Jack McCarthy

The U.S. Department of Veteran Affairs’ use of telemedicine to treat patients at its Vermont hospital at White River Junction resulted in an average travel payment savings of $18,555 per year between 2005 and 2013, according to a study published in the journal Telemedicine and e-Health. The study found that telemedicine resulted in an average savings of 145 miles and 142 minutes per visit, resulting in the aforementioned payment reductions, while telemedicine services volume grew significantly over the study period such that by the final year the travel savings had increased to $63,804, or about 3.5 percent of the total travel pay for that year. [Also: VA picks up $233 million from Congress to fund VistA EHR upgrades] Authors of the report explained that the number of mental health telemedicine visits increased during the study period but remained small relative to the number of face-to-face visits. And a higher proportion of telemedicine visits involved new patients. On a nationwide scale, the VA has taken strides to use telehealth tools for treating its patients. For example, an August 2015 study determined that older veterans with depression benefited from telemedicine talk as much as in-person therapy sessions. That study, published in The Lancet, found that older veterans with depression benefited from telemedicine talk as much as in-person therapy sessions. With many seniors facing difficulties to getting help for depression, including mobility issues and fear of social stigma, telemedicine can increase their access to treatment, the study found. And with the national VA healthcare system’s travel pay to patients for getting to appointments projected to cost nearly $1 billion in 2015, a 3.5 percent reduction, if achievable at scale, can yield significant savings. Twitter: @HealthITNews

Primary care doctors now lose more than an hour a day to sorting through approximately 77 electronic health record notifications, researchers at Baylor University found. “Information overload is of concern because new types of notifications and ‘FYI’ (for your information) messages can be easily created in the EHR (vs in a paper-based system),” the researchers wrote in the Journal of the American Medical Association  Internal Medicine.      Making the workload harder to endure, reading and processing these messages is uncompensated in an environment of reduced reimbursements for office-based care, according to the study. [Also: Epic to develop Apple Watch app, 'Limerick,' a test results notifier] Physicians are receiving these increasing amounts of notifications in EHR-based inboxes such as Epic’s In-Basket and General Electric Centricity’s Documents. The messages include test results, responses to referrals, requests for medication refills, and messages from physicians and other healthcare professionals. The system is crying out for change the researchers wrote. “Strategies to help filter messages relevant to high-quality care, EHR designs that support team-based care, and staffing models that assist physicians in managing this influx of information are needed.” What’s more, optimistic predictions that EHRs would improve patient care through better doctor-patient communications have not ubiquitously materialized. “Unfortunately, we are far from this promise and now also grapple with the unintended consequences of EHRs,” Joseph Ross, MD wrote in an editorial accompanying the research.  In fact, electronic “paperwork” has burdened doctors and reduced the time for patient care. Ross advocated that inbox notification capabilities be periodically reviewed to be sure EHRs are working in the best interests of patient care and not creating an unnecessary burden on physicians. [Like Healthcare IT News on Facebook] In addition, doctors should be reimbursed for time spent reviewing EHR notifications. “Although many of these notifications are in the service of patients,” Ross wrote, “we need to be sure that physicians’ reimbursement, particularly for primary care physicians, is taking into account the full time needed to manage patients’ care.”  Twitter: @HealthITNews

New resources focus on available technologies, emerging professional roles and leadership to help health information management professionals more effectively work with both clinicians and patients.

The federal government is pursuing a fistful of bold visions to transform healthcare including the Precision Medicine Initiative and the National Cancer Moonshot, and for those to succeed patients are going to need the ability to access and share health data in new ways, according to three federal officials. “When patients are engaged in research and voluntarily sharing their health data with the research community, the opportunities for new discoveries at the intersection of human biology, behavior, genetics, and data science are unlimited,” wrote U.S. Chief Data Scientist DJ Patil, Senior Advisor Claudia Williams and Precision Medicine Initiative project manager Stephanie Devaney. [Also: Obama taps Biden to lead cancer cure 'moonshot'] The authors cited President Barack Obama’s Precision Medicine Initiative, an innovative approach that takes into account individual differences in people’s genes, environments, and lifestyles in treatment and research, and the National Cancer Moonshot, which leverages Big Data to find solutions to genetic abnormalities, as examples of data sharing to accelerate research and translate findings into new treatments. HHS has been taking steps to enable the data sharing that PMI, the Cancer Moonshot, and key research projects will demand. The agency recently issued guidance to clarify patient rights to access a variety of health information, including personal health records, the information in their health records, clinical laboratory test results, and genetic data. And earlier this month, the Food and Drug Administration held a workshop with patients and providers to understand the best ways to return information that is usable, meaningful, and actionable. “We’ve worked hand-in-hand with the private sector (to provide patient access to health records) and together, last week, the companies that provide 90 percent of electronic health records to hospitals nationwide pledged to improve the flow of data across healthcare settings, provide people with easy and secure access to their information, and adhere to federally recognized standards that assure that patients can access their own data,” the authors explained. HHS is also encouraging the development of apps that use open, standardized application programming interfaces to help consumers aggregate their health information in one place that is under their control. And at the recent Precision Medicine Initiative Summit hosted by President Obama at the White House, six of the major electronic health record vendors announced that they will pilot the use of standard APIs for individuals to access and contribute their data to research. [Like Healthcare IT News on Facebook] The authors also pointed to the early traction Blue Button has gotten. Through the public-private effort some 150 million Americans can now access information from providers, medical laboratories, retail pharmacy chains, and state immunization registries. What’s more, three million veterans, service members, and Medicare beneficiaries have now accessed their personal health data more than 43 million times. “These are exciting steps toward ensuring individuals have access to their data,” Patil, Williams and Devaney wrote. “But we’re far from done.” Twitter: @HealthITNews

Cyberattackers targeted Apple users over the weekend with the first known ransomware written specifically for Apple software, according to security firm Palo Alto Networks.     Ransomware is a fast-growing threat that encrypts data on infected machines and demands that users pay a ransom in digital currencies, such as Bitcoin, to receive an electronic key so they can retrieve their data. [Also: Hollywood Presbyterian gives in to hackers, pays ransom] The most high-profile ransomware attack happened just last month when attackers struck Hollywood Presbyterian Medical Center and held its data hostage, effectively reverting the hospital back to a pre-digital state in which employees used paper records and fax machines. While most pieces of ransomware target Windows operating systems, in this new case hackers attacked Macs through a tainted copy of a program known as Transmission, which can transfer data via the BitTorrent peer-to-peer file sharing network, Palo Alto Networks explained. Any Mac users that downloaded version 2.90 of Transmission, released on Friday, were infected with the ransomware. “On March 4, we detected that the Transmission BitTorrent client installer for OS X was infected with ransomware, just a few hours after installers were initially posted,” Palo Alto Networks said on its site. “We have named this Ransomware KeRanger.” Transmission responded by removing the malicious version of its software from its website and . on Sunday it released a version that it claims automatically removes the ransomware from infected Macs. Transmission users were advised to immediately install the new update, version 2.92, if they suspected they might be infected. KeRanger is programmed to stay quiet for three days after infecting a computer, then connect to the attacker's command and control servers to start encrypting files so they cannot be accessed, Palo Alto Networks added. [Like Healthcare IT News on Facebook] “The malware then begins encrypting certain types of document and data files on the system,” the company said. “After completing the encryption process, KeRanger demands that victims pay one bitcoin (about $400) to a specific address to retrieve their files.” If paying the ransom seems far-fetched, hospital executives should know that’s exactly what Hollywood Presbyterian was forced to do when they settled for a $17,000 ransom. Twitter: @HealthITNews

U.S. Department of Veterans' Affairs CIO LaVerne Council said last week that the VA needs to reconsider whether its proprietary Veterans Information Systems and Technology Architecture is the best electronic health record for its more than 1,200 healthcare sites. Council explained during testimony to U.S. House appropriators that changes in the VA's healthcare delivery plan, such as emphasis on mobility, security and women's health, as well as connections with private sector providers, are forcing the reconsideration of VistA. Specifically, Council said it was time to "take a step back" from the planned modernization of the VistA health record and announced VA plans to review whether it should continue upgrading VistA or turn to a commercial off-the-shelf product, much the way the Department of Defense elected to forego its in-house Armed Forces Health Longitudinal Technology Application, aka AHLTA, and is replacing it with a Cerner EHR. [Like Healthcare IT News on Facebook] “We have not made up our minds about VistA,” Council said. When asked during a separate hearing last week by Montana Democrat Sen. Jon Tester why it’s taking so long to either fix or replace VistA, VA undersecretary David Shulkin, MD, explained that Council “has gone in with her private sector background and really challenged all of the assumptions that frankly have led to an underperforming part of the organization.” Council and Shulkin’s comments come after the Government Accountability Office published recommendations in Late February that both VA and DOD “develop and compare the estimated cost and schedule of their current and previous approaches to creating an interoperable electronic health record and, if applicable, provide a rationale for pursuing a more costly or time-consuming approach.” Twitter: @HealthITNews

Healthcare organizations are recognizing that clinical decision support technology that integrates with electronic health records can be utilized to improve quality of care and better utilize staff and resources. Community Medical Centers, for instance, had already embarked on adoption of an EHRs system when in 2014 it added clinical decision support technology to develop an evidence-based approach to care. Such a system promised to help nurses and doctors save valuable time by integrating CDS tools into their care plan and, in turn, improving their communication with patients. [Poll: What topics will define HIMSS16?] “The goal was to enhance quality of care and efficiency,” said Lauren Garrick, Corporate Informatics Nurse and Plan of Care Coordinator at Community Medical Centers in Fresno, California. The hospital group selected ZynxCare, a plan of care solution from ZynxHealth, which provided templates to allow nurses and doctors to recommend and provide relevant services by providing access to medical research libraries, comprising hundreds of diagnoses and procedures. With this evidence-based information at their fingertips, the clinicians could  focus on their individual patients. The CDS tools also easily integrated with Community Medical Centers’ digital Epic EHR system. Garrick said a benefit for Community Medical Centers was the ability of the ZynxCare system to be customized according to the needs of the hospital group. “They have software you build and an integration process you use to integrate it into your system,” Garrick said. “You can pull up these templates for plan of care and support changes and create templates in Excel files, and our tech team can migrate the files into EHRs.” Garrick, along with Judi Binderman, VP and chief medical informatics officer for Community Medical Centers, will outline how CDS technology program was conceived, developed and implemented across the four hospitals in a presentation at HIMSS16.    [Also: 21 awesome photos from past HIMSS conferences] Their talk, “Taking Plans of Care from Clinician to Patient-Centric” will examine how Community Medical Centers replaced its homegrown, generic plans of care with the evidence-based, CDS system specific to the patient’s condition and adjustable to special requirements the patient may have. Garrick said that with the CDS program in place, nurses can now easily access information on generic conditions for patients while examining and communicating with the patient closely. “A nurse would have access to relevant information, and be able to instantly go through medical journals and web links for a patient,” she said. “For example, if they are advising someone about Sudden Infant Death prevention, a staff member can click on links and read research right at the patient’s bedside.” “Taking Plans of Care from Clinician to Patient-Centric,” is scheduled for Wednesday March 2, 2016 from 10-11 AM in the Sands Expo Convention Center Palazzo G. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

The development of standards through the lab will help ONC further develop interoperability standards, official says.

While early-adopting healthcare organizations are seeing strategic value by leveraging predictive analytics to inform their plans and programs, most providers are only in the initial phases of implementation. “The question in healthcare now is how to budget and manage care with the proliferation of new data,” said Scott Allister, senior manager of health analytics with Accenture. “What do we do about it?” [Also: NorthShore University Health System leverages predictive modeling] Allister said the value of predictive analytics for providers is becoming more apparent every day. Providers are exploring multiple uses for analytics, he added, such as “how you work with analytics, including how you can manage medication, how you can set up your infrastructure, how you can govern your data in specific ways, and how you manage the culture of the enterprise.” The transition to a service informed by predictive analytics, however, is not always easy. Organizational silos must be broken down, and new ways of decisionmaking enacted. “This is a journey,” Allister said. Among the hospitals making great strides in adoption of analytics, Allister said, is Presbyterian Healthcare Services in Albuquerque, New Mexico, a private, nonprofit healthcare system with eight hospitals, a statewide health plan and a multi-specialty medical group. [Also: 21 awesome photos from past HIMSS conferences] Allister, along with Soyal Momin, vice president of analytics at Presbyterian Healthcare Services, will show how Presbyterian has moved toward an integrated system in a presentation at HIMSS16, which kicks off in late February. Their talk, “Data and Analytics Done Right: Driving Value Creation” will examine how the healthcare provider recognized the need to optimize the growing amounts of electronic data that it was capturing, and thus sought a data and analytics transformation strategy. Among the points covered in the talk will be how to recognize the changing data and analytics requirements faced by healthcare providers with health plans, as well and assessing the benefits an end-to-end data and analytics transformation can deliver. See all of our HIMSS16 previews Allister said that Presbyterian so far has overcome many of the barriers often facing providers as they adopt an analytics strategy. “They recognized the problems of really getting value out of data,” he said. “A lot of organizations have plans, but Presbyterian stuck to it and they are starting to show some important results.” The session “Data and Analytics Done Right: Driving Value Creation,” is scheduled to take place on March 2, from 10-11 a.m. in the Sands Expo Convention Center Marcello 4401. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

Hackensack University Medical Center is tapping new technologies to achieve more effective medication adherence, according to Hackensack UMC’s director of pharmacy Nilesh Desai. Hackensack UMC has been an early adopter of technologies and processes to advance medication safety and nurse workflows, Desai explained, along with interoperability between automated dispensing cabinets and EHRs. [Also: 11 essential quotes from notable HIMSS keynotes] Nurses are responsible for interacting with the automated medication dispensing cabinets, and the time they spend at the cabinets can be reduced significantly via more interoperable systems, for instance. Desai will discuss the hospital's progress in this realm during a HIMSS16 session titled “Impact of an ADC System on Medication Administration.” See all of our HIMSS16 previews Medical administration systems must be able to address patient-specific medications and offer robust inventory and data management processes, Desai said. Hackensack UMC tapped Omnicell, a provider of medication and supply management solutions and analytics software for healthcare facilities, to deliver automated medication management solutions throughout the 775-bed hospital. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.