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    Chicago-based Rush Health will adopt the InterSystems HealthShare interoperability platform for collaborative care coordination – a platform that will make it possible for the health system to roll out a private health information exchange.

    The HIE will provide the hospital, physicians and affiliate members a complete view of their patient records across the care continuum from within their electronic health record,

    The technology connects primary, specialty, sub-acute and hospital-based providers, as well as other HIEs regardless of the EHR system.

    HealthShare will serve as the health system’s health information hub, making it possible for all stakeholders to use their own EHR systems to exchange information and get the most complete medical picture for each patient.

    Rush Health includes four hospitals, more than 1,100 physician members and 350 non-physician network clinicians. HealthShare will give providers complete visibility into all of their patients’ medications, tests and procedures, which will help reduce unnecessary prescriptions and treatments and deliver better care.

    “Implementation of our HIE is critical to Rush Health’s transition to value-based care, Rush Health CEO Brent Estes said in a statement. “It will serve as the hub for all care coordination activities, triggered by real-time monitoring of quality, resource use and cost. It will fill in any gaps in our members’ EHRs.”

    , Rush Health’s clinical leaders cited HealthShare’s proven ability to access all data –  not just HL7 information – with an integrated analytics toolset that enables actionable insights at the point of care.

    HealthShare also features an alert and notification system capabilities for clinical events across Rush’s integrated network, as well as an integrated enterprise master patient index to ensure consistent identification of patients across external and internal medical record systems.

    As Rush Health executives see it, simply exchanging healthcare records is not enough to impact the quality or cost of care delivery. Clinicians need to access all the patient data to fully understand what is happening with a patient and drive clinical actions at the point of care.

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    Augmedix, which has harnessed Google Glass technology to develop tools to improve physician workflow and productivity, has secured a $23 million round of funding from new investors McKesson Ventures, OrbiMed and others.

    The main Augmedix product is remote scribe technology, enabled by Google Glass, that aims to help physicians manage the voluminous charting and documentation required, ideally freeing them to see more patients, with a better patient relationship.

    Augmedix has landed more than $60 million in VC funds since its founding in 2012. In addition to McKesson Ventures and OrbiMed, this funding round included its existing institutional investors, Redmile Group, Emergence Capital and DCM Ventures.

    [Also: McKesson launches venture capital fund]

    Several of its health system customers – including Catholic Health Initiatives, Dignity Health, Sutter Health and TriHealth – are also investors in Augmedix.

    "Augmedix has brought together an impressive coalition of the nation's leading health systems as its customers, and their physicians and health system executives have a strong passion for Augmedix," said Steven Yecies, Venture Partner at OrbiMed. "Across the country, Augmedix has delivered consistent and considerable improvements to physician productivity and satisfaction for the health systems they serve."

    Using Augmedix together with Google Glass, docs are able to access patients' medical history and document the patient visit without having to interact with a computer: The chart note is created in real-time by remote scribes based in secure, HIPAA-compliant facilities.

    Physicians can then review the note and a summary of the visit can be provided to the patient with care instructions.

    [Also: Sutter, Dignity Health, others give Google Glass startup Augmedix $17 million in funding]

    Augmedix says it has pioneered the largest remote scribe service in the world, building out a secure enterprise platform that's been deployed at some of the biggest health systems in the U.S. The scribe service complements other services aimed at helping with staffing, quality assurance, network and technical support, analytics and business process improvement.

    "Augmedix is uniquely able to improve doctors' quality of life by allowing them to concentrate on their patients rather than on data entry," said Tom Rodgers, managing director of McKesson Ventures. "This makes their technology invaluable for settings like our U.S. Oncology clinics. We are excited to bring McKesson's experience and ubiquitous market presence to help them scale to doctors across the country in the coming few years."

    Twitter: @MikeMiliardHITN
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    The National Institutes of Health challenged the biotechnology community on Thursday to design a wearable device able to measure blood alcohol content in real-time for its National Institute on Alcohol Abuse and Alcoholism.

    Challenge winners will receive $200,000 to create a device able to measure the concentration of alcohol in the blood or interstitial fluid surrounding the body’s cells, for a more accurate reading. Current systems detect alcohol through sweat or vapor. Those who place second will receive $100,000.

    The challenge is designed to help researchers collect more accurate data to better understand alcohol use disorder and conditions affected by alcohol use, officials said. The ideal device could also be used by consumers who wish to track their drinking habits.

    "I expect tangible breakthroughs in real-time alcohol-sensing technology through this competition," NIAAA Director George F. Koob, said in a statement. "Creative solutions could include the adaptation and miniaturization of technologies such as spectroscopy or wave technology or other designs."

    "We’ve learned that there is real interest in the private sector around wearable alcohol biosensors, and that innovation using distinct means of alcohol detection are on the horizon," NIAAA’s Division of Metabolism and Health Effects Director Kathy Jung, said in a statement.

    Competition submissions will be accepted until May 15, 2017 and judging will take place from May 16 to July 26, 2017, with winner announced in August 2017.

    Also announced on Thursday, NIH will offer a grant of about $1 million in two phases for researchers who can determine a way to use EHR and other data for alcohol treatment.

    Projects should focus on major data collection able to integrate into clinical records and data warehouses, among other electronic resources, officials said. The project will address questions on improving clinical care for alcohol use disorder patients and understanding existing barriers to the use of EHR data in treating alcohol abuse.

    Applicants can submit their projects beginning May 16, 2017.

    "Electronic health records are increasingly being utilized to support major research initiatives, as they bring opportunities to access diagnostic, treatment and outcome data of vast numbers of patients," according to the announcement.

    "Alcohol and other substance use disorder treatment lags far behind the rest of healthcare in the deployment of electronic health records," it continued. "This funding opportunity announcement is intended to provide a mechanism to stimulate such research."

    Twitter: @JessieFDavis
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    Mobile EHR vendor dchrono launched a device that lets patients check themselves in at physicians’ offices. With the device, called Kiosk, providers can equip their front office with an iPad stand that patients can use to check in, verify insurance information, and sign any necessary consent forms without needing a staff member to manage the process.

    The vendor also announced patient education functionality for the Apple iPad, enabling providers to share materials with patients. This feature enables providers to upload and share patient education information on any iOS device or the web.

    In addition, drchrono said it is a new Apple mobility partner, allowing it to broaden access to medical records through its native iOS app, which it optimized for iPhone, iPad and Apple Watch and supports the latest features of iOS and watchOS. 

      The Healthcare IT News Cloud Computing Forum is slated for HIMSS17. Register here.

    With drchrono’s platform, doctors can now provide healthcare on demand to patients as long as they have an iOS device with an internet connection. They can electronically order labs or imaging and receive the results and prescribe controlled substances for their patients anytime, anywhere on their mobile devices.

    “With drchrono EHR, our providers can take care of their patients in the home environment with access to their charts and ability to order lab or imaging tests directly from an iPad without being tied to an office location,” Renee Dua, Founder and Chief Medical Officer at Heal, said in a statement.

    The mobile EHR solution will also save providers time on administrative work,” said Michael Nusimow, CEO and co-founder of drchrono.

    “From the moment a doctor wakes up, seeing patients at the office, doing house calls, or at night after driving home, he will have access to his patients’ data and ability to provide care at a moment's notice,” Nusimow said in a statement. 

    Helpful advice on planning your purchase of cloud computing services. 

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    A former CIO gets a close up look from the assessment side

    I recently participated as the CIO reviewer on a HIMSS Analytics Stage 7 validation. The long travel to the West Coast aside, I was happy to contribute my time and expertise to be exposed to an advanced organization and to meet a wonderful group of leaders. The review team also included a chief medical information officer and the HIMSS Analytics regional director for North America.

    As of the 3rd quarter this year, only 4.6 percent of hospitals have achieved Stage 7 while 30.5 percent have achieved Stage 6. Just over a third of hospitals are currently at Stage 5.

    All three hospitals I’ve served as CIO have achieved Stage 6. Getting from Stage 6 to 7 is a significant leap. There is a greater focus on analytics and using the data from the electronic health record to improve patient outcomes.

    From the HIMSS Analytics website, here is how Stage 7 is described:

    The hospital no longer uses paper charts to deliver and manage patient care and has a mixture of discrete data, document images, and medical images within its EMR environment. Data warehousing is being used to analyze patterns of clinical data to improve quality of care, patient safety, and care delivery efficiency. Clinical information can be readily shared via standardized electronic transactions (i.e., CCD) with all entities that are authorized to treat the patient, or a health information exchange (i.e., other non-associated hospitals, ambulatory clinics, sub-acute environments, employers, payers and patients in a data sharing environment). The hospital demonstrates summary data continuity for all hospital services (e.g., inpatient, outpatient, ED, and with any owned or managed ambulatory clinics). Blood products and human milk are included in the closed-loop medication administration process.

    The orientation session on validation day was attended by a broad range of IT, operational and clinical leadership. That alone demonstrates the importance of achieving Stage 7 – it is not about IT. It is about the entire organization and how they deliver care.

    This first session includes an overview of the organization, systems, governance, interoperability, disaster recovery, and analytics. Several case studies are presented. The review team gets a good sense of the organization – what they’ve accomplished with their electronic health record and how they’ve done it.

    The overview session is followed by tours and interviews of key areas: several nursing units, emergency department, NICU, pharmacy, radiology, blood bank, and health information management. There are key indicators of system use and being paperless that we look for in all areas. In the NICU, we look at how breast milk is being managed using bar codes. In the blood bank, we look at how blood products are managed and tracked using bar codes. These latter two are key components of Stage 7 that many Stage 6 organizations still need to implement.

    As we tour, we are able to get a sense of the organization overall. On our visit, it was obvious that collaboration and transparency were a strong part of this organization’s culture. Many health care best practices were evident aside from the technology. My “aha moment” was realizing the strong correlation between an organization’s focus on operational excellence with their advanced use of technology. Clearly, you can’t have one without the other.

    When HIMSS Analytics first rolled out the EMR Adoption Model (EMRAM) concept and framework, I was the CIO at Brigham and Women’s Hospital in Boston. We thought we were pretty advanced. We had implemented computerized physician order entry (CPOE as it was called then) in the early 1990’s and the electronic medication administration record (EMAR) in 2005. Yet the EMRAM framework ordered key systems and applications into stages in such a way that Brigham was not as high on the model as we expected. It seemed somewhat arbitrary at the time and I remember debating with them using Brigham as the example.

    Since that time, HIMSS Analytics has evolved the acute care EMRAM model and has developed a parallel model for ambulatory. Over time I have come to respect HIMSS Analytics for pursuing the EMRAM framework and setting the bar high for our industry. Health care provider organizations aspire to reach Stage 6 and 7 and learn from one another on their journeys. And our patients benefit – with advanced use of technology, organizations all over the country are demonstrating improved patient outcomes, patient safety and operational efficiencies.

    And that’s a win for all of us.

    This post was first published onSue Schade's Health IT Connect blog.

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    The CommonWell Health Alliance and Carequality announced December 13 they will be collaborating on efforts to boost data sharing among healthcare providers nationwide, committing to work together on advancing interoperability.

    The goal is to increase health IT connectivity and offer more inormation sharing options for hospitals and physician practices, officials said.

    To understand the collaboration, it helps to think of CommonWell as a network – much like a telephone service provider, and to think of CareQuality, which works under the Sequoia Project, as providing the framework – the rules of the road. Both are critical for data sharing.

    The goal of the collaboration is to give providers easier access to more health information, when a healthcare provider is making a diagnostic or treatment decision, for example, and needs access to key medical information.

    Here are the main elements of the collaboration, outlined by Carequality and Commonwell executives:

    • CommonWell will become a Carequality implementer on behalf of its members and their clients, enabling CommonWell subscribers to engage in health information exchange through directed queries with any Carequality participant.
    • Carequality will work with CommonWell to make a Carequality-compliant version of the CommonWell record locator service available to any provider organization participating in Carequality.
    • CommonWell and The Sequoia Project, the non-profit parent under which Carequality operates, have agreed to these initial connectivity efforts and will explore additional collaboration opportunities in the future.
    • The agreement between CommonWell and Carequality resulted from yearlong discussions between the two entities on how to improve connectivity, data sharing and collaboration, Yeager said.

    "There was always collaborative dialogue in terms of how we wanted this work to come together," Mariann Yaeger, who heads the Sequoia Project, the parent of Carequality, told Healthcare IT News.

    "But, the efforts were really in formative stages early on, and it grew to a point where once there was traction, momentum that it was time to figure out how to get these activities interconnected,"  she added.

    [Also: Carequality says athenahealth, eClinicalWorks, Epic, NextGen, Surescripts now exchanging data via Interoperability Framework]

    "To achieve nationwide interoperability that truly improves patient care, two things are required:  collaboration across the healthcare industry and the will to take real action," said Jitin Asnaani, executive director of CommonWell Health Alliance.

    "Our vision has always been for a patient's health data to follow him/her regardless of where care occurs, and in turn give providers and caregivers increased access to critical health data when and where it is needed," he said.

    Dave Cassel, director of Carequality, agreed. "Collaboration and inclusion are the keys to success in health data sharing and interoperability," he said. "Collaboration and inclusion are the keys to success in health data sharing and interoperability."

    "We are glad to see so many organizations joining the Carequality community and participating in standards-based interoperability at a national scale," Epic President Carl Dvorak said in a written response to Healthcare IT News' request for a comment on the Care Quality-CommonWell collaboration.

    On its website, Carequality has posted detailed answers to anticipated questions, definitions of terms and details about collaboration and membership.

    Read the FAQs and responses here.

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    After more than two years in the making, President Barack Obama signed the 21st Century Cures Act into law on December 13.

    The bill passed with overwhelming approval in both the House and Senate. The bi-partisan legislation provides $6.3 billion to electronic health records, precision medicine, mental health and interoperability.

    "It's so nice to see both parties coming together for a common cause," President Obama said. "I think it indicates the power of this issue and how deeply it touches every family across America.

    "Today with the Cures Act, we are making good on those (technology) efforts," he added. "We're bringing to reality some new breakthroughs to tackle some of the greater health challenges of our time."

    [Also: 21st Century Cures Act brings provisions for EHRs, interoperability, precision medicine and more]

    The bill includes $1 billion in state grants over the next two years to combat the opioid abuse and addiction epidemic. It also contains $4.8 billion to advance Obama's Precision Medicine Initiative, Obama's BRAIN Initiative and the Cancer Moonshot spearheaded by Vice President Joe Biden.

    "This is a consequential piece of legislation," said Biden. "Without true bipartisan support, this legislation would have never occurred. The 21st Century Cures Act is going to harness the best minds, science and technology to tackle some of the biggest healthcare challenges today.

    "God willing, this bill will literally save lives," he continued. "It gives millions of Americans hope; this is going to accelerate the kinds of efforts, right now, to extend life."

    The bill also contains provisions to push federal agencies and the healthcare industry to use EHR systems and collect data for both research and treatment.

    However, the law has raised concerns in the healthcare industry – with some criticizing cuts in funding from the Prevention and Public Health Fund, Medicaid and Medicare, deregulation of the FDA's approval process and a lack of provisions to combat rising drug prices.

    Despite this, however, the president and other federal officials are steadfast in the positive impacts the bill will have on healthcare innovation.

    "The law has provisions that will improve HHS ability to promote interoperability, combat data blocking and foster transparency in the marketplace," said National Coordinator for Health IT Vindell Washington, MD, at the HIMSS Connected Health Conference in National Harbor, Maryland on December 13. "It doesn't have all the funding currently needed, but the infrastructure is set up for us to be successful."

    "These efforts build upon the work we have done to improve healthcare over the last eight years. I'm hopeful in the years ahead Congress will keep working together to help us move forward and not backward on improving healthcare for millions of Americans," Obama said. "It's good day to see us doing our jobs."

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    Healthcare IT News EHR Satisfaction Survey 2016
    ⇒ Comparison chart: How readers rated their EHR in 2016 vs. 2015
    ⇒ EHRs getting better? Readers rank them higher than last year in new survey
    Health IT executives have a new favorite dirty word 
    EHR interoperability: Ripe for disruption?

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    Patients are unhappy there is no central location for their health records, and they are also frustrated at trying to access and share them, according to a new survey from health information network Surescripts.

    The 2016 Connected Care and the Patient Experience survey also revealed that patients expect to see digital  care settings in the near future through the use of telehealth and other technologies.

    “Despite major medical and technological advancements in our country, and the fact that patients are more active consumers of care, healthcare is still inefficient, complex and unsatisfying for them,” Surescripts CEO Tom Skelton said.

    The Surescripts survey, which polled more than 1,000 AMerians, also found that 94 percent of patients surveyed want their health data to be stored electronically in a single location because doing so would not only save doctors time but also make it less likely they would the wrong medication.

    Surescripts also determined that patients are increasingly dissatisfied with the amount of time and effort they’re spending on recounting medical information and waiting in doctors’ offices or pharmacies. Patients are typically spending an average of 8 minutes telling their doctor their medical history (up from 6 minutes in 2015) and 8 minutes filling out paperwork at a typical doctor visit (up from 6 minutes in 2015). Eighty percent of patients indicated they should only have to complete this paperwork the first time they visit a new provider.

    These repeat scenarios often stem from a lack of patient data access and information exchange between providers, according to Surescripts findings.

    The survey also showed patients are playing a more active role in their care plans and, in fact, 58 percent of patients have tried to compile their own complete medical history — a task that is both tedious and often inaccurate or incomplete.

    Twitter: @Bernie_HITN
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    Healthcare IT News EHR Satisfaction Survey 2016
    ⇒ Comparison chart: How readers rated their EHR in 2016 vs. 2015
    ⇒ EHRs getting better? Readers rank them higher than last year in new survey
    Health IT executives have a new favorite dirty word 
    EHR interoperability: Ripe for disruption?

    Like Healthcare IT News on Facebook and LinkedIn

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    Vindell Washington, MD, is aiming to do as much as he possibly can as National Coordinator to advance interoperability and eradicate EHR data blocking before the new Presidential administration steps in.

    Washington, the top official at the Office of the National Coordinator for Health IT, spoke at the Connected Health Conference in the morning and then in the afternoon held a session to show off a demonstration of the FHIR (Fast Healthcare Interoperability Resources) protocol in action.

    During his keynote speech, Washington highlighted how much ONC has accomplished during the Obama administration, citing the near-universal implementation of electronic health records.

    But he also cautioned those present not to get complacent as that administration enters its final days.

    “Rarely in our history has this much changed so quickly,” he said. “It’s great now that EHRs are the normal course of business, but let’s go beyond the normal course of business. If there’s one thing I want you to remember, it’s that our mission, today, tomorrow, and into the future, is to unlock health data and to put it to use for the benefit of patients and their families.”

    To that end, in his afternoon session with Epic, Allscripts, and Cerner, startups Medisafe, RxRevu, and CareEvolution all showed off their own FHIR-based apps that pulled data from EHRs to deliver an updating, de-duplicated medication list to a patient. The demonstrations were the culmination of a project begun at the HIMSS Annual Conference in February.

    “At the HIMSS conference, [HHS Secretary Sylvia Burwell] brought together many of the partners you’ll see on the stage and they made this pledge, or this voluntary agreement to share information,” Washington said. “There were a lot of stakeholder groups including provider organizations that they would engage in this. And one of the key aspects of this was the patient would be empowered to take that information and send it where it was needed for care for their own use. … The concept is you empower patients to get an interoperable list of their medications across a number of different sites where that information might be held. We felt that was one of the better focus areas that would allow us to address a missing piece in the process.”

    Medisafe, RxRevu and CareEvolution each demonstrated their apps with the same fictional patient, "Mary", an elderly woman taking a number of medications and supplements. Different platforms allowed her to not just access an updated, de-duplicated medication list, but to pull it into the company’s own apps and share it with a family member or incorporate it into an adherence platform.

    “The one specific thing I want to underscore is the idea that Mary has a choice in this activity,” Washington said. “We are trying to facilitate a world and a platform on which others can build and in which innovation can occur.”

    Washington told MobiHealthNews after the show that he believes the apps demonstrated are very close to being out in the world — a requirement of the demo was that it involve real technology and real connections to the EHRs.

    “I think the real value proposition comes when we can propagate this in a relatively large swath,” he said. “Part of that is having the real data, something that will push and prick the demand.” 


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    Gearing up for HIMSS17, the Healthcare Information and Management Systems Society revealed 20 Social Media Ambassadors.

    The SMAs are handpicked to contribute to a dialogue about the conference, key trends and topics, including but by no means limited to closing disparity gaps in care delivery. 

    They are chosen for both social media prowess and for having unique insights about health IT, care delivery and the enormous potential within today’s overarching trends. 

    "We are going to focus on two main things this year: alignment and impact," said Michael Gaspar, social media program manager at HIMSS Media. "This will come in the form a mission statement that can drive all of us to stay focused throughout this year’s campaign." 

    Here’s the HIMSS17 roster: 

    Andrew DeLaO: @CancerGeek
    Bill Bunting: @WTBunting
    Charles Webster: @wareflo
    Colin Hung: @Colin_Hung
    Danielle Siarri: @innonurse
    Drex Deford: @drexdeford
    Geeta Nayyar: @gnayyar
    Jane Sarasohn-Kahn: @healthythinker
    Janice McCallum: @janicemccallum
    John Lynn: @techguy
    Linda Stotsky: @EMRAnswers
    Lygeia Ricciardi: @lygeia
    Mandi Bishop: @MandiBPro
    Matthew Fisher: @Matt_R_Fisher
    Max Stroud: @MMaxwellStroud
    Nick Van Terheyden: @drnic1
    Rasu Shrestha: @RasuShrestha
    Shahid Shah: @ShahidNShah
    Tamara StClaire: @drstclaire
    Vanessa Carter: @_FaceSA 

    The lineup draws from innovators, executives, policy wonks, nurses, futurists and other health IT professionals. 

    "These Ambassadors all have an abundance of energy to offer the health IT social community," Gaspar said. "Their passions, expertise and social media savvy will provide a sense of discipline to help observers understand pervasive challenges the industry faces, and meet that adversity with inspiration and ideas to tackle them." 

    SMAs have already started the conversation using the hashtag #HIMSS17. HIMSS is hosting the #AIM2Innovate Twitter chat on Thursday, Dec. 15, 2017, at 3 PM EST. And the HIMSS17 discourse will continue on Twitter long after the conference as it has in year’s past. 

    Subscribe to the official HIMSS17 Social Media Ambassadors Twitter list. 

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    This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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    The 'No More Ransom' campaign, established by Intel Security, Kaspersky Lab, Europol and the Dutch National police in July, expanded again with the addition of 34 new partners and 32 new decryptors, Europol announced Thursday.

    Security companies Emsisoft, Check Point, Trend Micro and Bitdefender are now associate partners of the project, which means the companies directly contribute to the development of decryption keys and tools.

    Emsisoft discovered the decryptor for the Stampado ransomware strain, soon after it was released on the black market. Trend Micro released decryptors for some strains of the TeslaCrypt, CryptXXX, AutoLocky, SNSLocker and Chimera ransomware families.

    These companies have helped to add the 32 new decryption tools.

    As of December 15, more than 6,000 users have been able to decrypt their files without paying the ransom, using the decryption tools from the 'No More Ransom' site.

    eu-LISA (the European Agency for the operational management of large-scale IT systems in the area of freedom, security and justice) and the national police from: Austria, Croatia, Denmark, Finland, Malta, Romania, Singapore and Slovenia have joined the cause as supporting partners.

    There are now 22 countries involved with the cause.

    Also joining the project as supporting partners are: ESET; Heimdal Security; Computer Emergency Response Team for the EU institutions, agencies and bodies; Irish Reporting and Information Security Service; and the Computer Incident Response Center Luxembourg, among others.

    "Both the private sector and law enforcement are stepping up efforts to fight these cybercriminals who are using ransomware to deprive their victims of large amounts of money," Europol officials said in a statement. "However, awareness remains key to preventing ransomware from being successful."

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    Technology-enabled patient safety efforts have helped save 125,000 lives and almost $28 billion.

    A new report compiled by the Agency for Healthcare Research and Quality shows that a steep drop in hospital-acquired conditions has accompanied a decrease of 3 million adverse events in the past five years.

    The U.S. Department of Health and Human Services says a sustained focus on patient safety, enabled in large part by the Affordable Care Act, has saved as many as 125,000 lives and more than $28 billion – the result of continuing decrease in hospital-acquired conditions from 2010 through 2015.  

    That 21 percent drop is thanks in part to care coordination and patient safety efforts enabled by health information technology.

    "The Affordable Care Act gave us tools to build a better health care system that protects patients, improves quality, and makes the most of our health care dollars and those tools are generating results," HHS Secretary Sylvia Burwell said in a statement.

    Hospital-acquired conditions include adverse drug events, catheter-associated urinary tract infections, central line associated bloodstream infections, pressure ulcers and surgical site infections and others. While these conditions occur frequently, they're largely preventable.

    [Also: Electronic health records trim odds of hospital-acquired infections, other adverse events, AHRQ says]

    Much of the evidence on how to prevent hospital-acquired conditions was developed and tested by AHRQ, such as its Comprehensive Unit-based Safety Program – a proven method that combines improvement in safety culture, teamwork and communications with evidence-based practices to prevent harm and enable safer care.

    "AHRQ has been building a foundation of patient safety research for the last decade and a half at the request of Congress," said AHRQ director Andy Bindman, MD, in a statement. "Now we’re seeing these investments continue to pay off in terms of lives saved, harm avoided, and safer care delivery overall. We’re gratified by the progress, and we look forward to building on this work to help make patient care even safer as the work continues."

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    Almost every healthcare CFO signed off on a big check to implement electronic health records software in the past six years. Not because they knew it would bring the same financial return as a shiny new MRI machine or building to house a slick surgery center, but instead because the federal government said they must.

    athenahealth chief medical officer Todd Rothenhaus, MD, made that assertion in a pre-HIMSS17 interview.

    “Our big moonshot work here in 2017 is getting back to a true ROI,” Rothenhaus said. “We’re working to get past the idea that an EHR is a necessary expense. Instead it’s a tool for automation.”

    Rothenhaus added that one part of the company’s move into the post-EHR era will include an “ROI guarantee” along the lines of the offer it laid out ahead of the ICD-10 conversion deadline. And while Rothenhaus did not reveal the exact percentages of the ROI guarantee, CEO Jonathan Bush at that time threw down the coding gauntlet: “We’ll get you to ICD-10 or you don’t have to pay for it.” 

    [Also: Post-EHR era: Empty buzzword or here before long? CIOs weigh in]

    In addition to the ROI guarantee, Rothenhaus said athenahealth is working to leverage its technologies to create cloud services that link patients to tests and treatments, find gaps in care, and facilitate claims -based analysis layered with clinical data.

    “We’re now integrating that with our athenaClinicals EHR service – that’s the future,” Rothenhaus added. And while the company spent it’s first years thinking about what Rothenhaus called “the box that was a medical group or hospital, now it’s about the network.”

    That network includes athenahealth clients, accountable care organizations, integrated delivery networks, and to a certain extent doctors using other EHR platforms operating as part of a care team for patients also seeing other physicians who are using athenahealth services.

    Rothenhaus added that in those instances the care teams can even be practicing coordinated care without realizing that they are all looking at the same patient information.

    “The patient,” he said, “is a network.” 

    HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

    This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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    The National Governors Association Center for Best Practices Health Division published a roadmap to help states boost information flow between providers.

    Titled “Getting the Right Information to the Right Health Care Providers at the Right Time: A Road Map for States to Improve Health Information Flow Between Providers,” the roadmap is meant to help improve the exchange of critical health data.

    The association worked with state officials, interoperability experts, including the Office of the National Coordinator for Health Information Technology, to create the roadmap.

    Road map authors pointed out that the country has experienced significant advancements in medical diagnostics and treatments for complex health problems in recent years. Healthcare, however, still lags other sectors of the economy in the exchange of information to improve efficiency.

    The new roadmap offers states strategies to address legal barriers, such as restrictive laws, misinterpretation and fear of liability: aligning state privacy laws with HIPAA, build standardized consent forms, create meaningful economic interests that incentivize health information exchange, set a vision and then hold people accountable to it.  

    National Governors Association said the overarching goal of the roadmap is to “activate governors and their senior state leaders to drive forward policies that support the seamless flow of clinical patient healthcare information between providers while protecting patient privacy, as a step toward nationwide interoperability.”

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    Develop a disaster recovery plan that enables clinicians to provide patient care without disruption. Providing advanced recovery services, co-location and managed recovery-as-a-service are critical to supporting clinicians’ access to patient information 24/7.


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    Steve Lieber, president and chief executive of HIMSS since 2000, announced his plan to retire today. Lieber broke the news to the HIMSS staff in a morning conference call, saying that he expected to stay through the end of 2017.

    During Lieber’s tenure, HIMSS has grown steadily with more than 65,000 professionals now enrolled as members of the association. The organization has also grown in influence, affecting policy in healthcare and information technology, and helping to shape services available to improve care delivery.

    Lieber, 63, assumed his position in April 2000 as president and chief executive officer of HIMSS. He is a familiar figure to members and attendees at the annual conference. Among his many memorable appearances at HIMSS have been on-stage interviews with former Presidents Bill Clinton and George W. Bush as part of the annual conference keynote sessions.

    Under Lieber’s leadership, HIMSS has become a global operation with educational events taking place around the world including Turkey, Spain, Singapore and Sydney. Lieber also led the acquisition of MedTech Media, publisher of Healthcare IT News, which now operates as the HIMSS Media business unit within HIMSS.

    HIMSS has started a search for his successor. The process is scheduled for completion by the summer. Lieber told the HIMSS staff that he expects to serve alongside the new president and CEO to ensure a smooth transition.

    “The past 17 years at HIMSS have been the most exciting and rewarding time of my professional life,” Lieber said in a prepared statement. “I feel that our work at HIMSS has resulted in considerable improvements to the quality of care delivered to patients, to the safety of the treatments they receive and to the value of care provided. I hope that, in some way, I can continue this work of making care better and safer through information technology.”

    “HIMSS has seen tremendous growth in size, reach and influence during Steve’s leadership,” said Sebastian Krolop, HIMSS Board of Directors Chair and VP and Partner at Philips Healthcare in Berlin, Germany. “Steve has provided the right balance of strategic and operational leadership necessary for HIMSS to transform from a small, US-only based professional society to a large, globally focused diversified organization.”

    Lieber serves on the Board of Directors of HIMSS and its related corporations. He was one of the founders of the Certification Commission for HIT and the Health Information Technology Standards Panel, two U.S. federally funded initiatives at the foundation of the U.S. interoperability effort. 

    HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

    This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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    Many larger health systems are embracing the vast new promise of precision medicine, and many of them are learning from each other as they go. At HIMSS17, John Deeken, MD, of Fairfax, Virginia-based Inova Health System will offer some lessons learned for providers looking to put technology to work for genomics-based care.

    Deeken, chief operating officer of Inova's Translational Medicine Institute, said his organization has made some very encouraging strides in recent years with pharmacogenomics and personalized medicine.

    But in his HIMSS17 talk, "Building an Integrated Precision Medicine Infrastructure," which he'll present alongside Inova's technology partner, Translational Software, he'll also offer tips for clearing some of the hurdles along this new clinical path – namely, how best to integrate genetic and genomic data into workflows, ensuring its in the optimal format to help clinicians make informed decisions at the point of care.

    "It's a challenge across the board for health systems to do this, and for their EMRs to do this," said Deeken. "From a technology standpoint, it's one of the key challenges moving forward."

    The promise of genomic testing is no secret. But the reality of using IT to capture, interpret and put that data to use is another matter. Thankfully, Inova has been able to best some of the tricky technical and infrastructure pitfalls on the way toward a substantial genomic testing program that's enabling tailored treatment protocols.

    [Also: EHRs and health IT infrastructure not ready for precision medicine]

    "As a health system, we've committed to precision medicine and personalized care as one of our main strategic goals," said Deeken. "One of our main initiatives is that, through our Translational Medicine Institute, we've developed a CLIA-certified genomic testing laboratory. In that lab we've set up standard-of-care genomic tests but also, more broadly, useful tests in different clinical settings."

    For example, he explained, "if people are going into surgery, if pediatric patients are going into cancer therapy, if people are in need of help with psychiatric medications, we've developed genomic testing platforms – and, in partnership with Translational Software, have developed the reporting capability – to make it as user friendly to the physicians and the patients as possible."

    That's no small feat, said Deeken: "A big challenge in the precision medicine field is physician education and physician utilization: What we needed to do is make the report and the results as useful and understandable to the reporting physicians as possible."

    One of Inova's big recent initiatives on the precision medicine front gets started on the ground floor, so to speak.

    "If one believes that using genomics to help personalize care starts at any age, what better time to do that than when people are born?" said Deeken.

    "Our main hospital here is Inova Fairfax, where we have about 10,000 babies born each year," he explained. "We started pharmacogenetic testing for every newborn as part of our free service to that new family. Parents are offered to have this test done, and the results are sent back to the physician and to the parents of the newborn – a profile of the testing: seven different genes that are involved and at least 21 different medications. Most of those medications won't be relevant to the child until later in life, but what better time to start this approach of personalized care?"

    Getting there, however, has not been without its impediments.

    On the technology side, at least, the gene extraction and genetic testing, "is pretty straightforward and getting easier and cheaper by the year," said Deeken. "The challenge is mainly on the data extraction and interpretation."

    A core question to answer there, he added, is "to really have this at its highest use, how do we get this information into electronic medical records? How can treating physicians or pharmacists have warnings or notices go up when they're taking care of a patient that might be impacted? A lot of the work we've been doing is around both how to incorporate this into the laboratory software and – even more of a challenge – into electronic medical records."

    All big health systems that have tried to deploy personalized medicine into their clinical workflows have had similar challenges, he said, and are all works in progress at this point.

    At Inova, "we have a number of health settings and patient populations we've looked at, and we've developed this capability and the infrastructure, under a CLIA umbrella, of high-throughput testing capability," said Deeken. "Translational Software has developed the ability to take data and turn it into highly-useful, highly interpretable results for physicians and patients. So that's what we'll be talking about at HIMSS – how we've partnered to do that."

    Another help in figuring best how to integrate genomic results has been to learn from other heath systems facing similar challenges but perhaps trying different approaches, such as Intermountain, University of Maryland and Vanderbilt," he said.

    He's hopeful too that, in the not-too-distant future, what they learn will help ensure that prediction medicine won't just mainly be the domain of large health systems and academic medical centers.

    "I certainly hope it's something we have across the board and that there's a democratization of this effort," said Deeken.

    "It's certainly true that the technology is outpacing the utilization," he added. "I would say the biggest challenge – and I say this as a doctor who's been in this field 15 years – is not technology or even health system willingness (to embrace personalized care), but education and physicians' ability to change the way they practice from how things were when they were back at medical school – to get on board with this new approach." 

    Deeken's session, "Building an Integrated Precision Medicine Infrastructure," is scheduled for Monday, Feb. 20, 2017 at 3:))-4:00 PM EST in Room 331A. HIMSS17 runs from Feb. 19-23, 2017 at the Orange County Convention Center.

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    This article is part of our ongoing coverage of HIMSS17. Visit Destination HIMSS17 for previews, reporting live from the show floor and after the conference.

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    The Centers for Medicare & Medicaid Services will reduce Medicare payments for fewer physicians in 2017 than in years past, but the adjustment for those not meeting meaningful use will be bigger: potentially 3 percent, rather than the 2 percent penalty imposed in 2016.

    While the number of providers facing lower reimbursement is on a downtick – 257,000 docs were penalized in 2015 and 209,000 in 2016 – the size of the downward adjustment is larger than in years past.

    Moreover, the penalties come even as the government has made concerted efforts over the past year to enable more practices to apply for meaningful use hardship exemptions.

    CMS makes allowances for providers unable to prove meaningful use due to infrastructure challenges (they're able to demonstrate that they're in an area without sufficient internet access, for instance) or "extreme and uncontrollable circumstances" (ranging from natural disasters to ongoing challenges related to 2014 edition certified EHRs).

    In addition, for eligible professionals practicing in multiple locations, lack of control over the availability of certified technology at certain of their practices. Specialists such as anesthesiologists, pathologists and radiologists are also eligible for exemptions.

    Medicare payment adjustments began on Jan. 1, 2015 for EPs, and will sunset in 2018 as the provisions of MACRA supplant meaningful use for physicians.

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    The Office of the National Coordinator for IT on Dec. 20 released its Interoperability Standards Advisory for 2017, collecting essential standards and implementation specifications for technology developers and clinicians to know.

    Whether they're required by specific federal programs or simply useful to furthering the spread of interoperability, these specs are all meant to enable easier sharing of clinical data, says ONC.

    "The ISA is a key step toward achieving the goals we have outlined with our public and private sector partners in the Shared Nationwide Interoperability Roadmap, as well as the Interoperability Pledge announced earlier this year," said National Coordinator Vindell Washington, MD, in a statement.

    [Also: Burwell: EHR giants Epic, Cerner, Meditech among those taking pledge to standardize health IT]

    That Interoperability Pledge, first announced at HIMSS16 in Las Vegas, saw electronic health record vendors with products installed in 90 percent of U.S. hospitals promise to follow three core commitments to interoperability: to use standardized APIs, make it easier for patients to access their data and not block information.

    The 2017 ISA - an update to the 2016 version released a year ago and the draft 2017 version published this past August - aims to help vendors and providers achieve these goals, said Washington.

    "We incorporated detailed stakeholder feedback to provide a consolidated, public list of standards and specifications that can be put to use to address clinical, public health and research needs for sharing electronic health information," he said.

    ONC recently moved the ISA to an interactive online platform, to help those across the industry better engage with and shape its content on an ongoing basis. It offers real-time updates and comments, as well as links to projects included in the Interoperability Proving Ground that might be use specific ISA-referenced standards.

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    In an expansion that now covers 140 million patients and more than 2 billion patient visits, Surescripts says providers in eight health systems are the most recent to go live with its National Record Locator Service.

    The NRLS, which operates under the Carequality legal and technical frameworks, offers another approach to cross-system interoperability, allowing data sharing across connected technology platforms and networks nationwide.

    It gives providers that connectivity within their existing EHR workflows – helping them identify and share patient records across geographies and among disparate technology vendors.

    [Also: Surescripts gives EHR vendors access to its record locator service, Epic and others sign up]

    After just two months using the record locator service, for instance, "We've already exchanged more than 82,000 patient records through the service, enabling our physicians to have a more complete care history of their patients regardless of where they were treated," said Lewis Low, MD, chief medical officer at Portland, Oregon-based Legacy Health, in a Surescripts statement.

    In addition to Legacy Health, which has seven hospitals and more than four dozen clinics across the Pacific Northwest, parts of seven other health systems have recently joined the NRLS:              

    • Cedars-Sinai. 886 licensed beds, 2,100 physicians, 2,800 nurses of its network in the Greater Los Angeles area;
    • Contra Costa Health Services. One hospital and 11 health centers in its integrated system of healthcare services, community health improvement and environmental protection in Contra Costa County, California;
    • NorthShore University HealthSystem. 2,100 providers in four hospitals and 130 offices in the Chicago area;
    • Novant Health. 1,380 providers in 530 locations across North Carolina, Virginia, South Carolina and Georgia;
    • Parkview Health. Eight hospitals and several specialty outpatient facilities in northeast Indiana, as well as more than 220 physicians' offices in Indiana and Ohio;
    • Sansum Clinic. 200 physicians serving California's central coast, and
    • Sutter Health. 5,000 affiliated doctors and 27 hospitals serving more than 100 communities in Northern California.

    Since the launch of the service in March 2016, Surescripts says it has answered almost 6.5 million requests for patient locations and returned over 1.6 million location of care summaries.

    "Clinicians at these leading health systems can connect to our nationwide network and get critical patient information at the point of care," said Surescripts CEO Tom Skelton in a statement. "It's great to see these organizations take proactive steps to delivering better, safer care by becoming truly interoperable and sharing critical patient data."

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