Can EHR’s Survive Cyber Attacks with An Antidote of Machine-Learning, Ambience and Behavioral Analytics?

Guest post by Santosh Varughese, president, Cognetyx.

Santosh Varughese
Santosh Varughese

Since cybersecurity healthcare threats on hospital EHR systems have become a topic of nightly newscasts, no longer is anyone shocked by their scope and veracity. What is shocking is the financial damage the attacks are predicted to cause as they reverberate throughout the economy.

In the 30 days of June 2016, more than 11 million patient EHRs were breached, making it the year’s worst incident according to a study by DataBreaches.net and Prontenus. For comparison, May had less than 700,000 and 2016’s former breach leader (March) topped out at just over 2.5 million.

While traditional security filters like firewalls and reputation lists are good practice, they are no longer enough. Hackers increasingly bypasses perimeter security, enabling cyber thieves to pose as authorized users with access to hospital networks for unlimited periods of time. The problem is not only high-tech, but also low-tech, requiring that providers across the healthcare continuum simply become smarter about data protection and privacy issues.

Healthcare security executives need to pick up where those traditional security tools end and investigate AI cybersecurity digital safety nets. IDC forecasts global spending on cognitive systems will reach nearly $31.3 billion in 2019.

CISOs are recognizing that security shields must be placed where the data resides in the EHR systems as opposed to monitoring data traveling across the network. Cloud deployment directly targeting EHR systems data is needed rather than simply protecting the network or the perimeter.

Pre-cursors to AI are also no longer that reliable. Organizational threats manifest themselves through changing and complex signals that are difficult to detect with traditional signature-based and rule-based monitoring solutions. These threats include external attacks that evade perimeter defenses and internal attacks by malicious insiders or negligent employees.

Along with insufficient threat detection, traditional tools can contribute to “alert fatigue” by excessively warning about activities that may not be indicative of a real security incident. This requires skilled security analysts to identify and investigate these alerts when there is already a shortage of these skilled professionals. Hospital CISOs and CIOs already operate under tight budgets without needing to hire additional cybersecurity guards.

Some cybersecurity sleuths deploy a variety of traps, including identifying an offensive file with a threat intelligence platform using signature-based detection and blacklists that scans a computer for known offenders. This identifies whether those types of files exist in the system which are driven by human decisions.

However, millions of patient and other medical data files need to be uploaded to cloud-based threat-intelligent platforms, scanning a computer for all of them would slow the machine down to a crawl or make it inoperable. But the threats develop so fast that those techniques don’t keep up with the bad guys and also; why wait until you are hacked?

The Mix of Forensics and Machine Learning

Instead of signature and reputation-based detection methods, smart healthcare CSOs and CISOs are moving from post-incident to pre-incident threat intelligence. AI innovations that use machine learning algorithms to drive superior forensics results and deploy pre-incident security are just what the IT doctor should be prescribing.

In the past, humans had to look at large sets of data to try to distinguish the good characteristics from the bad ones. With machine learning, the computer is trained to find those differences, but much faster with multidimensional signatures that detect problems and examine patterns to identify anomalies that trigger a mitigation response.

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The Rise of Trump Care: 7 Ways Trump Could Impact Healthcare Reform

Guest post by Abhinav Shashank, CEO & co-founder, Innovaccer.

Abhinav Shashank
Abhinav Shashank

On Nov. 9, 2016 the United States of America witnessed a major turnaround in the administration. Republican candidate Donald Trump is the 45th president-elect of the United States. Donald Trump plans to bring about numerous changes to “Make America Great Again,” and true to his Republican roots, Trump’s plans for the healthcare focus on some key facets which have always been a concern for the GOP.

Trump has outlined his healthcare plan for America that is centered around mainly the following key facets. A study conducted by the Commonwealth Fund with RAND Corporation using simulation analyzed his plans and came up with probable impacts.

1.) Repeal Affordable Care Act

Donald Trump and the GOP want to fully repeal the ACA and replace it with something new, dubbed “Healthcare Reform to Make America Great Again.” However, the intention is to achieve a better law with some parts of ACA.

Planned changes: Pre-existing condition clause will remain. As the Republican plan “the better way” dated June 22, 2016, Trump plans to continue with it as no American should be denied on the basis of pre-existing medical conditions or demographics. Remove the individual and employer mandate, as no one should be forced to buy health insurance. Reduce the growth rate of Medicare spending and implementation of new taxes and fees.

2.) Use of Health Savings Accounts (HSA)

A Health savings account is a tax-advantaged medical saving account available to the people of US, which allows people to contribute or draw money from for paying off medical expenses, tax-free.

Planned changes: Under Obamacare, HSAs were available to only individuals who were enrolled in “High Deductible Health Plans.” Keeping the basics same, Trump proposes to expand HSAs, allowing all individuals to use HSAs where the contributions would not only be tax-free but will also accumulate over time. Moreover, he would allow HSAs to become a part of a person’s estate and would be passed on to heirs without any penalty.

3.) Making premiums tax deductible

Before ACA came along, there were substantial tax advantages available to people who had their employer cover for them, but that privilege did not extend to people who took up private, individual-market policies not provided by the employer. To solve this disparity, ACA had the provision of means-tested advance premium tax credits, known as APTCs – where the government reduces the cost of insurance by providing APTCs to bridge the gap between the cost of premium and payment limit.

Planned changes: Trump’s plan will allow individuals to fully deduct their premiums from their tax returns under the current tax system, facilitating a free market to provide insurance coverage to companies and individuals. The scheme Trump has will abolish APTCs and let individuals use pre-tax money to purchase individual market insurance.

The aim is to provide people with an incentive to pay for coverage when they are healthy, and not make it mandatory.

4.) Funding Medicaid through block-grants

Under the current law, Medicaid gets join funds by the federal and state government and the federal government contributes 50 percent to 75 percent of the total costs and the rest is borne by the states.

Planned changes: Trump proposes to fund Medicaid all over the country through block grants. Under this, the federal government would give a fixed amount of money to states and let them fund their programs.
The rationale behind this is that state governments know best about their population and should have the sole authority on how the money should be spent and will fare better without federal administration overhead.

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Building Effective Provider-Payer Partnerships

Guest post by Steve Tutewohl, strategic accounts officer, Valence Health.

Steve Tutewohl
Steve Tutewohl

Payers and providers have always had inherent tension. Their business models never provided a true incentive to work together.

However, as the industry moves toward value-based care, providers and payers are now incentivized to focus on improving quality while lowering costs.

When I got into the healthcare business 20 years ago, as an actuary working on the provider side, my clients were taking bold risks with limited information, little analytical support and hardly any data. Today, providers often have more access to data than payers.

Healthcare is at a critical juncture, which creates a great opportunity for different types of professionals, including actuaries. We will continue to find new purposes, new roles and new responsibilities in healthcare, because the need for sophisticated analytics is growing exponentially every year.

One of the first Affordable Care Act challenges actuaries were uniquely prepared to address was the financial impact of risk adjustment transfers when the healthcare exchange opened.

The insurance industry had never seen anything of this magnitude before. It could either be catastrophic or a huge boon for healthcare insurers depending on how it paid out. Insurers are used to dealing with a certain level of uncertainty, but no company is comfortable operating blindly indefinitely. Based on our understanding of the business and our technical know-how, actuaries were able to offer providers and payers:

Effective payer-provider partnerships are formed when both align on a value proposition. They have to see and understand what value the other one brings to the equation.

On the provider side, it’s pretty simple: They are looking to secure their patient base and increase their market share. On the payer side, there are slightly different objectives. If they are going to move towards assigning risk to providers, they need assurances the provider network can bend the cost curve so they, as payers, can focus on selling product.

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3 Health IT Trends for Small Practice Performance, Profitability and Productivity

Guest post by Gaby Loria, analyst for mental health software, Software Advice.

Gaby Loria
Gaby Loria

There are certain factors clinicians are constantly working to improve at their practices, such as:

While these three P’s apply to every health care provider, regardless of practice size or specialty, they are especially important for independent physicians.

Solo and small practice doctors face more challenges than their counterparts in group-owned or hospital-affiliated organizations. They shoulder all the responsibility for:

For all of these reasons, it’s wise for small practices to invest in health IT tools that can give them an edge in a competitive and increasingly data-driven industry. The three tech trends we describe below can help improve performance, increase profitability and impact productivity without breaking tight budgets.

Improve Performance with Population Health Tools

The goal of managing population health is to achieve measurable improvements in the health outcomes of a group of people. In other words, taking steps to help groups of patients get healthier instead of solely focusing on one individual’s treatment plan at a time.

That may sound like a lot of work, but it’s not—if you have the right IT.  Nowadays, there are a number of population health-enabled capabilities that are built into electronic health records (EHR) software systems commonly used by small practices. The breadth and depth of these capabilities vary depending on the system, but here are some examples:

This technology makes it feasible for busy physicians to provide extra attention and care to patient populations that need it most, so they can prevent a worsening condition from developing. Such clinical interventions on a group scale can therefore make it possible to improve the overall health of a practice’s patient base.

Increase Profitability via Telemedicine

Telemedicine is the use of technology to support remote medical services. One of the most lucrative ways small practices can adopt telemedicine is by offering video consultations, which are virtual patient-physician interactions enabled by videoconferencing software. This allows doctors to see more patients per day without adding overhead costs (e.g., office space or staffing).

Interested physicians have two main options to capitalize on this trend:

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The Largest Hospital in Each State

Healthcare jobs are plentiful, and at least through 2024, the demand for healthcare professionals such as nurses, anesthesiologists and physicians will only continue to rise.

The Bureau of Labor Statistics has said that healthcare jobs are “expected to have the fastest employment growth and to add the most jobs between 2014 and 2024.” Given the healthcare industry’s propensity for increased growth, hospitals need to embrace scalable IT—for their own sake and for the sake of their patients.

Fortunately, there are options.

Healthcare organizations increasingly rely on cloud-based IT solutions, and SADA Systems has reported that the number of organizations living in the cloud could be as high as 89 percent. There’s a reason for the high percentage—cloud solutions are safe, scalable, and efficient.

Hospital data safety is no small concern.

In 2008, 9.4 percent of hospitals used EHRs. By 2014, the percentage had skyrocketed to 96.9 percent. The switch to digital records was necessary, but in the rush to modernize, hospitals were left more vulnerable to data theft than other industries that had migrated more slowly.

According to Niam Yaraghi, healthcare systems are left with an additional concern. “Hospitals cannot tolerate the consequences of computer lockdowns,” writes Yaraghi. “If Wal-Mart gets attacked, it will likely shut down for a short period of time and fix the issue…Hospitals on the other hand, are dealing with patients’ lives.”

Cloud-based IT solutions provide both reliable security and almost nonexistent downtime.

Further arguments for cloud IT include the sheer number of patients hospitals see every year. Hospitals treat 136.3 million patients in the emergency room alone, according to cdc.gov, and believe it or not, that number is growing. Cloud IT accommodates growing demand seamlessly.

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The Promise of Tomorrow’s EHR

Guest post by Paul Brient, CEO, PatientKeeper, Inc.

Paul Brient
Paul Brient

Advances in technology have fundamentally altered and inarguably improved the way we drive, shop and travel. Just ask anybody who uses Google Maps, Foodler or Uber.

Sadly, however, information technology has failed to deliver so far in the most crucial service of all – healthcare.  This is at least partly because electronic health records (EHR) systems grew out of the computer systems that run the hospital’s inner workings — patient scheduling, admission and discharge, staff payroll and accounts receivable. For system designers, physicians’ needs were an afterthought, which is problematic because physicians are, after all, the linchpin of the healthcare delivery system.

To begin pulling healthcare IT out of the past, we must first take a look at how it supports physicians. The short answer today is “not well.” In fact, EHRs are creating as much frustration as benefit.  Problems include poor presentation of patient data, fragmented information sources and unwieldy user interfaces that require dozens of mouse clicks or screen taps. It’s no wonder more than half of physicians who responded to a recent survey claimed their EHR system had negative impacts on costs, efficiency and productivity – three things IT should help, not hinder. These issues not only affect physicians’ professional satisfaction, they contribute to the phenomenon of physician burnout, which is a growing concern across healthcare. Studies show some 30 percent of primary-care physicians age 35 to 49 plan to leave medicine, and there’s an expected shortage of 25,000 surgeons by 2025. A Mayo Clinic study released earlier this year directly connected the burnout problem to physicians’ use of EHRs.

Today’s EHRs have done little more than “pave the cow paths.” We’ve gotten rid of paper in the hospital and made processes electronic, which is why EHRs can legitimately claim to have reduced transcription errors. But eliminating paper is just table stakes; the critical next phase is to do for healthcare what Uber has done for transportation: Reinvent the process so it’s optimized for and native to the technology that enables it.

Patients and physicians can and should advocate for such change. Today, patients have access to a vast body of information—the notes a doctor took, quality of care rankings, the level of personalization provided—and it’s only going to increase.  As Lygeia Ricciardi, former director of the Office of Consumer eHealth at ONC said, “Getting access to personal health information is the start of engaging patients to be full partners in their care.”

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Predictive Analytics: Precision Planning for Healthcare’s Most Important Resource – Its People

Guest post by Jackie Larson, president, Avantas.

Jackie Larson
Jackie Larson

Predictive analytics and advanced labor management are the most important – and underutilized – methods to assure that provider organizations have the right caregivers in the right places at the right times.

A recent survey of nurse managers by AMN Healthcare and Avantas, Predictive Analytics in Healthcare 2016: Optimizing Nurse Staffing in an Era of Workforce Shortages, (available on the AMN website) brought the need for more awareness to light in just a few stats related to staffing and scheduling:

The survey also revealed a lack of sophisticated scheduling tools being utilized:

Further, the survey found that while nearly 90 percent of nurse managers said that a technology that can accurately forecast patient demand and staffing needs would be helpful, 80 percent were unaware that such a solution exists.

Strategies to Fulfill the Potential Predictive Analytics

This process to predict future patient demand and strategically plan clinician scheduling and staffing is scalable, cost effective and accurate. First, staffing data are processed with advanced algorithms, then forecasting models are created and validated, customized for each unit or service area within the organization, allowing workforce projections up to 120 days prior to the shift. The forecast is updated weekly, and by 30 days in advance of the shift, the forecast of staffing need is 97 percent accurate.

Compared to how scheduling and staffing is conducted at most healthcare organizations today, predictive analytics may seem like something out of a sci-fi movie. The truth is, this sophisticated forecasting of labor needs has been leveraged in other industries with great success. And, in healthcare, it can lay the foundation for significant advancement in utilization of staff, leading to improvements in morale, quality, and financial results. The advanced labor management strategies and tools layered on an accurate projection of staffing needs – months and weeks in advance of the shift – will turn an accurate forecast into an effective resource management strategy.

Adopting Workforce Analytics
Every organization’s staffing mix should be unique to the fluctuations in its patient volume. Once an organization understands its demand, it can then determine its supply – scheduling and staffing to meet patient demand in the most productive manner possible. The organization can analyze and solve the problems that reduce its available supply of core staff, such as leaves of absence, continuing education, training and other issues. This precision understanding of workforce availability is then layered with patient volume predictions, and the result is accurate insight into the core and contingency staffing levels needed to meet patient demand.

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Shifting From Volume to Value with Technology

Guest post by Abhinav Shashank, CEO and co-founder, Innovaccer.

Abhinav Shashank
Abhinav Shashank

Since 1966, Americans have received more Nobel Prizes in Medicine than rest of the world combined with astonishing advancement in medical treatments, but how much of it reflected on ground level is still a troublesome figure. The soaring costs of healthcare; the amount spent on healthcare is approximately 20 percent of the country’s GDP and the amount spent on one person per year is going to be roughly $10,000 in 2017; much higher than any other country. Despite ACA, more than 30 million people in the U.S. are still uninsured. With so many concerns, the healthcare industry needs innovation to change this bleak picture.

Innovative solutions have emerged in these aspects – the delivery of treatments to patients, the technology as well as the business aspects. A few innovations in healthcare are here to stay, resulting in a more convenient and effective treatment for patients today, where time is of the essence and providing patients a better future is a priority.

Big Data. Big Use. Big Outcomes

Data-driven innovations are poised to do wonders in healthcare industry. Big data has been used to predict diseases, find their cure, improve the quality of care and avoid preventable deaths. From increasing awareness in patients to transforming data into information, big data offers healthcare a paradigm shift. Instead of analyzing a single patient’s data, we can now explore entire patient population and predict patients’ health trend.

Some healthcare leaders have already extracted value from big data and are already putting them to good use. Many value-focused healthcare organizations are working to improve healthcare delivery and healthcare delivery and patient outcomes by making an integrated technology system that will allow practices to deliver evidence-based care that is more coordinated and personalized.

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How Nurses Are Using Health Informatics to Improve Patient Care

nurse-informaticsNursing is increasingly becoming as “high tech” as it is a “high touch” profession. Today’s nurses have more technology at their disposal than any nurses ever before, and as one might expect, it’s considerably improving patient care.

One area where nurses are putting technology to use is in informatics. Officially known as the study of information, in the world of health care, health informatics is the management of health information. Using electronic medical records, devices that collect health information electronically, and other electronic information standards, health informatics nurses are responsible for managing, interpreting, and communicating the data that comes in and out of health care facilities, all with one primary purpose: Improving the quality of patient care.

But how does that happen, specifically? How are nurses using informatics as a way to improve the care they — and their colleagues — provide to patients? As it turns out, there are several key ways that informatics is part of that effort.

Improved Documentation

Documentation has long been considered an important part of the nursing profession, but it’s more vital than ever to the delivery of quality care. While the theory and practice of nursing, the standards of nursing practice, legal and ethical considerations, and other points that are taught in advanced nursing programs all influence the practice of nursing, it’s information, and specifically, electronic documentation, that is having the greatest influence on modern nursing.

Modern nursing care is driven by individual patient needs and history — information that is collected and organized in electronic patient records. By documenting a patient’s condition, and sharing that information electronically, nurses are able to more effectively manage care, and by extension, improve the quality of that care.

A great deal of documentation takes place automatically thanks to connected devices, which collect specific information in real time and transmit it to patient records. By looking at the documentation of a patient’s condition over time, nurses can make better decisions about how to provide care and when changes or adjustments need to be made.

Reduced Medical Errors

Patient safety is a primary concern of any health care provider, and nurses are often on the front lines of ensuring that their patients are kept safe and preventing medication errors, misdiagnoses, falls, and other problems. Health informatics provides important data that can prevent these errors; for example, an electronic record can provide information about a possible dangerous medication interaction or allergy that might not otherwise be immediately apparent. Armed with data, nurses can make quick decisions that keep their patients safe.

In fact, in a study by the Agency for Healthcare Research and Quality (AHRQ), a majority of nurses reported that when they have access to EHRs, they have fewer problems with getting patients ready for discharge, fewer medication errors, and better quality of care. And when it comes to transfers between departments, nearly 15 percent of the nurses surveyed reported that information was more likely to be shared and less likely to “fall between the cracks” when electronic systems are used.

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How Healthcare Technology is Disrupting the Traditional Market

Do you know how tech is disrupting the traditional healthcare market? Well, we do, and we have gathered all the information you need to know about this topic in one infographic. Today technology is constantly evolving and starting to take over surprising segments of our lives. The leading health tech accelerators, startups, companies and minds are doing their best to make this industry grow. Every day med tech makes people feel safe and more comfortable, it helps us to have more control over our health and body. We’ve made a research on the biggest challenges of the health tech sector, on global investment in health tech companies, on health tech influencers to follow, on the reasons of health tech industry growth and more interesting stuff.

It didn’t take much time for investors to see the perspectiveness of the health tech sector and to start investing in it. Such companies as Y Combinator, Dreamit Ventures, GE Ventures, Google Ventures, Rock Health and many others started to invest into dozens of health tech startups. At the same time a lot of different governmental programs were established, with the purpose to support health tech development and healthcare innovations. Canada founded a new $20 million Health Technology Innovation Evaluation Fund to support made-in-Ontario technologies. In Australia $4 million Mental Health Innovation Fund supports health tech startups to come up with health-driven innovations fighting with mental illness. At the same time, with $4.5 billion funding from the government, 2015 became the year of digital health for the US.

The biggest challenges of the health tech sector are: difficulty of market entry for new generation drugs; misuse of USB ports can cause medical devices to malfunction; robotic surgery: complications because of insufficient training; and other factors. A lot has been done yet there is still much to accomplish. So the following infographic about health tech and its role in healthcare industry attempts to give you important information in a creative way. We hope you’ll like it.

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