QUEENS, NY - In one of the best examples in recent memory of medical self-ownership, a proactive patient not only sought medical attention but also did his own admission orders and H&P when it turned out his concerns warranted further work-up. “I can’t always expect someone to hold my hand through everything in life, including when medical issues pop up,” explained Max Adderley, who states he’s noticed his stool turning black since yesterday. “I realized I needed to take ownership of my own health, to advocate for myself.”

Health care professionals always applaud patients who taken ownership of their own health, in the form of regular checkups, being compliant with medications or therapies, and seeking evaluation for any acute issues sooner than rather than later. However, to actually to do one’s own admission, that’s next-level thinking.

“Adderley is one gold standard patient, he insisted that I take it easy, that he would do all the orders and notes, he even told the nurse that he’d put in his own IV and he did,” explained hospitalist Tanya Smith. “I even double checked his owners, everything was on point: he’s NPO, started on a PPI, he’s ordered for serial hemoglobin levels, he even consulted GI. The best part? He ordered only Tylenol for pain.”

May 19, 2020 - The Office of the National Coordinator for Health Information Technology (ONC) final interoperability rule has the potential to transform EHR systems by improving interoperability and addressing clinician burden, according to health IT experts from Pew Charitable Trusts and American Medical Association.

Similar to how cellular phones have transformed technology and enhanced daily life for individuals, Pew explained that application programming interfaces (APIs) and enhanced interoperability mandated in the ONC final rule can have a similar positive impact on the future of EHRs.

While the ONC final rule takes a hard stance on information blocking, it also calls on medical providers and device developers to promote patient data access using third-party apps and APIs.

“Many Americans already use programs that rely on these types of interfaces, perhaps without realizing it,” Ben Moscovitch, project director for Health Information Technology at Pew; Ashley Ashworth, Pew; Matt Reid, AMA; and Laura Hoffman, AMA, wrote in a recent post. “For example, APIs are the underlying technology that enables online shopping and personal finance tracking. If broadly used in health care, they could usher in a new era for EHRs, enabling patients, clinicians, and researchers to access data in simpler, more efficient ways than they’re able to today.”

Ransomware attackers have focus on the healthcare industry as their target de jour. The attacks are hard to prevent and costly. In this guest post, Rick Clark, corporate security director for a provider of accounts receivable management and revenue recovery solutions for the healthcare industry, reveals how hospitals can protect themselves.

Current patient deferral of nonurgent services could lead to a “care debt” down the line, say Duke researchers. To meet those needs, health systems should be building out a robust telemedicine infrastructure. In an article published in the Journal of the American Informatics Association this week, Duke University researchers examined COVID-19’s effect on transforming the telehealth landscape.

“Whether healthcare enterprises are ready or not, the new reality is that virtual care has arrived,” researchers said.

Two medical professionals cited a study that found three pillars that could decrease clinician burnout in the ever-evolving medical landscape. May 18, 2020 - Enhancing provider autonomy, competence, and relatedness can improve intrinsic motivation and potentially reduce clinician burnout, according to a perspective piece published in The New England Journal of Medicine.

COVID-19 has shined a spotlight on clinician burnout and its massive impact on healthcare professionals in an unprecedented manner.

EHR implementation and the changes in the healthcare system were supposed to make life easier for clinicians across the country. However, the burden that it has caused has not only had a profound impact on clinicians, but it is also costing the healthcare system roughly $4.6 billion per year, according to the entry.

“Initially, the prevailing attitude was that burnout is a physician problem and that those who can’t adapt to the new environment need to get with the program or leave,” wrote article authors Pamela Hartzband, MD, and Jerome Groopman, MD. “Some dismissed the problem as a generation of ‘dinosaur’ doctors whining and pining for an inefficient, low-tech past. But recently, it has become clear that millennials, residents, and even medical students are showing signs of burnout.

Hartzband and Groopman examined a study written by Gagné M and Deci EL, that was published in JAMA Internal Medicine.

One person in Wuhan eats an uncooked bat, and your local Walmart runs out of toilet paper. This is such a surreal scenario, no wonder people are looking for alternative answers to how their normal lives got blown into pieces in the matter of weeks. And while conspiracy theories are usually a marginal phenomenon, in this age of misinformation, these theories seem to take over the place of truth and science.

While the truth is usually complex and often hard to understand, these clean-cut conspiracy narratives are designed to prey on pre-established suspicions, so they can seem like viable alternatives. And unfortunately, in our ever-connected social networks, these theories have a tendency to spread just as rapidly as COVID-19 does.

Besides hospitals and academic institutions, dozens of nonprofits, including so-called “nongovernmental organizations” - or NGOs - around the world must protect their COVID-19 research and related activities from those seeking to steal data or disrupt their operations, says cyber risk management expert Stanley Mierzwa of Kean University.

A wide variety of these nonprofit organizations are potential targets for cyberattacks during the COVID-19 pandemic. These include those that exist to “advance science around the world with research and serving to advance particular missions,” he says in an interview with Information Security Media Group.

Other nonprofits work on policy issues or public health concerns, he notes. “They often research and recommend strategies to governments in countries and can be involved with implementing programs,” he says. “Any of these could be targeted for cyberattacks if they are involved in pursuing COVID-19 research activities … including the response to COVID-19.”

Attacks on these organizations could affect their partners as well, he adds.

COVID-19 can cause serious cardiovascular complications including heart failure, heart attacks and blood clots that can lead to strokes, emergency medicine doctors report in a new scientific paper. They also caution that COVID-19 treatments can interact with medicines used to manage patients’ existing cardiovascular conditions.

The new paper from UVA Health’s William Brady, MD, and colleagues aims to serve as a guide for emergency-medicine doctors treating patients who may have or are known to have COVID-19. The authors note that much attention has been paid to the pulmonary (breathing) complications of COVID-19, but less has been said about the cardiovascular complications that can lead to death or lasting impairment.

“In writing this article, we hope to increase emergency physicians’ knowledge and awareness of this new pathogen and its impact on the cardiovascular system,” said Brady, of UVA’s Department of Emergency Medicine. “As we encounter more and more patients with COVID-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular. The rate of learning on this area is amazingly rapid. Information continues to change weekly, if not daily.”

The company is building the world’s largest RWE platform in behavioral health and chronic diseases to expand data-driven, evidence-based care for people managing behavioral health conditions. Founded in 2015, Singapore-headquartered digital health and data analytics company Holmusk yesterday announced a $21.5 million funding round, led by Optum Ventures (OV) and Health Catalyst Capital (HCC) and included existing investors Heritas Capital and other individuals.

Dr Vijay Barathan from OV and Charles Boorady from HCC will be joining the Board of Directors.

Holmusk has offices in New York City, London and Shanghai. The new funding round allows Holmusk to expand its US operations in New York City, and enables investment in its proprietary technology to harness and analyze real-world data to accelerate drug development and data-driven medicine.

Singapore-MIT Alliance for Research and Technology (SMART), MIT’s research enterprise in Singapore, has received a grant from the National Medical Research Council (NMRC) COVID-19 Research fund for the acceleration of research and development of rapid paper-based serological and diagnostic tests for COVID-19.

Giving an example of patients in rural areas that may have challenges getting transportation to appointments, he said in a phone interview: “With the advancements in technology, with remote monitoring and the ability to track vital health stats on a patient remotely tied to this audio-visual communication method, you’re going to see telehealth being more adopted broadly.

In Israel, using an AI-based system has been found to be an effective way to help find people most at risk of severe COVID-19 complications. Maccabi Healthcare Services, a leading health maintenance organisation (HMO) in the country, said the system enabled it to determine who among its 2.4mln members were in the high-risk group.

The AI company Medial EarlySign co-developed the technology, which was adapted from an existing system trained to detect people most at risk from flu. The system is backed by huge sets of medical data from Maccabi going back 27 years. These medical records include a person’s age, BMI, health conditions (eg, diabetes; heart disease), and history of hospital admissions.

By trawling through this comprehensive database, the AI tool has already identified around 40,000 of Maccabi members in the high-risk group. These members were then prioritised for testing.

In addition, the AI system helps with assessing the level of treatment these at-risk members might need should they get sick: 1) home-based care; 2) confinement in a quarantine hotel; or 3) admission to hospital.

Maccabi is currently in talks with major health providers in the United States who have shown interest in using the AI system to help flag their own high-risk patients. However, bringing such a tool to the U.S. and other countries may not be that easy. In the U.S., for instance, medical records are kept in “data silos” of hospitals and other healthcare organisations. “Our ability to develop algorithms to identify individuals as high risk is limited by the lack of data sets,” notes Darren Schulte, an MD and CEO of AI firm Apixio, who hopes that the current pandemic will bring about needed improvements in data sharing.

The selected projects will search for immediate and impactful solutions that health services can use responding to the pandemic. As a Knowledge and Innovation Community of the European Institute of Innovation and Technology (EIT), EIT Health actively participates in the wider EU efforts in relation to COVID-19.

In its ‘Rapid Response’ initiative, EIT Health has reallocated its 2020 budgets to support the fight against COVID-19. The 14 projects, run by 36 partners, cover biotechnology, diagnostics, digital health and med tech. Healthcare organisations will be part of the consortia to ensure the solutions can be built in line with clinical needs and implemented without delay.

Jan-Philipp Beck, CEO, EIT Health, praised the efforts by the employees, partners and wider network of EIT Health and noted that COVID-19 had opened new opportunities for collaboration. “The projects that we have selected all show great potential using the power of the EIT Health network to develop cutting edge solutions,” he said.

The Practice Fusion kickback scheme highlighted the dangers of EHR clinical decision support tools and a group of healthcare professionals say there is too much commercial influence in the EHR space.

This ethical thought experiment, known as the Trolley Problem, was put forth by Philippa Foot back in 1967 to challenge different schools of moral thought. In Lodi, Italy, this dilemma is far from theoretical. Doctors had to decide whom to allocate ICU beds to, due to the shortage of resources amidst the COVID-19 crisis. Dr. Di Bartolomeo reports that some patients “are not candidates” for ventilation support due to their old age or frail condition.

We have already analysed how COVID-19 would have taken place in a digital health utopia, if all the digital tools had already been in place when this pandemic hit us. (Spoiler: it would’ve been much, much better). When weighing the possible outcomes of COVID-19, we drew three scenarios on how life will, can, and should change after the pandemic. This time we put on our VR headsets, fast forward to 2030 and have a look at what we have gained and what we lost to the virus.

What if the COVID-19 pandemic had been forecasted months in advance? And hospitals didn’t experience shortages thanks to the help of an A.I. helping administrators better manage their resources when facing such a virulent disease? What if telemedicine was the norm and unnecessary doctor-patient visits were eliminated, reducing transmission risks and helping with containing the virus faster and easier? What if patients could check if they’ve contracted the disease with at-home tests delivered via medical drones and self-isolate if they are positive?

The coronavirus has turned our world upside down revealing holes in our healthcare system. In this guest post, Vladimir Ljubicic, MD, MBA, clinical lead in the global healthcare business unit at a software corporation that manages business operations and customer relations, explains why we can’t go back to business as usual and what we need to do to change going forward.

A qualitative RAND Corporation study finds that psychiatrists offering telemedicine for the first time during the COVID-19 pandemic have had largely positive perceptions of the transition. Many, however, say they plan to return to in-person care when possible, due to the challenges psychiatric telemedicine entail.

WHY IT MATTERS

Before the COVID-19 pandemic struck, a variety of logistical and regulatory hurdles prevented many psychiatrists from using telemedicine. Although research supported the efficacy of video telepsychiatry, the National Institute of Mental Health-funded study notes, only 5% of psychiatrists in the Medicare program had ever provided a telemedicine visit.

“While there were some pockets where psychiatrists were doing a lot of telemedicine, that wasn’t the norm in the United States,” said Lori Uscher-Pines, lead author on the report and senior policy researcher at RAND.

The research team interviewed 20 outpatient psychiatrists in regions where early flares of COVID-19 activity had triggered social distancing measures and shelter-in-place orders, such as New York, California, and Louisiana.

“Our key finding is that the rapid transition to telemedicine went fairly smoothly,” said Uscher-Pines. “Psychiatrists were pleasantly surprised about how well it was going and about patient response.”

Many respondents noted the safety advantages of avoiding in-person contact; some pointed out the benefits of seeing inside a patient’s home.

The shift to telemedicine was made simpler, researchers note, by regulatory and reimbursement changes.

International Nurses Day is observed each year on 12 May marking the anniversary of Florence Nightingale’s birth (200th this year). The International Council of Nurses (ICN) has celebrated this day since 1965.

According to Iris Meyenburg-Altwarg, Managing Director of Nursing and Director of the Academy for Nursing Education & Training at Hannover Medical University and President of European Nurse Directors Association (ENDA), nurses play a vital role in providing health services. “They devote their lives to caring and often stand as the first and only point of care in their communities. Nurses play a critical role in health promotion, disease prevention, emergency care and primary and community care delivery. … Their various roles as caregivers, coordinators, leader communicators, managers, family planners, educators, counsellors, record keepers and supervisors are appreciable. It is very essential to acknowledge, appreciate and address their contribution in challenging global health and nursing care,” she says.

To celebrate International Nurses Day, the World Health Organization (WHO)/Europe has published “Competencies for nurses working in primary health care,” a set of resources aimed at strengthen primary health-care nursing workforce across the world. The publication is intended for policy-makers, instructors, managers and clinicians involved in nurses’ competencies development in primary healthcare.

Five competence clusters are covered in the document:

Patient advocacy and education Effective communication Teamwork and leadership People-centred care and clinical practice Continuous learning and research.

The coronavirus pandemic has slowed the momentum in growth for the healthcare industry this year, but experts say COVID-19 has brought opportunities for healthcare startups to succeed and innovate.

In 2019, billions were invested in digital healthcare companies, with $7.4 billion invested across 359 deals, according to Rock Health, a venture fund for digital health. A strong first quarter showed 2020 would have continued on that trend, but the pandemic caused investors to slow down, according to a panel of industry experts who spoke on Industry Update and Market Trends for HIMSS20 Digital. Moderator Indu Subaiya is a cofounder of Health 2.0 and senior advisor for HIMSS.

Still, digital communication companies are thriving amidst a boom in telemedicine brought on by the pandemic, while companies such as Doctor on Demand are hiring more physicians to meet the surge in virtual care.

The researchers at King’s College London, Massachusetts General Hospital and health science company ZOE analysed the data from the COVID Symptom Study free smartphone app that was launched in the U.K. and the U.S in March 2020. It collects self-reported data from both asymptomatic and symptomatic individuals and tracks the progression in real time. The information recorded includes symptoms, hospitalisations, test outcomes, demographic data and pre-existing medical conditions.

Overall, the sample of over 2.6 million people in the UK and the U.S. was analysed. Almost 806,000 users reported symptoms associated with COVID-19. Of those 18,374 reported to have been tested for coronavirus with 7,178 confirmed cases.

The study aimed to identify the combination of symptoms most predictive of COVID-19. Although many people have presented with flu-like symptoms, the researchers found that the majority (two thirds) of those who tested positive for COVID-19 experienced anosmia (loss of taste and smell) compared with just over a fifth of the users who tested negative. Thus, anosmia could be a potential COVID-19 predictor in addition to commonly considered symptoms such as fever and persistent cough, the authors concluded.

COVID-19 Vaccine and Therapeutics Tracker, updated daily.

As manufacturers - including companies such as automakers that do not typically produce healthcare devices - race to help fill medical equipment shortages during the COVID-19 crisis, steps must be taken to ensure adequate security testing, says Fairuz Rafique of cybersecurity services firm EmberSec.

“If a lot of these products are being rushed to be deployed to hospitals - and they’ve rushed the manufacturing process itself … we should be asking if they are performing an adequate level of security testing … since they are supporting human life,” Rafique says in an interview with Information Security Media Group.

In the interview (see audio link below photo), Rafique also discusses:

Supply chain and operational IT security considerations during the COVID-19 response; Security risks faced by temporary healthcare facilities set up to handle coronavirus cases; Cyberthreat trends, including ransomware and phishing attacks, during the COVID-19 crisis. Rafique is governance, risk and compliance practice lead at EmberSec, a cybersecurity consulting firm. He’s Atlanta chapter president for the Control System Cyber Security Association International.

AmericanEHR has launched a website to help users find COVID-19 testing sites across the US and Canada. Complete with searchable maps and filters, the website is powered with a set of verified COVID-19 testing locations that have been identified by a growing team of volunteers. Testing sites can add and/or claim their profile in order to update users on availability, hours, and criteria for COVID-19 testing. The website can be found at HealthAlerts.io.

Health Alerts COVID-19 Testing allows users to submit new testing locations and real time updates through reviews and pictures as a means to crowdsource rapidly changing test site information.

Further, HealthAlerts.io connects users to self-assessment tools based on their geographic location. Self-assessments are generally the first step in determining a person’s eligibility for testing. For example some test sites require patients to make an appointment, have a physician referral, and be a member of a particular health organization in order to qualify for a COVID-19 test.

Ensuring users have access to the most trusted COVID-19 information is critically important. To achieve this HealthAlerts.io also provides real-time health alert bulletins from CDC, HHS, FDA, WHO, Health Canada, HealthLinkBC, and ECDC.