Electronic health records are still waiting to be transformed

In 2018, a Stanford Medicine/Harris Poll found that nearly half of U.S. primary care physicians said that electronic health records actually detract from their effectiveness as clinicians, and 44% said they believed that the primary value of these systems is data storage. Far from being a transformative health care tool to support clinical decision-making, a large portion of physicians feel they have traded physical filing cabinets for digital ones.

Electronic health records still have the potential to make health care more predictive, preventive, and precise — but only if we can achieve sustained collaboration among health care providers, technology companies, and health insurers to address their shortcomings. One step in that direction took place on Stanford’s campus last June, where we convened leaders in patient care, technology, design thinking, and policy to discuss a path forward for electronic health records. In principle, the group agreed on three points:

1. First, electronic health record systems must become interoperable.
2. Electronic health records must be redesigned to better respond to physicians’ needs. 
3. Building a more clinically relevant electronic health record system should incorporate artificial intelligence that can synthesize anonymized patient records; combine them with the medical literature; and provide insights at the point of care. 

The full STAT article can be viewed at this link.  

The Case for a Hippocratic Oath for Connected Medical Devices: Viewpoint

Prior to graduating from medical school, soon-to-be physicians take the Hippocratic Oath, a symbolic declaration to provide care in the best interest of patients. As the medical community increasingly deploys connected devices to deliver patient care, a critical question emerges: should the manufacturers and adopters of these connected technologies be governed by the symbolic spirit of the Hippocratic Oath? In 2016, I Am The Cavalry, a grassroots initiative from the cybersecurity research community, published the first Hippocratic Oath for Connected Medical Devices (HOCMD). Over the past three years, the HOCMD has gained broad support and influenced regulatory policy. We introduce five case studies of the HOCMD in practice, leading to a safer and more effective adoption of connected medical technologies.

The full article can be downloaded below.  

Better Diabetes Care: Healthcare Startups Say They’ll Get Paid When Patients Get Better

Value-based care is in the air, but the majority of doctors aren’t necessarily ready to be paid on commission. Thirty-one percent of doctors surveyed by Deloitte last year reported being paid through a value-based model, the same as in 2016; more doctors reported salary or traditional fees for services as payment sources. Two companies—Aledade, another Venrock investment by Kocher, and Goldman Sachs-backed Privia Health—aim to help independent doctors implement the technology tools they need to track their patients’ outcomes and negotiate value-based payment contracts with insurers. Privia says it helped save $117 million in healthcare costs in 2017. Americans spent $3.5 trillion on healthcare that year, but it’s a start.  

The full Forbes article can be viewed at this link.  

More Telehealth Benefits Coming To Medicare Advantage Plans In 2020

Access to telehealth services for seniors got another boost Friday when the Centers for Medicare & Medicaid Services said it would allow private Medicare Advantage plans to offer additional access to virtual doctors in their basic benefit packages.

The so-called final rule will bring new benefits to seniors in 2020 as part of their Medicare Advantage plans. Such coverage is growing rapidly and expected to account for half of Medicare beneficiaries in the coming years, some analysts say.

The full Forbes article can be viewed at this link.  

Take Your Medicine: This $1.5 Billion Health Startup’s Smart Pills Keep Patients From Forgetting

Proteus Digital Health, a Redwood City, California-based tech health startup, hopes to create that loop. Founded in 2004 by Andrew Thompson and Dr. George Savage, the company makes a 1 millimeter sensor—“the size of a poppy seed or grain of sand,” says Thompson—that is embedded in medications, which are then swallowed. The sensor, made of “elements found in a typical diet,” including magnesium and copper, says Thompson, will turn on when it contacts a patient’s stomach acid. It then sends a signal a the palm-size patch that patients wear on their skin. The patch, which also tracks physiological signs like steps, rest and heart rate, then sends information to a smartphone app for patients and the desktop browser portal that doctors use.

The full Forbes article can be viewed at this link.  

Modeling lottery incentives for daily adherence

Many health issues require adherence to recommended daily activities, such as taking medication to manage a chronic condition, walking a certain distance to promote weight loss, or measuring weights to assess fluid balance in heart failure. The cost of nonadherence can be high, with respect to both individual health outcomes and the healthcare system. Incentivizing adherence to daily activities can promote better health in patients and populations and potentially provide long-term cost savings. Multiple incentive structures are possible. We focus here on a daily lottery incentive in which payment occurs when both the participant's lottery number matches the number drawn and the participant adheres to the targeted daily behavior. Our objective is to model the lottery's effect on participants' probability to complete the targeted task, particularly over the short term. We combine two procedures for analyzing such binary time series: a parameter-driven regression model with an autocorrelated latent process and a comparative interrupted time series. We use the output of the regression model as the control generator for the comparative time series in order to create a quasi-experimental design.

The full article can be downloaded below.  

BCBSA Data Analytics Reveal Shifts in Behavioral, Mental Health

The nation’s behavioral and mental health patterns are changing rapidly as patients and providers change their responses to issues such as depression, ADHD, and pain management, reveals large-scale data analytics from the Blue Cross Blue Shield Association (BCBSA).

In a series of data briefs building off the 25th annual Health of America Report, BCBSA explored critical population health trends such as opioid prescribing rates, the treatment of major depression, and the management of attention disorders in pediatric patients.

The full Health IT Analytics article can be viewed at this link.  

What the future of cloud computing holds for health insurance companies

With the increasing importance of analytics and data management, a cloud-first mentality is ideally suited for health insurers, who are using the technology to streamline operations, reduce costs, and better interact with their customers.

At the same time, the move toward value-based care means claims-based data and analytics can provide a comprehensive view of an insurer’s transactions by aggregating claims across healthcare plans.

The full Healthcare IT News article can be viewed at this link.  

Cleveland Clinic ready to push AI concepts to clinical practice

The Cleveland Clinic’s Center for Clinical Artificial Intelligence (CCAI) will not feature robots greeting visitors at the door, says its new director, but it will leverage new technology to improve diagnosis, prognosis and treatment planning. 

The center is meant to be an international “hub of collaboration,” bringing together experts from pathology, radiology, oncology, information technology, computer science and genetics and providing programmatic and technology support for initiatives in augmented intelligence (AI), often called “artificial intelligence.” 

“We’re not in it because AI is cool, but because we believe it can advance medical research and collaboration between medicine and industry—with a focus on the patient,” said Aziz Nazha, MD, an AMA member and an assistant professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. 

The full American Medical Association (AMA) article can be viewed at this link.  

Health care's huge cybersecurity problem

The health care industry increasingly relies on technology that’s connected to the internet: from patient records and lab results to radiology equipment and hospital elevators. That’s good for patient care, because it facilitates data integration, patient engagement, and clinical support. On the other hand, those technologies are often vulnerable to cyberattacks, which can siphon off patient data, hijack drug infusion devices to mine cryptocurrency, or shut down an entire hospital until a ransom is paid.

“If systems are disrupted over the internet, by an adversary or an accident, that can have a profound impact on patient care,” says Beau Woods, a cybersecurity advocate and cybersafety innovation fellow with the Atlantic Council.

The full article from The Verge can be viewed at this link.