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Seven Factors That Will Make 2018 A Challenging Year For EMR Vendors

Posted on May 24, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Unless they’re monumentally important, I generally don’t regurgitate the theories researchers develop about health IT. But this time I’m changing strategies. While their analysis may not fit in the “earth shattering” category, I thought their list of factors that will shape 2018’s EMR market was dead on, so here it is.

According to a report created by analyst firm Kalorama Research, a number of trends are brewing which could make next year a particularly, well, interesting one for EMR vendors. (By the by, the allegedly Chinese curse, “May you live in interesting times” probably wasn’t Chinese in origin — it seems to have been minted in the 19th century by a British politician named Joseph Chamberlain. But I digress.)

According to Kalorama publisher Bruce Carlton, many forces are converging, including:

  • Frustrated physicians: Physician rage over clunky EMRs may boil over next year. No one vendor seems positioned to scoop up their business, but of course many will try.
  • Hospital EMR switches: While hospitals have been switching out EMRs for quite some time, defections may climb to new levels. Their main objective: Improve workflows.
  • Emerging technologies: Trendy approaches like dashboarding, blockchain and advanced big data analytics will begin to be integrated with existing EMR technologies. Or as the report notes, “the Old EMR doesn’t cut it anymore.”
  • IT staff shortages: It takes a pretty seasoned IT pro to run an EMR, but they’re hard to find, especially if you want them to have a lot of relevant experience. But without their expertise, provider organizations may not get the most out of their systems. This may spell opportunity for vendors offering better service, the report says.
  • Breach of the day: With each cybersecurity breach, EMRs get negative coverage, and the effects of this bad PR are accreting. Tales of ransomware, a particularly lurid form of cybercrime, are only making things worse.
  • Many EMR vendors remain: Despite a barrage of M&A activity in the sector, there are still over 1,000 vendors in the EMR space, Kalorama notes. In other words, competition for EMR customers will still be brisk, particularly given that no one vendor – even giants like Cerner and Epic – owns more than one-fifth of the market (This assertion comes from firm’s own market estimates.)
  • New Administration, new goals: To date the White House hasn’t proposed specific changes to health IT policy, but one clue comes from the appointment of an HHS Secretary who dislikes the meaningful use program. Anything could happen here.

In addition to the factors cited by Kalorama, I’d suggest one other trend to consider. As I’ve noted above, Kalorama argues that customers will demand EMRs that incorporate sexy new technologies, perhaps more so than in the past. I’d go further with this projection. From what I’m hearing, a consensus is emerging that EMR architectures must be completely deconstructed and rethought for today’s data.

With important data flows emerging from wearables, apps, remote monitoring devices and the like, it may not makes sense to put a big database at the center of the EMR platform anymore. After all, what’s the point of setting up an enterprise EMR as the ultimate source of truth if so much important data is being generated by mobile devices at the network edge?

Anyway, that’s my two cents, along with Kalorama’s predictions. What do you think 2018 will look like for EMR vendors, and why?

AMIA Shares Recommendations On Health IT-Friendly Policymaking

Posted on April 17, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The American Medical Informatics Association has released the findings from a new paper addressing health IT policy, including recommendation on how policymakers can support patient access to health data, interoperability for clinicians and patient care-related research and innovation.

As the group accurately notes, the US healthcare system has transformed itself into a digital industry at astonishing speed, largely during the past five years. Nonetheless, many healthcare organizations haven’t unlocked the value of these new tools, in part because their technical infrastructure is largely a collection of disparate systems which don’t work together well.

The paper, which is published in the Journal of the American Medical Informatics Association, offers several policy recommendations intended to help health IT better support value-based health, care and research. The paper argues that governments should implement specific policy to:

  • Enable patients to have better access to clinical data by standardizing data flow
  • Improve access to patient-generated data compiled by mHealth apps and related technologies
  • Engage patients in research by improving ways to alert clinicians and patients about research opportunities, while seeing to it that researchers manage consent effectively
  • Enable patient participation in and contribution to care delivery and health management by harmonizing standards for various classes of patient-generated data
  • Improve interoperability using APIs, which may demand that policymakers require adherence to chosen data standards
  • Develop and implement a documentation-simplification framework to fuel an overhaul of quality measurement, ensure availability of coded EHRs clinical data and support reimbursement requirements redesign
  • Develop and implement an app-vetting process emphasizing safety and effectiveness, to include creating a knowledgebase of trusted sources, possibly as part of clinical practice improvement under MIPS
  • Create a policy framework for research and innovation, to include policies to aid data access for research conducted by HIPAA-covered entities and increase needed data standardization
  • Foster an ecosystem connecting safe, effective and secure health applications

To meet these goals, AMIA issued a set of “Policy Action Items” which address immediate, near-term and future policy initiatives. They include:

  • Clarifying a patient’s HIPAA “right to access” to include a right to all data maintained by a covered entity’s designated record set;
  • Encourage continued adoption of 2015 Edition Certified Health IT, which will allow standards-based APIs published in the public domain to be composed of standard features which can continue to be deployed by providers; and
  • Make effective Common Rule revisions as finalized in the January 19, 2017 issue of the Federal Register

In looking at this material, I noted with interest AMIA’s thinking on the appropriate premises for current health IT policy. The group offered some worthwhile suggestions on how health IT leaders can leverage health data effectively, such as giving patients easy access to their mHealth data and engaging them in the research process.

Given that they overlap with suggestions I’ve seen elsewhere, we may be getting somewhere as an industry. In fact, it seems to me that we’re approaching industry consensus on some issues which, despite seeming relatively straightforward have been the subject of professional disputes.

As I see it, AMIA stands as good a chance as any other healthcare entity at getting these policies implemented. I look forward to seeing how much progress it makes in drawing attention to these issues.

Will Data Aggregation For Precision Medicine Compromise Patient Privacy?

Posted on April 10, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Like anyone else who follows medical research, I’m fascinated by the progress of precision medicine initiatives. I often find myself explaining to relatives that in the (perhaps far distant) future, their doctor may be able to offer treatments customized specifically for them. The prospect is awe-inspiring even for me, someone who’s been researching and writing about health data for decades.

That being the case, there are problems in bringing so much personal information together into a giant database, suggests Jennifer Kulynych in an article for OUPblog, which is published by Oxford University Press. In particular, bringing together a massive trove of individual medical histories and genomes may have serious privacy implications, she says.

In arguing her point, she makes a sobering observation that rings true for me:

“A growing number of experts, particularly re-identification scientists, believe it simply isn’t possible to de-identify the genomic data and medical information needed for precision medicine. To be useful, such information can’t be modified or stripped of identifiers to the point where there’s no real risk that the data could be linked back to a patient.”

As she points out, norms in the research community make it even more likely that patients could be individually identified. For example, while a doctor might need your permission to test your blood for care, in some states it’s quite legal for a researcher to take possession of blood not needed for that care, she says. Those researchers can then sequence your genome and place that data in a research database, and the patient may never have consented to this, or even know that it happened.

And there are other, perhaps even more troubling ways in which existing laws fail to protect the privacy of patients in researchers’ data stores. For example, current research and medical regs let review boards waive patient consent or even allow researchers to call DNA sequences “de-identified” data. This flies in the face of conventional wisdom that there’s no re-identification risk, she writes.

On top of all of this, the technology already exists to leverage this information for personal identification. For example, genome sequences can potentially be re-identified through comparison to a database of identified genomes. Law enforcement organizations have already used such data to predict key aspects of an individual’s face (such as eye color and race) from genomic data.

Then there’s the issue of what happens with EMR data storage. As the author notes, healthcare organizations are increasingly adding genomic data to their stores, and sharing it widely with individuals on their network. While such practices are largely confined to academic research institutions today, this type of data use is growing, and could also expose patients to involuntary identification.

Not everyone is as concerned as Kulynych about these issues. For example, a group of researchers recently concluded that a single patient anonymization algorithm could offer a “standard” level of privacy protection to patient, even when the organizations involved are sharing clinical data. They argue that larger clinical datasets that use this approach could protect patient privacy without generalizing or suppressing data in a manner that would undermine its usefulness.

But if nothing else, it’s hard to argue Kulynych’s central concern, that too few rules have been updated to reflect the realities of big genomic and medical data stories. Clearly, state and federal rules  need to address the emerging problems associated with big data and privacy. Otherwise, by the time a major privacy breach occurs, neither patients nor researchers will have any recourse.

Study: “Information Blocking” By Vendors And Providers Persists

Posted on April 6, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A newly-released study suggests that both EHR vendors and providers may still be interfering with the free exchange of patient healthcare data. The researchers concluded that despite the hearty disapproval of both Congress and healthcare providers, the two still consider “information blocking” to be in their financial interest.

To conduct the study, which appears in this month’s issue of The Milbank Quarterly, researchers conducted a national survey between October 2015 and January 2015. Researchers reached out to leaders driving HIE efforts among provider organizations. The study focused on how often information blocking took place, what forms it took and how effective various policy strategies might be at stopping the practice.

It certainly seems that the practice continues to be a major issue of concern to HIE leaders. Eighty-three percent of respondents said they were very familiar with information blocking, while just 12 percent reported having just some familiarity with the practice and 5 percent said they had minimal familiarity. On average, the respondents offered a good cross-industry view, having worked with 18 EHR vendors and with 31 hospitals or health systems on average.

Forms of Blocking:

If the research is accurate, information blocking is a widespread and persistent problem.

When questioned about specific forms of information by EHR vendors, 29 percent of respondents said that vendors often or routinely roll out products with limited interoperability capabilities. Meanwhile, 47 percent said that vendors routinely or often charge high fees for sharing data across HIEs, and 42 percent said that the vendors routinely or often make third-party access to standardized data harder than it needs to be. (For some reason, the study didn’t mention what types of information blocking providers have instituted.)

Frequency of blocking:

It’s hardly surprising that most of the respondents were familiar with information blocking issues, given how often the issue comes up.

In fact, a full fifty percent said that EHR vendors routinely engaged in information blocking, 33 percent said that the vendors blocked information occasionally, with only 17 percent stating that EHR vendors rarely did so.

Interestingly, the HIE managers said that providers were also engaged in information blocking, though fewer did so than among the vendor community. Twenty-five percent reported that providers routinely engage in information blocking, and 34 percent saying that providers did so occasionally. Meanwhile, 41 percent said information blocking by providers was rare.

Motivations for blocking:

Why do HIE participants block the flow of health data? It seems that at present they get something important out of it, and unless somebody stops them it makes sense to continue.

When it came to EHR vendors, the respondents felt that their motivations included a desire to maximize short-term revenue, with 41 percent reporting that this was a routine motivation and 28 percent that it was an occasional motivation. They also felt EHR vendors blocked information to improve the chances that providers would choose their platform over competing products, with 44 percent of respondents saying this was routine and 11 percent that it was occasional.

Meanwhile, they believed that hospitals and health systems, the most common motivation was to improve revenue by strengthening their competitive advantage, with 47 percent seeing this as routine and 30 percent occasional. Also, respondents said providers wanted to accommodate priorities other than data exchange, with 29 percent seeing this as routine and 31 percent occasional.

Solutions:

So what can be done about vendor and provider information blocking? There are a number of ways policymakers can get involved, but few have done so as of yet.

When given a choice of policy-based strategies, 67 percent said that making this practice illegal would be very effective. Meanwhile, respondents said that three strategies would be very or moderately effective. They included prohibiting gag clauses and encouraging public reporting and comparisons of vendors and their products (93 percent); requiring stronger demonstrations of product interoperability (92 percent) and national policies defining policies and standards for core aspects of information exchange.

Meanwhile, when it came to reducing information blocking by providers, respondents recommended that CMS roll out stronger incentives for care coordination and risk-based contracts (97 percent) and public reporting or other efforts shining a spotlight on provider business practices (93 providers).

Healthcare CIOs Focus On Optimizing EMRs

Posted on March 30, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Few technical managers struggle with more competing priorities than healthcare CIOs. But according to a recent survey, they’re pretty clear what they have to accomplish over the next few years, and optimizing EMRs has leapt to the top of the to-do list.

The survey, which was conducted by consulting firm KPMG in collaboration with CHIME, found that 38 percent of CHIME members surveyed saw EMR optimization as their #1 priority for capital investment over the next three years.  To gather results, KPMG surveyed 122 CHIME members about their IT investment plans.

In addition to EMR optimization, top investment priorities identified by the respondents included accountable care/population health technology (21 percent), consumer/clinical and operational analytics (16 percent), virtual/telehealth technology enhancements (13 percent), revenue cycle systems/replacement (7 percent) and ERP systems/replacement (6 percent).

Meanwhile, respondents said that improving business and clinical processes was their biggest challenge, followed by improving operating efficiency and providing business intelligence and analytics.

It looks like at least some of the CIOs might have the money to invest, as well. Thirty-six percent said they expected to see an increase in their operating budget over the next two years, and 18 percent of respondents reported that they expect higher spending over the next 12 months. On the other hand, 63 percent of respondents said that spending was likely to be flat over the next 12 months and 44 percent over the next two years. So we have to assume that they’ll have a harder time meeting their goals.

When it came to infrastructure, about one-quarter of respondents said that their organizations were implementing or investing in cloud computing-related technology, including servers, storage and data centers, while 18 percent were spending on ERP solutions. In addition, 10 percent of respondents planned to implement cloud-based EMRs, 10 percent enterprise systems, and 8 percent disaster recovery.

The respondents cited data loss/privacy, poorly-optimized applications and integration with existing architecture as their biggest challenges and concerns when it came to leveraging the cloud.

What’s interesting about this data is that none of the respondents mentioned improved security as a priority for their organization, despite the many vulnerabilities healthcare organizations have faced in recent times.  Their responses are especially curious given that a survey published only a few months ago put security at the top of CIOs’ list of business goals for near future.

The study, which was sponsored by clinical communications vendor Spok, surveyed more than 100 CIOs who were CHIME members  — in other words, the same population the KPMG research tapped. The survey found that 81 percent of respondents named strengthening data security as their top business goal for the next 18 months.

Of course, people tend to respond to surveys in the manner prescribed by the questions, and the Spok questions were presumably worded differently than the KPMG questions. Nonetheless, it’s surprising to me that data security concerns didn’t emerge in the KPMG research. Bottom line, if CIOs aren’t thinking about security alongside their other priorities, it could be a problem.

Nursing Informatics Pros Seeing Growing Salaries, Opportunities

Posted on March 24, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Here’s something I missed in the explosion of news around HIMSS17. According to a recent study released late last month by the organization, nurse informaticists are largely well-paid and satisfied with their jobs.

According to the American Nurses Association, nurse informaticists have broad responsibilities, including integrating data and supporting provider and patient decision-making. The job description continues evolve with health IT trends, and may vary from one institution to the other,but their work usually involves a mix of nursing science, health records management and information technology solutions.

As the job description has solidified, nursing informatics has begun to become a well-liked specialty. Eighty percent of respondents to the HIMSS study, the 2017 Nursing Informatics Workforce Survey, reported being satisfied or highly satisfied with their careers, HIMSS found. This may be in part due to their pay, with almost half respondents telling researchers that they had a base salary of over $100,000. Not only that, 34 percent said they also got a bonus.

Meanwhile, highly-trained nursing informaticists did better still. Those who had gotten a nursing informatics certification or post-graduate degree took home higher salaries than those who hadn’t. With over half of those who had additional education made more than $100,000 a year, as opposed to 37 percent of those who didn’t, the trade group said.

In addition, nurse informaticists are advancing themselves to a striking degree, with over half of respondents having a post-graduate degree, often in informatics or nursing informatics, HIMSS reported. (Of this group, 57 percent had completed post-graduate degrees, and 29 percent had a master’s degree or PhD in informatics.)

Meanwhile, 41 percent of nurses are involved in a formal informatics program, and almost half had a certification. These efforts seem be paying off, with two-fifths of respondents reporting that they moved into a new position with more responsibility after they got certified.

As nurse informaticists grow, they are accumulating deeper levels of experience.  All told, 31 percent of respondents had more than 10 years of informatics experience, 36 percent had five to 10 years of experience – dwarfing the 24 percent that had just one to four years. One-third of respondents said they’d been in their current position for more than five years, and a majority of respondents reported having seven years plus of related experience.

While these nurses seem like they enjoy their careers, they are still facing some bureaucracy-related problems.  For example, when asked about their concerns, they rated a lack of administrative and staffing resources as the top barrier to their success.

Ongoing shifts in their reporting roles may also be leading to some dissatisfaction. While most respondents told HIMSS that they reported to the information systems or tech department of their organization, a growing number report to administrative or corporate headquarters. (On the other hand, one-third said that their organization has a senior nursing informatics executive or CNIO, which one would hope proves to offer extra support.)

Though the HIMSS summary doesn’t say so explicitly, it seems very likely that demand for nurse informaticists is outstripping supply, given the substantial salaries these experts can command. If your organization needs to recruit such a person, be prepared for some tough competition.

HIMSS17: Health IT Staff, Budgets Growing

Posted on March 1, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study announced last week at the HIMSS17 event concludes that demand for health IT staff continues to grow as employers expand their budgets. Not surprisingly, given this growth, the healthcare employers are having trouble recruiting enough IT staffers to meet their growing needs.

Results from the HIMSS Leadership and Workforce Survey reflect responses from 368 U.S. health IT leaders made between November 2016 and early January 2017. Fifty-six of respondents from vendors and consulting firms were in executive management, as compared with 41% of providers.

The survey concluded that the majority of health IT respondents have positions they’d like to fill, including 61% of health IT vendors/consultants and 43% of providers who responded. Only 32% of vendor/consultant organizations and 38% or providers said they were fully staffed, HIMSS said. We’ve seen this challenge from many of the healthcare IT companies which post their jobs on Healthcare IT Central.

Demand for IT recruits grew last year, as well. Researchers found that 61% of vendors/consultants responding and 42% of providers responding saw IT staffing increases over the past year, and that the majority of respondents in both groups expect to increase their IT staffing levels or at least hold them steady next year.

Of course, someone has to pay for these new team members. HIMSS researchers found that IT budgets were continuing to rise over time. Roughly nine out of ten vendors/consultants and 56% of providers said they expected to see increases in their IT budgets this year.

As often happens, however, vendors and consultants and providers seem to have different HIT priorities. While vendors seem to be addressing new technology issues, providers are still focused on how to manage their existing EMR infrastructure investments, HIMSS said.

That being said, the survey found, health IT stakeholders have many overlapping concerns, including privacy and security, population health, care coordination and improving the culture of care.

One of the key insights from this study – that vendors/consultants and providers have different views on the importance of enhancing existing EMRs – is borne out by another study released at the HIMSS event.

The study, which was backed by voice recognition software vendor Nuance Communications, found that providers are broadly interested in implementing new technologies that enhance their EMR, especially computer-assisted physician documentation, mobility and speech recognition tools.

However, when asked to be specific about which tools interested them, they were less enthusiastic, with 44% showing an interest in mobility tools, 38% computer-assisted physician documentation and 25% speech recognition. Documentation tools that enhanced existing functions were especially popular, with 54% of respondents expecting to see them support a reduction in denied claims, 52% improved performance under bundled payments, 38% reduced readmissions and 38% better physician time management which improves patient flow.

This survey also found that the most popular strategy for enhancing physician satisfaction with health IT tools was providing clinician training and education (chosen by 82%). Since their EMR is probably their biggest IT investment, my guess is that the training will focus there. And that suggests that EMRs are still the center of their universe, doesn’t it?

Patient Misidentification Remains Common

Posted on February 27, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The following information was released several weeks ago, but I just found it and thought readers would still find it relevant. The research, from security researcher Ponemon Institute, concludes that patient misidentification is relatively common and continues to impact patient safety and experience.

Late last year, Ponemon surveyed 503 healthcare professionals from across the US, including nurses, physicians, IT practitioners and leaders in financial operations, on the frequency and root causes of patient misidentification, as well as the consequences.

According to the researchers, 86% of respondents said they’d witnessed or know of medical errors resulting from patient misidentification. And 67% said that when searching for patient information, they find duplicate medical records for that patient almost all of the time. Along the way, about three-quarters of respondents agreed that use of biometrics could reduce patient misidentification and by extension, cut down on medical errors.

The most common root cause of patient misidentification was incorrect identification at registration (chosen by 63%), followed by time pressure when treating patients (60%), insufficient employee/clinician training and awareness (35%), too many duplicate medical records in system (34%), registrar errors (32%), turf wars between departments (29%), inadequate safety procedures (20%), over-reliance on homegrown or obsolete identification systems (15%) and misinformation provided by patient (9%). (The remaining 3% was reported as “other”.)

The key causes of misidentification named in the survey included the inability to find a patient’s chart or medical record (68% of respondents), a search or query which brings up multiple or duplicate medical records for a patient (67%), patient associated with incorrect records due to same names and/or dates of birth (56%), or having the wrong record pulled up for a patient because another record in the registration system or EMR has the same name and/or date of birth (61%).

Not surprisingly, the survey also suggests that widespread patient misidentification can have a serious financial impact. On average, Ponemon says, respondents said that more than one-third of all denied claims resulted directly from an inaccurate patient identification or inaccurate/incomplete information. This costs the average healthcare facility $1.2 million per year, they reported.

Meanwhile, patient identification problems have a negative impact on patient experience, the survey concluded. Sixty-nine percent of respondents told researchers that staff spent up to or more than 30 minutes per shift contacting medical records or HIM departments to get critical patient information.

Not only that, misidentifying patients can have a ripple effect, with missing or incomplete information leading to patient care delays. Thirty-seven percent of respondents said that they spent an hour or more contacting medical records or HIM departments to get critical patient information.

Consumers Fear Theft Of Personal Health Information

Posted on February 15, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Probably fueled by constant news about breaches – duh! – consumers continue to worry that their personal health information isn’t safe, according to a new survey.

As the press release for the 2017 Xerox eHealth Survey notes, last year more than one data breach was reported each day. So it’s little wonder that the survey – which was conducted online by Harris poll in January 2017 among more than 3,000 U.S. adults – found that 44% of Americans are worried about having their PHI stolen.

According to the survey, 76% of respondents believe that it’s more secure to share PHI between providers through a secure electronic channel than to fax paper documents. This belief is certainly a plus for providers. After all, they’re already committed to sharing information as effectively as possible, and it doesn’t hurt to have consumers behind them.

Another positive finding from the study is that Americans also believe better information sharing across providers can help improve patient care. Xerox/Harris found that 87% of respondents believe that wait times to get test results and diagnoses would drop if providers securely shared and accessed patient information from varied providers. Not only that, 87% of consumers also said that they felt that quality of service would improve if information sharing and coordination among different providers was more common.

Looked at one way, these stats offer providers an opportunity. If you’re already spending tens or hundreds of millions of dollars on interoperability, it doesn’t hurt to let consumers know that you’re doing it. For example, hospitals and medical practices can put signs in their lobby spelling out what they’re doing by way of sharing data and coordinating care, have their doctors discuss what information they’re sharing and hand out sheets telling consumers how they can leverage interoperable data. (Some organizations have already taken some of these steps, but I’d argue that virtually any of them could do more.)

On the other hand, if nearly half of consumers afraid that their PHI is insecure, providers have to do more to reassure them. Though few would understand how your security program works, letting them know how seriously you take the matter is a step forward. Also, it’s good to educate them on what they can do to keep their health information secure, as people tend to be less fearful when they focus on what they can control.

That being said, the truth is that healthcare data security is a mixed bag. According to a study conducted last year by HIMSS, most organizations conduct IT security risk assessments, many IT execs have only occasional interactions with top-level leaders. Also, many are still planning out their medical device security strategy. Worse, provider security spending is often minimal. HIMSS notes that few organizations spend more than 6% of their IT budgets on data security, and 72% have five or fewer employees allocated to security.

Ultimately, it’s great to see that consumers are getting behind the idea of health data interoperability, and see how it will benefit them. But until health organizations do more to protect PHI, they’re at risk of losing that support overnight.

AMIA Asks NIH To Push For Research Data Sharing

Posted on January 23, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

The American Medical Informatics Association has is urging leaders at the NIH to take researchers’ data sharing plans into account when considering grant proposals.

AMIA is responding to an NIH Request for Information (topic: “Strategies for NIH Data Management, Sharing and Citation”) was published in November 2016. In the RFI, it asked for feedback on how digital scientific data generated by NIH-funded research should be managed and disclosed to the public. It also asked for input on how to set standards for citing shared data and software.

In its response, AMIA said that the agency should give researchers “institutional incentives” designed to boost data sharing and strengthen data management. Specifically, the trade group suggested that NIH make data sharing plans a “scoreable” part of grant applications.

“Data sharing has become such an important proximal output of research that we believe the relative value of a proposed project should include consideration of how its data will be shared,” AMIA said in its NIH response. “By using the peer-review process, we will make incremental improvements to interoperability, while identifying approaches to better data sharing practices over time.”

To help the agency implement this change, AMIA recommended that applicants earmark funds for data curation and sharing as part of the grants’ direct costs. Doing so will help assure that data sharing becomes part of research ecosystems.

AMIA also recommends that NIH offer rewards to scholars who either create or contribute to publicly-available datasets and software. The trade group argues that such incentives would help those who create and analyze data advance their careers. (And this, your editor notes, would help foster a virtuous cycle in which data-oriented scientists are available to foster such efforts.)

Right now, to my knowledge, few big data integration projects include the kind of front-line research data we’re talking about here.  On the other hand, while few community hospitals are likely to benefit from research data in the near term, academic medical organizations are having a bit more luck, and offer us an attractive picture of how things could be.

For example, look at this project at Vanderbilt University Medical Center which collects and manages translational and clinical research data via an interface with its EMR system.

At Vanderbilt, research data collection is integrated with clinical EMR use. Doctors there use a module within the research platform (known as REDCap) to collect data for prospective clinical studies. Once they get their research project approved, clinicians use menus to map health record data fields to REDCap. Then, REDCap automatically retrieves health record data for selected patients.

My feeling is that if NIH starts pushing grantees to share data effectively, we’ll see more projects like REDCap, and in turn, better clinical care supported by such research. It looks to me like everybody wins here. So I hope the NIH takes AMIA’s proposal seriously.