The digital health space refers to the integration of technology and health care services to improve the overall quality of health care delivery. It encompasses a wide range of innovative and emerging technologies such as wearables, telehealth, artificial intelligence, mobile health, and electronic health records (EHRs). The digital health space offers numerous benefits such as improved patient outcomes, increased access to health care, reduced costs, and improved communication and collaboration between patients and health care providers. For example, patients can now monitor their vital signs such as blood pressure and glucose levels from home using wearable devices and share the data with their doctors in real-time. Telehealth technology allows patients to consult with their health care providers remotely without having to travel to the hospital, making health care more accessible, particularly in remote or rural areas. Artificial intelligence can be used to analyze vast amounts of patient data to identify patterns, predict outcomes, and provide personalized treatment recommendations. Overall, the digital health space is rapidly evolving, and the integration of technology in health

Monday, September 23, 2013

FDA Releases Final Guidance for Mobile Health Applications

 

 

Monday, September 23, 2013

TOPIC ALERT:

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On Monday, FDA issued final guidance for mobile health applications, Reuters reports (Clarke, Reuters, 9/23).

Background

In 2011, FDA requested public comment on how it should regulate smartphones, tablet computers and apps that collect health information or are used to monitor medical conditions (iHealthBeat, 6/26).

According to FDA, the agency has approved about 100 mobile medical apps over the last decade, about 40 of which have received clearance over the past two years (Dolan, MobiHealthNews, 9/23).

Details of Final Rule

According to the final rule, FDA will focus oversight on apps that:

  • Were developed to be used as accessories to regulated medical devices, such as apps that allow health care providers to make diagnoses by viewing medical images on smartphones or tablets; or
  • Can transform mobile devices into regulated medical devices, such as apps that allow a smartphone to be used as an electrocardiography machine.

Note:  Information is curated from iHealthBeat, a publication of the California Health  Care Foundation (CHCF

Saturday, September 21, 2013

The Problem with Meaningful Use and the Affordable Care Act and What’s Pushing EMR Switching?

 

Photo John Lynn (EMR and HIPAA

curated from EMR and HIPAA

Most of us in health care knew that the enactment of the affordable care act was not conceived with the correct goals in mind.

The concept and goal of universal care for all Americans was emphasized at the expense of usability, adoption and ‘buy in ‘ by the health industry.  The health industry was searching for a streamlining and more efficient manner of accessing health care as well as making it more affordable. and uniform.

It has become apparent and more publicly recognized as deadlines fast approach for mandates, insurance exchanges, and expansion to the uninsured.

Are the wheels coming off ? Yes !  Will the Affordable Care Act stand….maybe…but certainly not as it is written.  It has caused a congressional crisis as the Republicans stand fast against President Obama and the Democrats with their wishful thinking and ignoring our debt crisis.

HIT implementation has been accelerated, however at the expense of purchasing unusable and immature EMR programs.

John Lynn of EMR and HIPAA offers the analysis and possible outcomes.

EMR and HIPAA report on ‘switching’.

Hospital Acquisition

EMR User Dissatisfaction

Not Meaningful Use Ready  EMR Switching Encouraged by Meaningful Use

Of course, EMR switching can be a real challenge and every EMR switch is unique. You have to consider what you want to do with your old data. Do you have a way to transfer it to the new EMR? Can you get the EMR data out of the old system? Do you want to transfer all or part of the data? Do you not want to transfer the data to the new EMR, but you still want to keep the old EMR around to access the previous EMR data?

And as time continues the formula for incentives significantly reduces the amount you will receive.  Changing EMRs will again reduce efficiency and increase your costs.  IS IT WORTH IT ?  Doubtful !

Many of the answers to these questions are heavily influenced by your original EMR contract. Sadly, many organizations did a poor job evaluating their EMR contract before they signed it. This can often lead to the old EHR vendor holding the EHR data hostage. It’s not pretty, but there are sometimes workarounds. Just be sure that you don’t make the same mistake with your new EHR vendor.

Tuesday, September 3, 2013

The Biopsy

 

From  The Biopsy, a Video

The Iconic Health Company as envisioned by FLO, a mobile EMR developed by a first year medical student gives hope to we aged MDs Nothing like fresh blood....they are our hope for the future.

Roheet Kakaday is a shining beacon, as he leads the way to a new concept in EMR, medical record flow and real meaningful use, not the stale unimaginative creation of HHS and CMS.

Not much is right in HIT and EMR despite proclamations of success by HHS and CMS. Despite accolades by data collection agencies, HHS, CMS and government agencies EMR by and large has made the clinical practice of medicine a nightmare, significantly reducing efficiency and patient face-to-face interaction leaving most patients dumfounded when their MD only glances at them during and examination...Many comment about MDs ,now treating the medical record, coming up for air only occasionally.

Yes there is more legible medical record available to consultants and doctors who see the patient after a primary encounter. Eric Topol MD explains this vividly in The Creative Destruction of Medicine..

Read what Roheet has to say about FLO;

“During medical school, we’re supposed to train on how to use hospital’s Epic EMR system. 

I took the training module for it and the moment it loaded, I was bewildered. My monitor had turned into a wormhole and was suddenly displaying software built in the 1990s. I stared for 30 minutes at what was basically a wall of text, trying to find my way around small buttons and clogged sub-screens. I hadn’t even learned how to use Epic yet and I was already frustrated. Perhaps it’s because Epic was a platform built upon billing practices that made it so confusing. Either way, I was done before I had even begun.

I’ve always been a fan of intuitive minimalist design. Everything in its place and a place for everything. I used my experience with that training module to inspire a better design that I think would help make medical work flows a bit easier.

Thus, I rapid prototyped Flo - a gesture-based patient-centric mobile EMR (mEMR) - to satisfy my needs. Flo tries to use our mobile screen space in creative ways instead of sticking to grids, tables, and a plethora of buttons like we’re used to in medicine. Information is displayed on a patient-by-patient basis, thus placing importance on the patient at hand. Swipe, rotate, or tap to get to the information you need. Simple.

This isn’t a robust or complete EMR, as there are a lot of assumptions functioning underneath this model, but, if we could get something like this, I would be so happy.

Let me know what you think.”

Monday, August 26, 2013

HIPAA Challenges

 

Oh for the day when medical records were on paper. In the blink of an eye, now millions of electronic medical records can be ‘carried off"’ to anywhere. This has become apparent in recent and repetitive reports of privacy and confidentiality breakdowns. Advocate Health reports the second biggest HIPAA breach ever.  Advocate Health System announced that the theft occurred at one of its Advocate Medical Group administrative building in Park Ridge, Ill. on July 15.

In the second biggest HIPAA breach ever reported, one of the nation's largest healthcare systems is notifying more than four million patients that their protected health information and Social Security numbers have been compromised after the theft of four unencrypted company computers.

Patient names, addresses, dates of birth, Social Security numbers and clinical information – including physician, medical diagnoses, medical record numbers and health insurance data — were all contained on the computers, officials say. 

This is the second big HIPAA breach for Advocate Health System. In 2009, company officials notified 812 patients that their protected health information had been compromised following the theft of an employee's unencrypted laptop.

This breach stands as the second biggest HIPAA breach ever reported, according to HHS data – just behind the TRICARE Management Activity breach which impacted more than 4.9 million patients back in 2011. 

Texas HIPAA blunder affects 277K

This time it was not an electronic medium that was breached. Texas Health Harris Methodist Fort Worth is notifying some 277,000 patients that their protected health information has been compromised after several hospital microfilms, which were supposed to be destroyed, were found in various public locations.

Texas Health Fort Worth had contracted with Toronto-based Shred-it to destroy the confidential patient information, but the microfilms were not actually destroyed, as had been agreed upon in the contract, officials say. Instead, a local resident found a portion of the microfiche in a nearby park in May. Additionally, three other sheets of microfiche were found in two other public areas.

The records on the microfiche contained patient names, addresses, dates of birth, medical record numbers, clinical information, health insurance information and in some cases Social Security numbers

These breaches are only two of many inadvertent breakdowns in health information security.

In 2011 a TRICARE Management Activity breach impacted more than 4.9 million patients back in 2011, in which a Lost Military Backup Tapes Results in HIPAA Violation Affecting 4.9 Million. TRICARE, the Defense Department’s healthcare program, reported what may be the largest health information breach documented in HIPAA history since the HITECH Act was established in 2009. Nearly 4.9 million patients of San Antonio area military hospitals and clinics have been affected by the loss of data backup tapes. These tapes contained an archive of sensitive information dating from Sept. 7, 2011, back to 1992.

Vernon Guidry, a spokesman for Science Applications International (SAIC), the organization that reported the breach, has confirmed that it was “not an electronic breach” but “a loss of magnetic storage media.”

The Federal Office of Civil Rights administers HIPAA, and reports its findings here:

The breaches result in fines and penalties as well as civil damages for civil rights violations.

Apparently the federal government has interdepartmental conflict over legalities of sharing protected information.

As yet no one has addressed this issue with the Affordable Care Act in which it is proposed that the IRS administer and enforce the Individual and Employer Mandates .

 

HIPAA/HITECH Act Enforcement: 2003-2013

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