopt) referential matching using third-party data and verifying phone numbers and other identifying information provided by patients.
  • To develop a stronger patient matching chassis, long-term opportunities include creating a single countrywide oversight organization, launching pilot projects for patients to use their own smartphones to help match records and determining the infrastructure and standards necessary to use biometrics and other more secure and effective patient-matching strategies.

 

Dive Insight:

Effective patient matching is among the necessary elements to move toward the elusive goal of interoperability. On that front, industry is eagerly awaiting proposed new rules laying out how HHS will curb providers from hoarding data via information blocking.

The 21st Century Cures Act requires the Government Accountability Office to take steps to reduce matching errors and HHS and the Office of the National Coordinator for Health Information Technology to support the nationwide exchange of health information.

EHRs can promote efficiency, but in the absence of standardization doctors are confronted with the question of whether they are worth the pain. Administration burden associated with EHRs are a leading cause of physician burnout and dissatisfaction, and problems with system implementation and operability can manifest in problems with patient care.

And for EHR systems to be effective, they need to be able to communicate effectively both intra and intersystem — a goal that depends on several factors such as desire of said institutions to share data and correctly link record to patient, according to Pew.

The report attempts to identify solutions to the latter dilemma, as patient-matching rates vary widely across the United States. Such inconsistencies can lead to safety problems and needless costs in repeat tests and delays in care.

Currently, matching is typically done through the use of algorithms, unique identifiers, manual review or a combination of those methods. Among the factors contributing to inadequate match rates are standardization variance, typos, unentered information, information changes and identity fraud.

Pew examined four main approaches for improvement. The first is in the realm of unique identifiers that identify a person and link to his or her records, such as biometrics. Biometrics (body measurements specific to a person, such as fingerprint or eye scan) are en vogue in European airports, for example, as a way to quickly and easily confirm someone’s identity. However, such measurements can be stolen and, once compromised, can’t be changed, for obvious reasons.

A second suggestion allow patients to ensure their records are matched correctly through a portal such as a smartphone app. However, patients would need to be motivated to participate for this strategy to have legs.

Pew also recommended standardizing demographic indicators across systems to promote interoperability and pinpointed referential matching, or using non-health related data from credit bureaus and other organizations, as a helpful scheme when other basic information such as address changes.

Pew researchers convened a series of panels, focus groups and interviews, including healthcare executives, yielded some interesting insight on how the C-suite views patient matching. Interorganization patient matching was found to offer the biggest opportunity for progress in their eyes.

Consistently, executives had a goal of 99% success rate in matching but no consistent method to measure progress to that goal, although many indicated they had already invested in software or employees to track matching.

Provider breaches more common than health plan breaches, but put fewer records at risk, study finds

 

 

Dive Brief:

  • Despite privacy protections like HIPAA and the HITECH Act, security breaches continue to plague the healthcare industry, and the problem is only getting worse, a research letter in JAMA shows.
  • The authors looked at breaches posted to the HHS Office For Civil Rights breach database from Jan. 1, 2010, to Dec. 31, 2017. A total of 2,149 breaches occurred, impacting 176.4 million records.
  • Healthcare providers were the targets in 70% of all breaches, putting 37.1 million records at risk. However, health plans, with just 13% of the breaches, accounted for the lion’s share of compromised records at 110.4 million.

Dive Insight:

During the review period, the number of breach reports increased every year except 2015.

The analysis also shows that while more breaches involved paper and film than electronic records, the impact was far less. A total of 510 breaches involved paper or film, compromising 3.4 million records. By contrast, the 410 breaches of EHRs affected 139.9 million records, the authors say.

Prime locations of breaches shifted from laptop, paper and film in 2010 to network servers in 2017. “These shifts were paralleled by increases in hacking or information technology (IT) incidents and unauthorized access, which both surpassed thefts by 2016,” the authors write.

“Although networked digital health records have the potential to improve clinical care and facilitate learning health systems, they also have the potential for harm to vast numbers of patients at once if data security is not improved,” they added.

Research has shown that insiders pose one of the biggest threats to health information security. In a Verizon analysis of security incidents in 2016 and 2017, 58% of breaches were triggered by people working in the organization, compared with 42% that were caused by outside actors. And while concerning, it’s not a total surprise. A 2017 study found widespread sharing of EHR passwords among doctors and clinical support staff, puts patients’ information at risk.

Part of the problem is that healthcare organizations aren’t following ONC guidelines to protect electronic records. A recent survey by researchers at the University of Texas Health Science Center at Houston found health systems have fully implemented just 18% of ONC’s recommendations.

This year alone has seen more than 200 breaches at healthcare organizations, including 10 affecting more than 100,000 patients each.

To increase compliance, systems must prioritize and fund these initiatives, make internal policy changes regarding security and get vendors involved, the UT researchers said.

Hackers exploit data in error messages to attack connected medical devices, report finds

 

 

Dive Brief:

  • Cyber criminals are using information from error messages to exploit vulnerabilities in connected medical devices, a new white paper by IoT security firm Zingbox warns.
  • Zingbox identified numerous IoT devices leaking sensitive and technical information due to error handling issues. Vendors were alerted to those findings between early May and late August of this year.
  • To date, only one company, Johnson Controls, has issued a patch to secure its devices, according to the report.

Dive Insight:

The internet of connected medical things market is forecasted to hit $158 billion by 2022. With more and more connected devices being used, more hospitals, physician practices and patients are at risk from cyber and ransomware attacks.

A recent FDA action plan seeks new authorities to require manufacturers to build security updates and patch capabilities into products beginning at the design stage and to have formal processes for handling vulnerabilities discovered after products are on the market.

This latest trend in cyberattacks greatly increases the odds of a successful attack, Zingbox says.

According to the analysis, information disclosed via error messages included database running in the server, database usernames, software stack trace, source code line numbers where failure occurs, server file system path, class names and arguments and source code methods and parameters.

The analysis uncovered error message issues with seven vendors’ products.

Johnson Controls released a patch for its Metasys and BCPro smart building systems. Two other vendors, Change Healthcare/peerVue and CareStream told Zingbox they are planning to issue a patch.

Siemens and Fujifilm indicated they would not release a patch, while CBORD and Nuance had yet to respond to Zingbox’s notification. Many of the notifications involved medical imaging devices.

To secure error messaging, Zingbox recommends vendors send custom error messages without disclosing details, including information sent to log messages, and avoid error messages that might alert an attacker about usernames, passwords and other internal configurations.

Providers can play a role, too, by identifying connected technologies in their network, monitoring them for suspicious activity, using real-time alerts and proactively addressing vulnerabilities when they’re exposed.

More than half of Americans share doctor experiences online, survey shows

 

 

Dive Brief:

  • Americans are increasingly going online to find doctors and rate their healthcare experiences. In a new Binary Foundation survey, 51% of respondents said they share their personal medical experiences via social media, online ratings and review sites — 65% more than did so a year ago.
  • Among millennials, 70% reported sharing doctor and hospital experiences online. The share was slightly lower for young millennials age 18 to 24 at 68%, but a whopping 94% jump from the previous year.
  • Meanwhile, 70% of Americans say their choice of doctor was influenced by online ratings and reviews, and 41% admitted checking out a doctor online even when another provider referred them.

 

Dive Insight:

Hospitals and doctors may not be thrilled about the growing reliance on online reviews, but with more consumers using them to select and rate their care, they need to take them seriously. With CMS focused on patient engagement and patient experience, how a provider handles patient feedback can impact their quality performance ratings.

Providers should suppress the urge to get angry over negative reviews and instead look at the review from the patient’s perspective, David Williams, chief strategy officer at LEVO Health, previously told Healthcare Dive. “The quicker the response, the more likely people will … feel heard,” he said.

In the latest survey, 95% of respondents called online ratings and reviews “somewhat” to “very” reliable. And of those, 100% of 18-24 year olds and 97% of 24-34 year olds said online comments and rankings are reliable, according to the second annual Healthcare Consumer Insight & Digital Engagement survey.

When asked about their expectations for patient care, 48% of all respondents said a friendly and caring attitude is the most important quality they look for in a doctor. Other key factors are the ability to answer patients’ questions (47%) and thoroughness of the examination (45%).

Americans also value their time and, with more virtual and retail care options available, don’t have to put up with limited hours and packed waiting rooms. More than four in 10 consumers (43%) said wait time is the most frustrating part of seeing the doctor. By contrast, 10% each mentioned cost and payment and waiting for exam results, while 9% chafed at scheduling appointments.

The foundation also highlighted providers’ need to understand and respond to what’s being said about their services online.

“The survey results underscore the significance of online ratings and reviews as online reputation management for physicians becomes ever-more important in today’s healthcare environment,” Aaron Clifford, senior vice president of marketing at Binary Foundation, said in a statement. “As patients are becoming more vocal about their healthcare experiences, healthcare organizations need to play a more active role in compiling, reviewing and responding to patient feedback, if they want to compete in today’s marketplace.”

Facebook is the platform of choice for sharing healthcare experiences among 25-54 year olds. Google replaced Twitter as the preferred platform among young millennials in this year’s survey.

DAS Health’s Vice President of Technology Solutions Appointed to the USF Cybersecurity for Executives Advisory Committee

TAMPA, Fla., Aug. 06, 2018 – Kyle Mynatt, Vice President of Technology Solutions for DAS Health, an industry leader in health IT and management, has been appointed to the USF Cybersecurity for Executives Advisory Committee. This committee contributes to the School in many ways including sharing invaluable knowledge to the faculty and students, as well as overseeing the Cybersecurity for Executives Certificate Program.

Kyle brings his extensive 17+ years of experience in technology to this esteemed committee.  The last 7 of those years have been spent with DAS Health, where he currently oversees departments with responsibility for the cybersecurity of 8 million patients’ records and a real-time Disaster Recovery (DR) system that spans the continent, as well as other customer facing disciplines. Kyle also has 10 years of prior technical experience in the field; including his active duty in the Marines where he worked with the National Security Agency (NSA) in counter intelligence. During this time, he trained in multidiscipline intelligence collection and operations and became skilled in troubleshooting computer hardware and network issues. Kyle was honored as a 2017 Tampa Bay Business Journal Heroes at Work, an award that recognizes veterans who contributed to their community through their personal and professional endeavors.

“We are delighted for Kyle to be appointed to such a crucial advisory committee,” said David Schlaifer, President and CEO of DAS Health. “Kyle brings a unique background and approach to the committee through his experience in Health IT and the remarkable mentorship he provides to his team.”

Kyle will be part of a group of industry leaders that hold an expansive professional record ranging from start-ups to government intelligence. This impressive group will guide the course content and mentor the attending executives through an intense, two-day Executive Education Program that is designed to provide a ‘survival guide’ for the rising executives. Kyle will be utilizing the extensive knowledge he has gained to offer input on USF’s program, create potential internship programs, and visit classrooms and conferences.


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