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We’re Talking #HIMSS18 – #HITsm Chat Topic

Posted on February 20, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 2/23 at Noon ET (9 AM PT). This week’s chat will be hosted by the #HIMSS18 Social Media Ambassadors. Appropriately so, we’ll be talking about the upcoming HIMSS 2018 annual conference.

While HIMSS18 is an exciting chance to bring the various communities within health IT together in one place, the sheer volume of conference offerings, social media activity, and attendees can quickly make the experience exhausting. Social media, if navigated thoughtfully, can make this experience even more enriching – whether you are joining your colleagues in Las Vegas or following along from home.

That’s why the #HITsm and #HIMSS18 Twitter communities will be coming together to discuss:

  • Market and technology trends to be on the lookout for via social media and from the conference itself
  • Tips & best practices to effectively manage your (social media) conference experience
  • Networking opportunities and how to best connect with colleagues onsite and via social media

The HIMSS Social Media Ambassadors will be in attendance for this chat to help share some of their social media savvy and conference expertise to guide you in your planning. The topics we will cover include:

T1: What #HIMSS18 conversations would signal positive trajectory for IT closing gaps in health(care) disparities? #HITsm

T2: With so much happening at #HIMSS18, what tips do you have to stay on top of relevant conversations and announcements to come out of the conference? #HITsm

T3: What emerging technologies (some of which will highlighted at #HIMSS18) give you hope for making positive change in health and care delivery? #HITsm

T4: If you were to launch a social media campaign at HIMSS18 to unearth challenges or highlight successes for health IT, what would it be and why? #HITsm

T5: What are the biggest pitfalls #HIMSS18 exhibitors succumb to when driving booth engagement? What advice do you have for them? #HITsm

T6: Who are you looking to meet at #HIMSS18 or connect with via social media and why? #HITsm

What other planning tips or questions do you have? Share them and connect with others using the #HITsm + #HIMSS18 hashtags on Twitter.

Upcoming #HITsm Chat Schedule
3/2 – Machine Learning and AI in Healthcare
Hosted by Corinne Stroum (@healthcora)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Practical Health IT Innovation Conference

Posted on February 15, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

For those regular readers, you’ve probably been seeing some of the promotion we’ve been doing for a new healthcare IT conference called Health IT Expo. Yes, this is our first time hosting a healthcare IT Conference of our own, but we are in our 5th year organizing the Healthcare IT Marketing and PR Conference. While we attend and enjoy attending ~30 healthcare IT conferences per year, we think there’s something missing in these conferences that we can address at Health IT Expo.

Hundreds of people over the years have suggested that we should host our own healthcare IT conference. I’d always resisted doing so because I didn’t want to just create another me too conference. In many ways, it felt like there were enough conferences. However, having attended hundreds of conference over the years, I realized that something really big was missing at these conferences: practical innovation.

Most healthcare IT conferences are short on practical innovation and long on useless platitudes.

Last month I wrote that Health IT Expo was the Anti Moonshot Conference. Not that there’s anything wrong with people working on moonshot ideas. That’s a lot of fun and really exciting. However, if you’re a healthcare IT professional that’s overwhelmed by operational minutiea, listening to moonshot ideas ends up leaving you empty and longing for practical innovations that can improve your work life.

Long story short, we’ll be focusing the conference on the following 5 areas of healthcare IT innovation to start:

  • Security and Privacy
  • Analytics
  • Communication and Patient Engagement
  • IT Dev Ops
  • Operational Alignment and Support

We want to take everything we’ve learned attending conferences and organizing one for 5 years and make Health IT Expo a one of a kind experience for those working in these 5 areas.

As part of this conference, we also want to extend the innovation that’s shared over the 2 day event well beyond the conference. One of the other major challenges in healthcare IT is that innovations aren’t shared between organizations. Unlike healthcare data, we don’t mind sharing innovations in healthcare IT. However, there hasn’t been a great platform for this sharing.

For example, how does an IT professional at a hospital share a unique way they implemented 1000 new virtual desktops and saved their organization time and money? The sad answer is they don’t. How does a healthcare IT professional learn about a new company that can solve their physician communication problems? In many cases they don’t.

One of our goals is to use Healthcare Scene and this new conference to create a platform for innovation sharing. As a simple example, we’re finalizing resource pages around each of the 5 topics listed above. These pages will list companies that are innovating in each spaceso they’re easy to find. I’ve been blogging for 12 years and published over 12,000 blog posts and even I was surprised by some of the companies we found. We’ll do a future post linking to those pages once they’re published.

At the end of the day, we have one major goal. How can we make healthcare IT professionals lives better so we improve healthcare?

If that goal interests you, take a minute to check out Health IT Expo. If you’re a healthcare IT professional that wants to be part of this community, reach out to us on our contact us page. Share your experience with us and we’ll give you a special discount code to attend the conference where it doesn’t break your budget.

How Connected is Your Healthcare? – #HITsm Chat Topic

Posted on February 13, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 2/16 at Noon ET (9 AM PT). This week’s chat will be hosted by Dr. Robert Wah (@RobertWahMD) from @DXCTechnology on the topic of “How Connected is Your Healthcare?.”

Healthcare providers are tapping into new tech solutions to connect patients, processes and data for better results. How is technology enabling a movement toward patient-center care?

Join us for this week’s #HITsm chat where we talk about connected health and where we still need work. We’ll look at disruptive innovations that are going to change everything and practical innovations that are going to have a huge impact on healthcare. Often it’s surprising how big a difference the small, creative changes can have on healthcare.

Topics for This Week’s #HITsm Chat:
T1: What does #ConnectedHealth mean to you? #HITsm

T2: What do you think is the biggest benefit of disruptive technology in the healthcare space? #HITsm

T3: What technology will have the biggest impact on #healthcare? #HITsm

T4: What are the redundant, repetitive administrative tasks you would automate? #HITsm

T5: How secure is your digital ecosystem of communications and connections? #HITsm

Bonus: What is your digital transformation goal for 2018? #HITsm

Upcoming #HITsm Chat Schedule
2/23 – #HIMSS18
Hosted by #HIMSS18 Social Media Ambassadors

3/2 – Machine Learning and AI in Healthcare
Hosted by Corinne Stroum (@healthcora)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

Radiology Centers Poised To Adopt Machine Learning

Posted on February 8, 2018 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.

As with most other sectors of the healthcare industry, it seems likely that radiology will be transformed by the application of AI technologies. Of course, given the euphoric buzz around AI it’s hard to separate talk from concrete results. Also, it’s not clear who’s going to pay for AI adoption in radiology and where it is best used. But clearly, AI use in healthcare isn’t going away.

This notion is underscored by a new study by Reaction Data suggesting that both technology vendors and radiology leaders believe that widespread use of AI in radiology is imminent. The researchers argue that radiology AI applications are a “have to have” rather than a novel experiment, though survey respondents seem a little less enthusiastic.

The study, which included 133 respondents, focused on the use of machine learning in radiology. Researchers connected with a variety of relevant professionals, including directors of radiology, radiologists, techs, chiefs of radiology and PACS administrators.

It’s worth noting that the survey population was a bit lopsided. For example, 45% of respondents were PACS admins, while the rest of the respondent types represented less than 10%. Also, 90% of respondents were affiliated with hospital radiology centers. Still, the results offer an interesting picture of how participants in the radiology business are looking at machine learning.

When asked how important machine learning was for the future of radiology, one-quarter of respondents said that it was extremely important, and another 59% said it was very or somewhat important. When the data was sorted by job titles, it showed that roughly 90% of imaging directors said that machine learning would prove very important to radiology, followed by just over 75% of radiology chiefs. Radiology managers both came in at around 60%. Clearly, the majority of radiology leaders surveyed see a future here.

About 90% of radiology chiefs were extremely familiar with machine learning, and 75% of techs. A bit counterintuitively, less than 10% of PACS administrators reported being that familiar with this technology, though this does follow from the previous results indicating that only half were enthused about machine learning’s importance. Meanwhile, 75% of techs in roughly 60% of radiologists were extremely familiar with machine learning.

All of this is fine, but adoption is where the rubber meets the road. Reaction Data found that 15% of respondents said they’d been using machine learning for a while and 8% said they’d just gotten started.

Many more centers were preparing to jump in. Twelve percent reported that they were planning on adopting machine learning within the next 12 months, 26% of respondents said they were 1 to 2 years away from adoption and another 24% said they were 3+ years out.  Just 16% said they don’t think they’ll ever use machine learning in their radiology center.

For those who do plan to implement machine learning, top uses include analyzing lung imaging (66%), chest x-rays (62%), breast imaging (62%), bone imaging (41%) and cardiovascular imaging (38%). Meanwhile, among those who are actually using machine learning in radiology, breast imaging is by far the most common use, with 75% of respondents saying they used it in this case.

Clearly, applying the use of machine learning or other AI technologies will be tricky in any sector of medicine. However, if the survey results are any indication, the bulk of radiology centers are prepared to give it a shot.

The Role of HealthIT in Driving Payer-Provider-Employer Collaboration – #HITsm Chat Topic

Posted on February 7, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 2/9 at Noon ET (9 AM PT). This week’s chat will be hosted by Heather Lavoie (@HSLavoie) from @Geneia on the topic of “The Role of HealthIT in Driving Payer-Provider-Employer Collaboration.”

2018 is shaping up to be another year of healthcare change, disruption and consolidation. In the past three months alone, more than $140 billion in healthcare deals have been announced, most notably the CVS Aetna merger. The news Amazon, Berkshire Hathaway and JP Morgan are collaborating to simplify employee healthcare dominated industry headlines and moved the market.

In the years since ACA was enacted, there has been increasing action towards payer provider convergence. ACOs and value-based care models continue to gain traction. The early success stories showing improved costs, quality and outcomes are characterized by greater alignment and collaboration among payers and providers. More recently, employers and employer coalitions are joining these efforts to work together with their payer and provider partners to reverse decades of increasing costs and declining employee health.

Reference Materials:

Join us for a robust discussion on the critical role of healthIT in successful payer-provider-employer collaboration and convergence.

Topics for This Week’s #HITsm Chat:
T1: We’ve all seen the big announcements around collaboration and convergence such as @Aetna, @CVSHealth and @Amazon. What do you think this means for the future of healthcare? #HITsm

T2: To what degree is #healthIT an enabler and/or a barrier to the kind of collaboration envisioned by the architects of the Aetna-CVS deal? #HITsm

T3: There is increasing talk about payer provider collaboration. How do you see employers joining these efforts? #HITsm

T4: What needs to happen from a #healthIT perspective to simplify payer-provider-employer collaboration? #HITsm

T5: Who should be the driver of #healthIT efforts to connect payers, providers and employers? What role might the consumer/patient have in driving payer-provider-employer collaboration? #HITsm

Bonus: What’s the role of advanced #analytics is making payer-provider-employer collaboration easier? #HITsm

Upcoming #HITsm Chat Schedule
2/16 – How Connected is Your Healthcare?
Hosted by Dr. Robert Wah (@RobertWahMD) from @DXCTechnology

2/23 – #HIMSS18
Hosted by #HIMSS18 Social Media Ambassadors

3/2 – Machine Learning and AI in Healthcare
Hosted by Corinne Stroum (@healthcora)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

5 Ways Your Certified EHR Can Help Boost Your MIPS Score

Posted on February 5, 2018 I Written By

The following is a guest blog post by Lisa Eramo, a regular contributor to Kareo’s Go Practice Blog.

How did you do in the first year of reporting under the Quality Payment Program? Are you expecting a negative payment adjustment under the Merit-based Incentive Payment System (MIPS)? Or did you only submit the minimum data necessary in 2017 to avoid this adjustment? The good news is that you can get on track to report critical MIPS measures in 2018 that will safeguard and perhaps even enhance your revenue in 2020 and beyond.

In fact, your electronic health record (EHR) technology may already include various features that can help increase your MIPS score, says Marina Verdara, senior training specialist at Kareo. All you need to do is take advantage of them. Verdara discusses five ways in which medical practices should be able to capitalize on their EHR to improve performance under MIPS.

  1. Use an EHR Certified With the 2015 Criteria

Technology certified using the 2015 criteria supports interoperability across the care continuum, and it also enables physicians to earn additional revenue under MIPS, says Verdara. According to the Medicare Access and CHIP Reauthorization Act final rule, physicians earn a one-time bonus of 10 percentage points under the advancing care information (ACI) performance category of MIPS when they report objectives and measures using only 2015 edition certified electronic health record technology during calendar year 2018. In 2018, 25% of a physician’s MIPS score is tied to ACI.

“The federal rule indicates the clinician will earn a 10% bonus to their ACI score if they report using only a 2015 CEHRT, but they will determine this based on the measures submitted,” Verdara explains. “Therefore, a clinician can switch anytime during 2018 as long as they can report at least 90 days for the ACI category.”

In addition to this bonus, clinicians are eligible to receive a bonus of 10 percentage points applied to the ACI category if they report Stage 3 objectives and measures, says Verdara. They can do this if their certified EMR can document and track these measures. Refer to Table 7 in the MACRA final rule for more information about these measures.

  1. Choose Applicable Quality Measures

In 2018, 50% of your MIPS score is based on the quality measures you submit. Your 2015 Certified EHR should support your quality measure selection. “For instance, our physicians have an easy-to-use tool within our EHR that prompts them to narrow down measures that are most applicable for their specialty,” says Verdara. Customers can contact them directly for more information about each measure, its specifications, and what CMS is looking for when calculating numerators and denominators.

When using your EHR to choose measures, Verdara suggests running a report for all of the quality measures your vendor supports, including those you may not plan to submit for attestation. That’s because the data could reveal one or more measures you hadn’t anticipated as advantageous for your practice that could ultimately boost your score, she adds.

Examine the entire report, and identify your top 10 measures (i.e., those on which you’ve performed most effectively). Now dig into the data. Are each of these measures applicable for your specialty? If so, focus on data capture for those 10 measures. If some of your top 10 measures are in other specialties, eliminate those from your workflow and choose ones that are relevant. “Make sure you understand how to document and improve the score for that measure,” says Verdara.

Ultimately, submit all 10 measures to CMS even though only six are required, says Verdara. During the submission process, the CMS attestation website automatically scores each measure based on available benchmarks, and physicians have an opportunity to remove the measures on which they’ve performed most poorly prior to final submission.

  1. Don’t Overlook Reporting Opportunities

Your EHR should be looking out for reporting opportunities so that you can focus on patient care. Verdara provides the example of smoking cessation counseling. Physicians commonly perform this type of counseling but may not receive credit under MIPS because they don’t check the box indicating the work was done. “We have built-in guides to help physicians understand why they might be missing out on a particular quality metric,” says Verdara, adding that physicians should be able to look to their EHR to prompt and guide them to understand where missed opportunities may lie.

  1. Use Clinical Decision Support to Enhance MIPS Performance

Your EHR should also provide prompts to remind physicians about age- and condition-specific preventive screenings and care that, when provided to patients, can help improve MIPS scores. Physicians using Kareo, for example, can improve performance on MIPS measures related to influenza and age-specific immunizations as well as screening for clinical depression, high blood pressure, and more, all of which directly translate to higher scores, says Verdara. “It helps the physician provide better care,” she adds. “It’s a win-win for the clinician and the patient.”

  1. Run Clinical Reports to Pinpoint Opportunities for Care Improvement

MIPS reports not only allow for attestation, but they also help practices understand what they do well—and what needs improvement, says Verdara. For example, practices tracking patients whose hemoglobin A1C is greater than 9% during the performance period can use this report for MIPS attestation and to improve outcomes. More specifically, they can reach out to patients with a poor A1C to provide additional counseling and guidance. “This is a good one to track because diabetes is an epidemic,” says Verdara. “It helps practices target patients who are non-compliant.” The same is true for measures related to controlling high blood pressure and asthma.

To learn more about MACRA, visit https://qpp.cms.gov/.

About Lisa Eramo
Lisa Eramo is a regular contributor to Kareo’s Go Practice Blog, as well as other healthcare publications, websites and blogs, including the AHIMA Journal. Her focus areas are medical coding, clinical documentation improvement and healthcare quality/efficiency.  Kareo is a proud sponsor of Healthcare Scene.

Nearly 6 Million Patient Records Breached In 2017

Posted on February 1, 2018 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.

Just how bad a year was 2017 for health data? According to one study, it was 5.6 million patient records bad.

According to health data security firm Protenus, which partnered with DataBreaches.net to conduct its research, last year saw an average of at least one health data breach per day. The researchers based their analysis on 477 health data breaches reported to the public last year.

While Protenus only had 407 such incidents, those alone affected 5,579,438 patient records. The gross number of exposed records fell dramatically from 2016, which saw 27.3 million records compromised by breaches. However, the large number of records exposed in 2016 stems from the fact that there were a few massive incidents that year.

According to researchers, the largest breach reported in 2017 stemmed from a rogue insider, a hospital employee who inappropriately accessed billing information on 697,800 patients. The rest of the top 10 largest data breaches sprung from insider errors, hacking, and one other incident involving insider wrongdoing.

Insider wrongdoing seems to be a particular problem, accounting for 37% of the total number of breaches last year. These insider incidents affected 30% of compromised patient data, or more than 1.7 million records.

As bad as those stats may be, however, ransomware and malware seem to be even bigger threats. As the study notes, last year a tidal wave of hacking incidents involving malware and ransomware hit healthcare organizations.

Not surprisingly, last year’s wave of attacks seems to be part of a larger trend. According to a Malwarebytes report, ransomware attacks on businesses overall increased 90 percent last year, led by GlobeImposter and WannaCry incidents.

That being said, healthcare appears to be a particularly popular target for cybercriminals. In 2016, healthcare organizations reported 30 incidents of ransomware and malware attacks, and last year, 64 organizations reported attacks of this kind. While the increase in ransomware reports could be due to organizations being more careful about reporting such incidents, researchers warn that the volume of such attacks may be growing.

So what does this suggest about the threat landscape going forward?  In short, it doesn’t seem likely the situation will improve much over the next 12 months. The report suggests that last year’s trend of one breach per day should continue this year. Moreover, we may see a growth in the number of incidents reported to HHS, though again, this could be because the industry is getting better at breach detection.

If nothing else, one might hope that healthcare organizations get better at detecting attacks quickly. Researchers noted that of the 144 healthcare data breaches for which they have data, it took an average of 308 days for the organization to find out about the breach. Surely we can do better than this.

From Makerspaces to Virtual Spaces: How 3D Changes Everything… – #HITsm Chat Topic

Posted on January 30, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 2/2 at Noon ET (9 AM PT). This week’s chat will be hosted by Chuck Webster, MD (@wareFLO) on the topic of “From Makerspaces to Virtual Spaces: How 3D Changes Everything…”

What do makerspaces, 3D-printing, and virtual & augmented reality have in common? Three-dimensional objects! Makerspaces, and their 3D printers, make 3D objects in the real world. Virtual & augmented reality are populated by virtual models of objects from physical real world.

At the recent RSNA meeting in Chicago, the same 3D models, of wounds, tumors, and proposed implants, could be viewed in either virtual or physical reality (via 3D printing). 3D printed models can be designed in virtual reality. Physical objects can be scanned and viewed in virtual reality.

What are the implications of this 3D printing / virtual reality connection? Well, for one thing, you’ll find a lot of virtual reality meetups in makerspaces (as occurs here in Columbus, at The Idea Foundary). Microsoft co-locates a “Mixed Reality” (VR + AR) space in its corporate makerspace.

But here is where I want to drive this. Makerspaces are inherently social, based on communities of peer-to-peer teaching and learning. However virtual reality has a loner stereotype, someone covering their eyes with electronics, and withdrawing from social interaction to explore, alone, fantastical, artificial landscapes.

The exception, in a big, big way, is social virtual reality. I wrote about this recently in my blog post Shared Social Virtual Reality Networking for Health, Healthcare, and Health IT Marketing. I won’t belabor the point here, except to say I am as excited about social virtual reality as a I was, and still am, about Twitter. In some ways, I’m reminded of the Blab and Firetalk group social video platforms (RIP!). A bunch of people, from anywhere in the world, can get together, virtually, to, well, do almost anything. Party in space. Watch movies underwater. Customize their avatars however they wish (yes, it can get freaky!)

If above seems like a bit of mishmash, I admit it does seem that way to me too. However, I didn’t want to call this HITsm tweet chat something like “Stuff @wareFLO Thinks Is Cool at The Moment.” So I thought hard, and came up with some connections!

PS. I’m bring my makerspace and virtual reality gear to HIMSS18! Look me up and check out this video preview!

Now for the topics we’ll be discussing during this week’s #HITsm chat. I hope you’ll join in on the discussion.

Topics for This Week’s #HITsm Chat:
T1: Did you ever make something (perhaps out of readily available household items!) that solved YOUR unique problem. How did you feel? Is there something there, about everyday people making stuff, that healthcare needs? #HITsm

T2: Have you tried out a virtual reality headset yet? Which one? What did you see? What was exciting? What was disappointing? How about augmented reality? (Lots of AR apps now on iOS) Same questions… #HITsm

T3: I’m basically an engineer who happened to go to med school. It’s how I got interested in workflow. But now I’m getting back into “mechatronics” (building robots, for example) I’m happy to share my expertise. Anyone wanna build something together? What? #HITsm

T4: What if all of us, in this Twitter chat, right now, by just pushing a button, could appear to each other, in real time, as holograms (think Star Trek or Star Wars) anywhere in the real or imaginary world, what place & setting would you chose? #HITsm

T5: What questions would you like to get answered about 3D printing and virtual/augmented reality? #HITsm

Bonus: How might 3D printing and virtual (or augmented) reality be used for health IT marketing & PR purposes? #HITsm

Upcoming #HITsm Chat Schedule
2/9 – The Role of HealthIT in Driving Payer Provider Employer Collaboration
Hosted by Heather Lavoie (@HSLavoie) from @Geneia

2/16 – TBD

2/23 – #HIMSS18
Hosted by #HIMSS18 Social Media Ambassadors

3/2 – Machine Learning and AI in Healthcare
Hosted by Corinne Stroum (@healthcora)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.

A Learning EHR for a Learning Healthcare System

Posted on January 24, 2018 I Written By

Andy Oram is an editor at O'Reilly Media, a highly respected book publisher and technology information provider. An employee of the company since 1992, Andy currently specializes in open source, software engineering, and health IT, but his editorial output has ranged from a legal guide covering intellectual property to a graphic novel about teenage hackers. His articles have appeared often on EMR & EHR and other blogs in the health IT space. Andy also writes often for O'Reilly's Radar site (http://oreilly.com/) and other publications on policy issues related to the Internet and on trends affecting technical innovation and its effects on society. Print publications where his work has appeared include The Economist, Communications of the ACM, Copyright World, the Journal of Information Technology & Politics, Vanguardia Dossier, and Internet Law and Business. Conferences where he has presented talks include O'Reilly's Open Source Convention, FISL (Brazil), FOSDEM, and DebConf.

Can the health care system survive the adoption of electronic health records? When the HITECH act mandated the installation of EHRs in 2009, we all hoped they would propel hospitals and clinics into a 21st-century consciousness. Instead, EHRs threaten to destroy those who have adopted them: the doctors whose work environment they degrade and the hospitals that they are pushing into bankruptcy. But the revolution in artificial intelligence that’s injecting new insights into many industries could also create radically different EHRs.

Here I define AI as software that, instead of dictating what a computer system should do, undergoes a process of experimentation and observation that creates a model to control the system, hopefully with far greater sophistication, personalization, and adaptability. Breakthroughs achieved in AI over the past decade now enable things that seemed impossible a bit earlier, such as voice interfaces that can both recognize and produce speech.

AI has famously been used by IBM Watson to make treatment recommendations. Analyses of big data (which may or may not qualify as AI) have saved hospitals large sums of money and even–finally, what we’ve been waiting for!–make patients healthier. But I’m talking in this article about a particular focus: the potential for changing the much-derided EHR. As many observers have pointed out, current EHRs are mostly billion-dollar file cabinets in electronic form. That epithet doesn’t even characterize them well enough–imagine instead a file cabinet that repeatedly screamed at you to check what you’re doing as you thumb through the papers.

How can AI create a new electronic health record? Major vendors have announced virtual assistants (See also John’s recent interview with MEDITECH which mentions their interest in virtual assistants) to make their interfaces more intuitive and responsive, so there is hope that they’re watching other industries and learning from machine learning. I don’t know what the vendors basing these assistants on, but in this article I’ll describe how some vanilla AI techniques could be applied to the EHR.

How a Learning EHR Would Work

An AI-based health record would start with the usual dashboard-like interface. Each record consists of hundreds of discrete pieces of data, such as age, latest blood pressure reading, a diagnosis of chronic heart failure, and even ZIP code and family status–important public health indicators. Each field of data would be called a feature in traditional AI. The goal is to find which combination of features–and their values, such as 75 for age–most accurately predict what a clinician does with the EHR. With each click or character typed, the AI model looks at all the features, discards the bulk of them that are not useful, and uses the rest to present the doctor with fields and information likely to be of value.

The EHR will probably learn that the forms pulled up by a doctor for a heart patient differ from those pulled up for a cancer patient. One case might focus on behavior, another on surgery and medication. Clinicians certainly behave differently in the hospital from how they behave in their home offices, or even how they behave in another hospital across town with different patient demographics. A learning EHR will discover and adapt to these differences, while also capitalizing on the commonalities in the doctor’s behavior across all settings, as well as how other doctors in the practice behave.

Clinicians like to say that every patient is different: well, with AI tracking behavior, the interface can adapt to every patient.

AI can also make use of messy and incomplete data, the well-known weaknesses of health care. But it’s crucial, to maximize predictive accuracy, for the AI system to have access to as many fields as possible. Privacy rules, however, dictate that certain fields be masked and others made fuzzy (for instance, specifying age as a range from 70 to 80 instead of precisely 75). Although AI can still make use of such data, it might be possible to provide more precise values through data sharing agreements strictly stipulating that the data be used only to improve the EHR–not for competitive strategizing, marketing, or other frowned-on exploitation.

A learning EHR would also be integrated with other innovations that increase available data and reduce labor–for instance, devices worn by patients to collect vital signs and exercise habits. This could free up doctors do less time collecting statistics and more time treating the patient.

Potential Impacts of AI-Based Records

What we hope for is interfaces that give the doctor just what she needs, when she needs it. A helpful interface includes autocompletion for data she enters (one feature of a mobile solution called Modernizing Medicine, which I profiled in an earlier article), clear and consistent displays, and prompts that are useful instead of distracting.

Abrupt and arbitrary changes to interfaces can be disorienting and create errors. So perhaps the EHR will keep the same basic interface but use cues such as changes in color or highlighted borders to suggest to the doctor what she should pay attention to. Or it could occasionally display a dialog box asking the clinician whether she would like the EHR to upgrade and streamline its interface based on its knowledge of her behavior. This intervention might be welcome because a learning EHR should be able to drastically reduce the number of alerts that interrupt the doctors’ work.

Doctors’ burdens should be reduced in other ways too. Current blind and dumb EHRs require doctors to enter the same information over and over, and even to resort to the dangerous practice of copy and paste. Naturally, observers who write about this problem take the burden off of the inflexible and poorly designed computer systems, and blame the doctors instead. But doing repetitive work for humans is the original purpose of computers, and what they’re best at doing. Better design will make dual entries (and inconsistent records) a thing of the past.

Liability

Current computer vendors disclaim responsibility for errors, leaving it up the busy doctor to verify that the system carried out the doctor’s intentions accurately. Unfortunately, it will be a long time (if ever) before AI-driven systems are accurate enough to give vendors the confidence to take on risk. However, AI systems have an advantage over conventional ones by assigning a confidence level to each decision they make. Therefore, they could show the doctor how much the system trusts itself, and a high degree of doubt could let the doctor know she should take a closer look.

One of the popular terms that have sprung up over the past decade to describe health care reform is the “learning healthcare system.” A learning system requires learning on every level and at every stage. Because nobody likes the designs of current EHRs, they should be happy to try a new EHR with a design based directly on their behavior.

Patient Portals and Chronic Disease Management – #HITsm Chat Topic

Posted on January 23, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’re excited to share the topic and questions for this week’s #HITsm chat happening Friday, 1/26 at Noon ET (9 AM PT). This week’s chat will be hosted by Monica Stout (@MI_turnaround) from Medicasoft on the topic of “Patient Portals and Chronic Disease Management.”

The Centers for Disease Control and Prevention posted a statistic stating that roughly 117 million people have one or more chronic health conditions. One in four people has two more chronic conditions. That is so many people! It’s 2018 and there are tons of innovative technologies out there. Why aren’t we doing a better job of managing our health conditions?

In a recent blog, I posted that chronic disease management represents one of the best opportunities for a personal health record or patient portal to link wellness and healthcare together to affect positive health outcomes. What changes in healthcare technology need to be made to more effectively treat and manage patients with chronic conditions?

Join us to talk about patient portals and chronic disease management during this week’s #HITsm chat.

Topics for This Week’s #HITsm Chat:
T1: Would you (or do you) use technology to help manage your health and wellness? Why or why not? #HITsm

T2: Effectively managing chronic disease can involve changing habits and forming good habits. What are some ways IT can help patients form and maintain good habits? #HITsm

T3: What’s a feature you wish patient portals had that they currently do not? #HITsm

T4: If patient portals collected data so providers could participate in MACRA/MIPS more seamlessly, would you be more apt to encourage their use in your organization? #HITsm

T5: Does your employer provide you a PHR as an employee benefit? If so, does it motivate you to be an engaged patient? #HITsm

Bonus: What are the benefits of having a complete personal health record that you can access anywhere? #HITsm

Upcoming #HITsm Chat Schedule
2/2 – From Makerspaces to Virtual Spaces: How 3D Changes Everything…
Hosted by Chuck Webster, MD (@wareFLO)

2/9 – The Role of HealthIT in Driving Payer Provider Employer Collaboration
Hosted by Heather Lavoie (@HSLavoie) from @Geneia

2/16 – TBD

2/23 – #HIMSS18
Hosted by #HIMSS18 Social Media Ambassadors

3/2 – Machine Learning and AI in Healthcare
Hosted by Corinne Stroum (@healthcora)

We look forward to learning from the #HITsm community! As always, let us know if you’d like to host a future #HITsm chat or if you know someone you think we should invite to host.

If you’re searching for the latest #HITsm chat, you can always find the latest #HITsm chat and schedule of chats here.