Tuesday, February 6, 2018

Can I use Cloud based solutions and be HIPAA Compliant? - Paubox





That is a good question and also applies to many other cloud based sharing and storage solutions which appear in consumer and enterprise offerings

The answer is not straight forward and requires several caveats to fulfill HIPAA regulations.

The list below provides specifics. When applicable they all require a BAA (Business Associate Agreement) signed by the user and the provider.


The HIPAA industry is vast so we can empathize with just how many people need to use cloud-based services in this sector.
We’ve covered the following cloud solutions and their capabilities for HIPAA compliance:


Can I use Cloud based storage and be HIPAA Compliant? - Paubox

Saturday, February 3, 2018

Dawning of the Age of Aquarius (Artificial Intelligence)

The Age of Aquarius



Anyone who watches television or Netflix sees how artificial intelligence and even quantum mechanics has become a protagonist in fiction stories.  Some of it is close to non-fiction and is based upon real world achievements in this fast moving field.

AI as it is called is already in our lives daily with chat boxes for customer service, home appliances with natural language processing (NLP) and call centers. Many of us spend signifcant waiting times with a 'smart' attendant when we call anyone.  Direct human to human interactions are in decline.

AI is used for diagnosing, image analysis, treatment algorithms, and more.

Algorithms in health care are in common use.

Wednesday, January 24, 2018

CMS to scrap plans for accelerated access to medical Devices

CMS scraps plans to accelerate access to medical devices


The CMS has withdrawn a proposed rule intended to accelerate access to medical devices. Officials put the rule forward to enable earlier Medicare coverage of medical devices, only to withdraw it nine months later.

Details of the plan to create the Expedited Coverage of Innovative Technology (ExCITe) pathway and why it was pulled are sketchy. The fullest publicly available account of what the CMS wanted the rule to achieve comes from the abstract it submitted to the White House unit that helps the president with policy and regulatory objectives.  

“This proposed rule would provide Medicare coverage of certain devices under investigation through a clinical research study and the associated routine care items and services in that research,” the CMS wrote in the abstract for the proposed rule. “The ExCITe pathway would remove the barrier in evidence generation by allowing CMS to provide faster access to new technologies that would have the potential to improve patient health and quality of care.”

From this writer's view, it may be a good thing.  While many medical device manufacturers have rushed to fill the 'hype' . it is largely being promoted by 'startups' and investors.  The devices need to be further vetted to verify their accuracy and worth.  Some have reached the market place and are in use.

The approval process for medical devices and for drugs is a long and expensive process.  Medical devices and pharmaceuticals must be approved first by the FDA. 

The conundrum for CMS is whether they will pay for these services. (devices) 

Details of the plan to create the Expedited Coverage of Innovative Technology (ExCITe) pathway and why it was pulled are sketchy. The fullest publicly available account of what the CMS wanted the rule to achieve comes from the abstract it submitted to the White House unit that helps the president with policy and regulatory objectives.

“This proposed rule would provide Medicare coverage of certain devices under investigation through a clinical research study and the associated routine care items and services in that research,” the CMS wrote in the abstract for the proposed rule. “The ExCITe pathway would remove the barrier in evidence generation by allowing CMS to provide faster access to new technologies that would have the potential to improve patient health and quality of care.”
http://tinyurl.com/yaynrms8

Wednesday, December 27, 2017

Four Ultrasound Trends to Watch in the New Year | Vitor Rocha | Pulse | LinkedIn



Across the health and technology landscape, we are standing at a pivotal moment in time. While clinicians and healthcare systems face challenges related to aging populations, growing caseloads and less time for direct patient care, artificial intelligence and machine and deep learning hold great promise for transforming the way we will deliver care in the future. And, automation, reproducibility, and portability will create expanded ultrasound applications and users. Already we’re seeing ultrasound become ubiquitous across a wide variety of clinical settings for screening, diagnosis, treatment and surgery. The future of ultrasound has never looked more exciting. While most of these are still a few years away, here are four key trends I see already influencing the way we think about developing and using ultrasound in the future.

 Automating how we acquire images
Although improvements to transducers and visual interfaces have enhanced the usability of ultrasound considerably, today it’s still very user-dependent requiring specific skill, knowledge and experience. To produce the best image possible, a clinician must carefully position the transducer in just the right spot, apply and adjust pressure and change the settings, which takes time and practice.
Advances in machine learning will remove some of the dependency of adjusting image acquisition settings and help speed image acquisition. We can expect to see more software that’s trained to identify specific problem areas, which will increase the efficiency of ultrasound exams and allow clinicians to examine many more patients.
Automation also will help us see a lot more images quickly. This will require more sophisticated hardware that can process images faster and software that can identify exactly what the clinician is looking for. Intelligently incorporating anatomically intelligent automation will help the user get the best image possible to gather accurate measurements efficiently.
Even more important than productivity and throughput benefits, I believe a key promise of automated tools is that they could allow clinicians and patients to spend less time conducting and reading the more routine physical exams, freeing up time to focus on the more complicated cases.
Portability breaking down walls
The ability to use ultrasound on-the-go will continue to be a key trend driving healthcare transformation in 2018. We will see even more adoption and implementation of app-based, handheld ultrasounds that don’t compromise image quality. These portable devices can be carried around in a pocket, making them convenient to use in many different settings, including the emergency department, on the sports field, and even for military medicine. It’s truly ultrasound without boundaries.
This change to smaller and more mobile applications is what I like to call “the form factor.” It’s smaller form factors that will help increase ultrasound use among clinicians who do not typically use it as a form of diagnosis. Increasing the mobility of ultrasound opens new doors to provide care beyond the hospital walls. 
A complementary tool for surgery and other imaging modalities
Ultrasound is transforming the way we guide structural heart surgeries. In the past, patients had to go through open heart surgery to get a valve replaced. With the rise of ultrasound use in the catheterization lab, more valve replacements and repairs can be done with minimally invasive surgery, using ultrasound to guide a catheter from the femoral artery up to the heart valve. This is much more cost-effective and helps reduce patient recovery time.
We are now seeing this expand beyond cardiology as ultrasound is used as a guiding tool for liver or breast ablations, as well as for biopsies. These advancements can significantly impact the patient experience. In prostate cancer, for example, ultrasound-guided biopsies provide more certainty to target the right tissue, so the patient only has to undergo three to four biopsies, instead of 18 or more, which was typical in the past. The integration of AI has to the potential to improve techniques even further.
There is tremendous potential to continue adapting the approach to interventions with AI guided procedures, enhancing the patient experience.
Wider adoption around the globe
A particularly exciting trend is that as ultrasound becomes smaller and more intelligent, it also becomes that much more accessible. These advances make it possible for a wide variety of providers who may not traditionally have used ultrasound to have the power of ultrasound at their fingertips, including nurses, midwives, emergency medicine and critical care professionals. In remote areas where healthcare resources are limited, the use of portable ultrasound can make a tremendous impact on both routine and critical care.
Ultrasound is also becoming a powerful standalone tool for prevention. As it becomes more accessible and easy to use, clinicians are adopting ultrasound more widely to screen for things like breast cancer, vascular disease and thyroid disease. In the future, it could also be used to assess stroke risk by imaging carotid plaque.
Overall, I believe these trends in ultrasound will help improve efficiency, bring down costs, and more importantly, give clinicians more time to focus on challenging cases, provide direct patient care and improve the patient experience. But it’s important to remember that even the most exciting advances take time to be evaluated and adopted effectively to preserve clinical confidence. While technological innovations like artificial intelligence and machine learning hold great promise, image quality will always be the foundation of ultrasound. How does that sound?


Four Ultrasound Trends to Watch in the New Year | Vitor Rocha | Pulse | LinkedIn