By Ken Perez, vice president of healthcare policy and government affairs, Omnicell, Inc.
Ken Perez
During the 2020 presidential election campaign, the top dozen or so health policies advocated by the Biden-Sanders Unity Task Force Recommendations, the Democratic Party Platform, and the Joe Biden for President Campaign Website fell into two distinct categories: ambitious progressive policies that would probably require a “go-it-alone” approach by the Democrats; and more moderate bipartisan policies that could be passed under the current rules in the Senate as an outcome of traditional political compromise.
Pursuit of the former approach is fashionable, as many Senate Democrats have advocated elimination of the filibuster. In addition, Senate Parliamentarian Elizabeth MacDonough recently determined that Democrats may be able to employ a fast-track process known as budget reconciliation multiple times before next year’s midterm elections, potentially allowing them to pass a bill with a simple majority, assuming that all 50 Democrats fall in line and Vice President Kamala Harris casts the tie-breaking vote as president of the Senate.
Nevertheless, there are key players in the Senate dedicated to pursuing bipartisanship.
By Devin Partida, technology writer and the editor-in-chief, ReHack.com.
Devin Partida
Many aspects of modern health care are increasingly dependent on IT professionals. Here are five challenges those experts are likely to encounter this year and some potential solutions.
1. Addressing the IT Needs of Rural Facilities
Many modern hospital processes require the internet. However, many hospitals are not in areas known for reliable internet access. These are typically rural facilities that often lack large IT teams.
However, these medical centers play substantial roles in the surrounding areas. Estimates suggest that rural communities account for 20% of the United States’ population. Hospitals are often among the primary places of employment for residents there.
Some IT obstacles at rural facilities relate to communication silos. However, a clinical mobility assessment could break down some of the barriers between IT professionals and clinicians. Moreover, investing in managed services can relieve the burdens at hospitals without large IT teams.
2. Coping With Too Many COVID-19 Vaccine Passport Standards
With COVID-19 vaccination programs rolling out in many countries, merely getting the appropriate number of shots is insufficient. People must also prove they did so. For now, they usually have paper vaccine cards with handwritten details.
However, several companies are working on digital vaccine passports. Those could prove vital for helping vaccinated individuals attend a concert or sporting event, travel abroad, or even dine in a restaurant.
People with knowledge of the matter say a primary issue is that there are currently four standards used for these projects and no sign of world leaders agreeing to stick with just one.
A related matter is that the United States alone has dozens of public vaccination databases. Implementing a system where a passport app could retrieve information from all of them requires one standard.
It’s also not clear whether people will need different vaccination apps depending on their desired activities. Since so many details remain unknown, the best thing for health IT professionals to do now is stay abreast of progress and consider how developments could affect their work.
The providers at Boice-Willis Clinic adore their eClinicalWorks EHR, but with 67 of them in seven locations and 10 practice areas, fast electronic consent signing is critical to the organization’s efficiency. It was a major goal of IT director Matt Reams to eliminate the workaround for e-signatures his team had been forced into.
The problem was an incompatibility between eClinicalWorks (eCW) and the signature pads the Rocky Mount, NC-based organization had purchased a few years prior.
eCW 11e, the browser-based version of the EHR used at most of the multi-specialty clinic’s registration desks didn’t recognize the previous pads being used, so the IT team utilized an enterprise content management system called Laserfiche as an intermediary. Patient consent forms were accessed through this software, and patients signed using the signature pads. The e-signature was stored in Laserfiche and sent to the medical records fax inbox. One of the health information management (HIM) staff had to then manually move it from the inbox into the patient document.
Complete Compatibility, Plus Plug-and-Play
Today, Boice-Willis has a new system using signature pads that’s saving HIM at least 10 minutes on every signed consent, and they process what Reams calls a “significant number” of forms per day.
Knowing that every front desk in the organization used the browser version of eCW which was incompatible with the old devices, Reams and his EMR manager searched eCW user forums for possible solutions. Upon seeing that multiple organizations had successfully changed to these signature pads, Reams ordered a unit to test.
The test showed that not only are the devices compatible with all versions of eCW, but they’re completely plug-and-play, not even requiring a driver download.
By Deborah Hsieh, chief policy and strategy officer, Ciox Health.
Deborah Hsieh
Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) in 1996. In the 25 years since, healthcare and technology have advanced beyond what any of the original writers of HIPAA could have imagined, creating innovative new tools and mechanisms to share information and to better engage individuals in their healthcare.
Recognizing the challenges in ensuring HIPAA remains relevant for technology, business practices, and patient needs of today, the U.S. Department of Health and Human Services (HHS) released proposed updates to HIPAA’s regulations. The proposed changes include needed flexibilities to promote information sharing, but fail to ensure patient privacy protections remain relevant for the changed context, and, in fact, encourage actions that could expose patients’ healthcare data. Rather than strengthening healthcare privacy protections, the proposal creates a new pathway for non-HIPAA-covered entities to freely access and exploit patients’ healthcare data.
In the proposed rule, HHS seeks to go beyond the existing statute and regulations that ensure patients have a right to direct a covered entity to transmit an electronic copy of their protected health information (PHI) in an electronic health record (EHR) to a designated person or entity of the patient’s choice (also called “patient directive”). HHS now proposes to create a wholly new, unprotected and unauthorized pathway enabling so-called personal health applications — third parties that meet a minimal set of criteria – to gain free access to electronic and paper-based data.
While HHS creates and encourages use of this new pathway for personal health applications, HHS is not able to regulate what these applications do. Because a personal health application “is not acting on behalf of, or at the direction of a covered entity,” it is not subject to HIPAA rules and obligations. Health data that a patient directs to a personal health application is no longer protected by HIPAA and patients are left to fend for themselves.
HHS states personal health applications are managed and controlled by the individual; however, there is no requirement that patients be informed their data is no longer being covered by HIPAA and what that means. Patients will lose their ability to control their access to and the use of their healthcare data and may be fully unaware that third parties may use personal health applications as a backdoor to gain access to millions of patients’ private health information for their own commercial purposes.
By Matthew Oldham, vice president of engineering, Graphium Health.
Matthew Oldham
Over the course of my career, working in a variety of industries, I have developed certain design patterns when modeling data that guide my approach to tackling a new data domain. One simple example is how I choose the right data type for a given value an application will capture.
While it may sound straightforward, interesting nuances can quickly surface during the data modeling step that necessitate a shared language and vocabulary between the functional experts and the software engineers. In other words, we need to figure out how to work together and speak the same language in order to solve the problem well.
The importance of nuanced semantics may be illustrated with the example of how an anesthesiologist documents the administration of an antibiotic. . The type and timing of antibiotic administration is a key metric that anesthesia providers have historically had to report to Centers for Medicaid and Medicare Services (CMS) since it correlates with both patient outcomes and healthcare costs.
As I analyzed the paper anesthesia record used, I noticed an “antibiotics” checkbox, accompanied by an antibiotic name, an amount, a unit of measure, and the route of administration. These all made sense to me, and I proceeded to incorporate these concepts into my data model. For the antibiotics checkbox, I naively interpreted it as a simple boolean value, and I named it Antibiotics Administered Indicator. In my mind, that simply indicated that the antibiotic denoted on the form was either administered (true), or not administered (false).
During a review of the model, I learned that a clinician interprets this checkbox to mean an “indication for antibiotics”; in other words, antibiotics were or were not determined as a necessary course of action given other clinical conditions. A true value didn’t mean that antibiotics were administered, only that they were indicated, and thus needed to be given. That is obviously a completely different understanding than the one at which I had arrived. Needless to say, this was eye opening for me, even having been down the road of developing a functional understanding of data domains many times before.
The illustration highlights the importance of having both functional (i.e., the doctors) perspectives and technical perspectives present and engaged during software design. A purely technical survey of a subject area will certainly be valuable, and in some cases may provide decent coverage in terms of establishing a foundational understanding of that domain. In most cases, however, a functional perspective will also be required to complete the picture and add the necessary insight required to create an accurate and intuitive user experience.
In fact, healthcare may serve as the poster child for just how challenging, complex, and unforgiving software design can be. Clinician dissatisfaction and fatigue with existing electronic health report software is well documented, and the explanations are plentiful: failed interoperability, difficult user experience, inefficiency with simple tasks, onerous data capture burden, etc. Perhaps the common denominator is a failed understanding of complex and poorly defined clinical workflows being interpreted and standardized in software by technical experts working in isolation. The real issue here is that foundational errors propagate as the software evolves, and there is no easy way to reverse course once construction begins.
For many of us, work gets in the way of exercise. There are simply not enough hours in the day to fit in all the work we have to do and a lengthy exercise routine. Some days it can even be too much effort to go for a stroll around the block. Yet, we know that sitting in front of a computer is bad for our health. It can lead to back and shoulder ache and a sedentary lifestyle increases our likelihood of developing cardiovascular diseases, high blood pressure and diabetes. It also increases the risk of colon cancer, osteoporosis, depression and anxiety and several other conditions.
If it could be possible to combine working with exercise it would be an ideal solution but you will need the right type of equipment.
What is a treadmill desk?
As the name suggests, a treadmill desk is a treadmill with a desk attachment. This could be a manual treadmill or a motorised version. With a manual treadmill, the motion of you walking or running causes the machine’s belt to move. They are cheaper to buy and don’t need a power supply so you can use them anywhere in your home. They tend to be smaller than the motorised versions and are particularly good for walking.
This makes them ideal for treadmill desks as you only need to be walking at a slow speed when you are working. By using a treadmill desk, you will be using up more energy (and therefore more calories) than if you are simply standing. Also, some people find that it puts less strain on the back – standing still for long periods can cause more back issues than walking does.
However, you do have to be careful if you have existing back or joint problems. It makes sense to build up the time that you use it gradually – perhaps over several weeks and months. If you have serious back or joint problems this may not be for you.
You may also take a while to adjust to working in this way. It can take several weeks for you to learn to write or type at the same time as walking.
Studies suggest that one in four Americans are using virtual assistants like Siri and Alexa to control their smart devices and access the Internet. However, older adults are much less likely to use these handy apps. That’s a shame because they’re missing out on so many features that can make life easier and keep them safe. So what do these digital assistants bring to the table? Why do some seniors struggle, and how can you help them use these programs?
How Can Virtual Assistants Help a Senior?
Virtual assistants work off of voice commands. They can also control smart devices around the home. This means that people with vision impairment, limited mobility, arthritis, or hand tremors can still use these household gadgets. They can adjust the thermostat, play audiobooks and more, without even leaving the couch.
These programs also streamline the smartphone experience. Older users don’t need to remember passwords, hunt through multiple layers of menus, or find the right app in a sea of options. The assistant handles all of this. At a simple request, seniors can video conference with loved ones or learn the score of Sunday’s game.
Virtual assistants also offer future proofing. Technology may continue to get more complicated, but the older user doesn’t need to worry about that. A virtual assistant will upgrade to handle these innovations.
Safety and Medications
Virtual assistants can make life safer for a senior. If your loved one is one of the 36 million seniors a year who fall, the assistant will contact emergency services. It can pull up maps and track locations if your loved one gets lost. These programs also remind older users to take medicine, and even tell the doctor about missed doses.
Respiratory health is a vital component of our overall health. The human respiratory system is a series of organs responsible for taking in oxygen and expelling carbon dioxide – basically breathing!!
The average adult breathes about 17,000 to 30,000 times a day, therefore it obvious why good respiratory health is essential in our overall health. Lung conditions are common and variable and can affect people of all ages.
It is widely known, and thoroughly researched, that exercise is highly beneficial for people living with chronic lung disease. Although lung conditions vary and present differently with each individual the role of exercise is global and positive in all cases.
Exercise can help to:
Improve your breathing
Clear mucus (or sputum) from your chest
Reduce your breathlessness during daily activities
Improve your oxygen saturations levels (Sao2)
Reduce shortness of breath — at rest and during exertion
Improve overall health
The frequency, type, intensity, duration and scheduling of exercise are important factors to take into account with prescription and should be implemented by an Accredited Exercise Physiologist. However, some key focus points to consider include:
A combination of aerobic and resistance- based exercise provide the best outcomes.
Diaphragmatic breathing and breathing control are imperative.
Periodisation and progression of planning are mandatory.
Work within your limits (mental, physiological and physical).
In addition to exercise, you can improve your respiratory health and lung capacity by:
Respiratory health is a vital component of our overall health. The human respiratory system is a series of organs responsible for taking in oxygen and expelling carbon dioxide – basically breathing!!