Health Level Seven International (HL7), the global authority for interoperability in healthcare information technology with affiliates in 35 countries, announced that it has published release 4 of the HL7 Fast Healthcare Interoperability Resources (FHIR) standard. This new version is the culmination of 18 months of extensive work to finalize the base parts of the specification and incorporates changes and enhancement requests received from implementation partners around the world.
HL7 FHIR is a standards framework that leverages the latest web standards and applies a tight focus on implementation. FHIR includes a RESTful API, which is an approach based on modern internet conventions and widely used in other industries. The standard represents a significant advance in accessing and delivering data while offering enormous flexibility and ease of development. For patients and providers, its versatility can be applied to mobile devices, web-based applications, cloud communications and EHR data-sharing using modular components. FHIR is already widely used in hundreds of applications across the globe for the benefit of providers, patients and payers.
The most significant change in HL7 FHIR Release 4 (R4) is that the base platform of the standard has passed a normative ballot and will be submitted to the American National Standards Institute (ANSI) as a normative standard. This means that future changes should be backward compatible so applications that implement the normative sections of R4 no longer risk being nonconformant to the standard. The following portions of the standard are now normative:
The RESTful API, the XML and JSON formats, and the basic datatypes
The Terminology Layer (CodeSystem and ValueSet)
The Conformance Framework (StructureDefinition and CapabilityStatement)
The key resources Patient and Observation
Thousands of other R4 updates and changes have been made in response to implementation experience and quality review processes.
On December 2016, the 21st Century CURES Act was signed into law, resulting in new regulations for the home health industry. The CURES Act mandates the use of electronic visit verification, or EVV, for all Medicaid-funded personal care services. On Jan. 1, 2019, these new federal requirements for EVV went into effect for personal care services.
EVV is a method of utilizing electronic technology to capture point of service information related to the delivery of in-home services, such as:
Type of service performed
Individual receiving the service
Date of the service
Location of service delivery
Individual providing the service
Time the service begins and ends
Types of EVV
There are three ways through which Home Health Care provider companies can comply to the new regulations involving CURES Act. Let’s take a closer look at them.
This type of EVV solution uses a dedicated hardware device which is used to record caregiver’s scan of fingerprints or record voice samples to register visits.
Biometric recognition may seem like a good solution to comply with EVV at first, but this system has some drawbacks. These devices are expensive and each care recipient has to have a dedicated biometric device installed on their premises. It can be an inconvenience to both the business and the patient.
Telephony method is commonly used in the home setting and don’t require the companies to install or service any devices. To record a visit with this method, the caregiver uses a recipient’s landline phone to dial a toll-free number at the start and completion of service delivery.
Based on a recent National Health Interview Survey (NHIS), it was found that almost half of the US household do not have a landline and are rapidly losing relevance. Smartphones have taken over and landlines are becoming obsolete. The decline of landlines makes this option historical and therefore a weak contender as an effective EVV solution.
Mobile technology (phone and tablets)
The modern EVV solution for all types of caregivers uses the app on the mobile devices, specifically smartphones and tablets. Most modern mobile devices have GPS for location-based Electronic Visit Verification via GPS tracking and geofencing.
Smartphones and tablets are constantly evolving and are becoming more powerful, and with increasing affordability of key technologies like mobile apps, sensors and cloud technology, the mobile technology offers to be the most future-proof EVV option.
Mobile technology EVV solutions go far beyond simple proof of visit. These more comprehensive solutions frequently combine mobile applications with back-office portals, providing additional functionalities:
In the more than 20 years since the landmark passage of the Health Insurance Portability and Accountability Act (HIPAA), healthcare organizations have come a long way in protecting the security and privacy of patient data. Organizations now use sophisticated tools in the form of electronic health records (EHRs), online patient portals and virtual clinics that have elevated modern medicine to a new level of care. As a result, patients have come to expect a seamless interaction – whether digitally or in-person – with their healthcare provider, and trust that their personal information is safeguarded throughout.
But just as these new digital records and online portals make it easier to access and manage patient care and medical history, there still looms a security threat that organizations may not be as well-equipped to prevent. Despite the regulations put in place to guard against privacy violations and data theft, healthcare data breaches now occur at a rate of more than one per day, with nearly 60 percent of these breaches coming from insiders. You read that right. Unfortunately, the greatest threat to a healthcare organization may not always be from outside cybercriminals hacking into an organization’s network and stealing patient medical records. While the vast majority of healthcare workers are good and honest people, it only takes one employee succumbing to curiosity and taking a peek at a patient’s EHR without a valid reason, to violate HIPAA compliance laws and potentially cause a massive data breach.
Why are insider threats on the rise?
The healthcare sector employs tens of millions of people across the country, and organizations go to great lengths to hire quality employees. But the fact remains that access to sensitive information, coupled with large organizations that employ people with varying levels of commitment – whether full-time, part-time or as contractors – can present opportunities for unethical and unlawful actions.
For instance, I recently spoke with Phil Fasano, CEO and co-founder of Bay Advisors, LLC, and former executive at Kaiser Permanente, and he noted that the size of many large healthcare providers is more like a city than a business, and they often employ temporary staff and contractors. When he was executive vice president and chief information officer at Kaiser in the early 2000s, the organization employed more than 300,000 people, with some 60,000 to 80,000 being temporary, such as contact center workers, custodians and administrative staff. In high turnover roles and with temporary staff, not only may there be a lower familiarization with compliance regulations and data security protocols, there may also be a greater willingness to skirt the rules for short-term gain. Thus it becomes even more imperative for businesses to have the right tools, technology and training in place in order to ensure data security and privacy – not only to comply with the law, but to protect patients and the long-term viability of their business.
This issue is not hypothetical. There have been many high-profile examples in the news of healthcare insiders stealing patient data to use for fraudulent purposes, or simply viewing it out of sheer curiosity, which is still a major violation. In a recent case of identity fraud, UMass Memorial Healthcare had to pay $230,000 to settle a lawsuit that resulted from two employees stealing patient information to open credit card and cellular phone accounts. In a truly egregious example from several years ago, an employee of the UCLA Medical Center leaked the late actress Farrah Fawcett’s cancer diagnosis to the National Enquirer before she even had the opportunity to break the news to family and friends herself. These cases are unfortunately not isolated incidents. Shockingly, a recent survey of healthcare workers found that one in five would be willing to sell confidential patient data if given the opportunity.
How to mitigate insider threats
First and foremost, healthcare organizations should institute mandatory background checks on all full-time, part-time and temporary hires – no exceptions. They should also aim to improve employee awareness and understanding of the laws by conducting annual training sessions and refreshers on all relevant data security and privacy regulations, including HIPAA, the General Data Protection Regulation (GDPR) and the Payment Card Industry Data Security Standards (PCI DSS) – this last one being especially important for patient billing and contact centers that handle payment card data. There are also several advanced technologies and strategies that an organization can implement to improve its defenses from insider threats, namely:
Establish staff guidelines for patient record access
The best way to avoid an internal compromise of sensitive information is to establish and enforce the principle of least privilege user access (LUA) on all computer systems, which states that an employee should only have the minimum level of access necessary to do their job. For example, an agent in the health system’s contact center may need access to some patient data such as payment or scheduling information, but they may not need to see information about medical history. Creating LUA controls limits unnecessary access and adds a strong, first level of security.
Monitor and flag staff access to patient data
Systems can include various levels of protection, from asking employees to enter password information twice before accessing confidential patient information, to red-flagging abnormal activity. Red-flagging provides an alert to senior staff of suspicious behaviors in the cases where an employee may be accessing large amounts of patient information or performing irregular activities within the network.
If you are looking for good business ideas, the healthcare industry should be your first option. The industry is a fantastic place for individuals with healthcare-related business ideas as well as aspiring entrepreneurs to invest in. Exploring these ideas is excellent for many reasons. There is an opportunity to serve the aging population in the country and helping individuals who are struggling with the drug crisis.
Currently, there are many technological and medical advances as well as widespread interests in health and wellness. All these are great incentives for healthcare entrepreneurs. Also, combining all these factors means that there is a thriving market for the health-related businesses and medical staffing network.
Aspiring entrepreneurs can convert one of the many health-related business ideas into viable ways to make a living. But before getting started, they need to understand how staffing, liability, and HIPAA guidelines play into their decision making since non-compliance can result in closures and fines depending on the severity of the violation. Here are the main healthcare businesses ideas that can help you invest in the industry:
Medical mobile screening
When thinking about a new healthcare-related business idea, then medical mobile screening is a good option for you since it requires less investment. Medical mobile screening is nothing but a simpler version of booking a physician’s appointment, ordering medicines, and scheduling vaccinations through the use of digitized technology.
This means that an individual can do all these activities without visiting a doctor or queuing for long hours while waiting for their turn to come up. From the business person’s point-of-view, this simplicity means far less overhead. Better yet, a medical staffing agency can be used to find worthy candidates from around the globe, further reducing business expenses by removing the need to headquarter everyone in the same location. The staff, just like the patients, can be situated virtually anywhere with an internet connection.
Retail pharmacy business
This business is the simplest and easiest way to venture in the healthcare industry. It is among the most flourishing and productive healthcare businesses in the sector today. If you are looking forward to establishing your own drug store business, you must a abide by the current regulations of the retail pharmacy business that manage and guide the stockpiling, sourcing supply, sale and recording keeping in regard to the HIPAA compliance.
Retail pharmacy business is the best for individuals planning to open a store in the vicinity of medical facilities since demand is more in such locations. The retail pharmacy business is among the growing and profitable healthcare business opportunities that never go out of consumers since they have daily use products.
Now that we are in 2019, its time to really take your health seriously. We aren’t talking about the usual “let’s lose a few pounds” as a New Year’s resolution; what we mean is taking advantage of the technology, information and health products available these days that can help your health today, tomorrow, and the rest of your life.
This is true whether you’re a young professional or a retiree, and it’s never too late to make some life-altering changes. Outline your goals beforehand and make a list of what you need to do to achieve them. With the advances in technology over the last several decades, staying on top of your health is easier than ever before.
If you’re retired, chances are your health needs are a bit different. Staying active is crucial, even if it’s only a walk around the neighborhood each day. This prevents muscle atrophy and weakness. If you’re struggling with movement and slowing down, consider investing in a remote monitoring with predictive analytics, especially if you live alone. These services can prove to be life-saving in the event of an emergency and it’s one way technology is helping to improve the quality of life for seniors. You can also make your home more mobility friendly if you have trouble getting around. This will limit the amount of stress you put on your body.
Caring for mental health
At least one in five Americans suffer from some form of mental illness, so chances are you know someone who does. Mental illness can lead to many devastating consequences including drug addiction, homelessness and relationship failures. The first step to getting help is recognizing that there’s a problem and getting a diagnosis from a qualified doctor as each diagnosis is treated differently in terms of medication and coping habits. There are many ways to get help including facilities that offer ACT therapy, rehabilitation and psychological help. In cases where medication and other forms of therapy fail, some doctors turn to TMS therapy, which uses an external electromagnet to stimulate the nerves in your brain that affect your mood. It sits on your head, offering a non-invasive method of treatment.
One of the most popular New Year’s resolutions–if not the most popular–is weight loss. Whether you have 5 or 50 pounds you want to lose, with a lot of hard work and dedication, you can make it happen. Try out new exercise routines streamed right to your smartphone or tablet via apps, and increase your activity to burn more calories in addition to overhauling your diet. It’s okay to indulge in sweets, but keep consumption to a minimum.
Technological innovations are helping medical experts advance and improve the healthcare industry. The advancements are not just quick, but also efficient. Some of the technologies allow healthcare professionals to diagnose diseases with 100 percent accuracy. Through technology and science, medical researchers are creating innovations that are improving, expanding and transforming the healthcare industry.
Technological advancements, like artificial intelligence, are aiding experts in creating new technologies in short periods. Also, machine learning applications are helping scientists analyze data incredibly fast. Here are the top medical technology breakthroughs this year:
When it comes to medical research and healthcare technology, radiology has been among the fastest growing sectors. Cutting-edge technological advancements and optimized manufacturing using Leading2Lean have enabled the creation of multi-functional systems that simultaneously diagnose a wide range of medical problems, symptoms, signs and biomarkers without being cost-prohibitive. Looking into the coming few years, both patients and physicians could see multi-functional MRIs, systems that detect the percentage of the cancerous cells in the body and a variety of other machines that offer an almost instantaneous diagnosis.
Smartphone applications and chatbots are currently making waves in the therapy field. It is another technological advancement that might bring mental health treatments back to human-to-human interactions. Teletherapy, which involves delivering therapeutic sessions by video-enabled interfaces, is probably an essential technological advancement of mental health.
As society becomes evolved about the roles of mental healthcare, the higher the demand will be on psychiatrists and therapists. When looking at 2018 in review, the number of healthcare providers, were not enough to meet the demand of the patients. The main problem with mental health is that demand is always higher compared to supply.
In almost every way, this technology is similar to traditional therapy. Patients visit their doctors and sit face-to-face with them and discuss the issue. But instead of a chair, patients use FaceTime and Skype or other video conferencing services. The benefit of teletherapy is that you will not travel to any place and you can have your session from wherever you are and whenever you are able.
Improved cancer recovery resources
Health experts are using cutting-edge genomics technology to diagnose and treat cancer while minimizing the utilization of radiation therapy. Experts forecast that the genomic sequencing technology will help revolutionize all aspects and processes of cancer treatment. As a result of the medical technology breakthroughs this year, scientists are developing new treatment techniques based on genomic alterations.
It began in the 1980s with those wonderful word processors. Electric typewriters bit the dust, and health records could be entered and saved on floppy discs. This was only the beginning.
We’ve come along way, baby. As technology came to disrupt every sector of the economy, healthcare was no exception. Consider all that has happened in this sector and where we are today.
Consolidated health records in the cloud
Anyone who has been to a doctor recently understands this. That doctor may have your entire health history, from multiple providers, all in one place. This technology allows any provider to provide better care protocols according to each individual’s unique history and make recommendations for testing, etc. that will not be duplicating those already done.
Patients can also access their full health histories and provide access to family members as well. This allows more control of patients over their own healthcare and allows them to make better decisions for future care.
Use of big data for treatment protocol decisions
Now that providers have access to health data from all over the globe, they can review research studies, identify effectiveness based on specific symptoms, DNA makeups, and more. The net effect is this: research from all over the world is now available through tools that gather data, churn it, categorize it, and provide reports based on specific queries. Ultimately, better care for all can occur because of this shared data. Amy Castello, a healthcare writer for Trust My Paper, says this: “I conduct a lot of research on a number of healthcare topics. One of the most interesting is the strides that have been made in the use of big data. I see a future of customized care solutions that
Use of AI and machine learning to identify and predict disease outbreaks
When artificial intelligence is applied to bag data gathering, environmental conditions can be analyzed for their contributions to disease outbreaks. Likewise, when there are higher than average disease conditions among certain demographics or in certain geographical areas, AI can analyze data and report common characteristics that may be contributing to those outbreaks.
Development of vaccines
Every year, a number of medical reporting organizations isolate the specific viruses that have resulted in flu outbreaks. All of this information is then physically reported during a consolidated meeting, and decisions are made for the next vaccine composition. Now, all of the data can be digitally reported, and the recommended vaccine compositions determined by the use of artificial intelligence. Ultimately, this can serve to reduce some of the human “guesswork” that now occurs.
A decade ago, patients had to travel to their doctors’ offices for regular checks on chronic conditions. Now, wearable devices provide ongoing data electronically, so that patients are monitored from home, with alerts to their doctors when conditions change that they might warrant an office visit or hospitalization. Getting real-time data of this sort not only increase efficiency of care but results in lower costs for both providers and patients.
Every person, from the newest employee to the CEO, can either strengthen or weaken an organization’s security posture. For this reason, healthcare companies need to help their employees take precautions against the latest ransomware scams, otherwise their organization may be the next ransomware victim.
One of the main reasons healthcare has become such fertile ground for ransomware hacks is the shift to digitalized personal healthcare records in a rapid time frame. Less than ten years ago, most physicians updated patient records manually and stored them in color coded file systems. By the end of 2017 industry data suggests that approximately 90 percent of office-based physicians have moved to electronic systems (electronic health records/electronic medical records) for the storage, retrieval and management of electronic health data. Virtually all of these systems are online and internet accessible. Electronic healthcare medical records really made the healthcare industry a perfect target for ransomware attempts.
But, the cost of a ransomware attack goes far beyond any extortion payment. When considering the associated costs including downtime, lost revenue, angry patients or customers, attack mitigation and recovery expenses, brand reputation damage, and non-compliance fines, in retrospect the cost of the ransom itself may seem trivial.
When United Kingdom’s National Health Service (NHS) was impacted by the global WannaCry outbreak of 2017, it brought hundreds of NHS facilities to a standstill for several days, resulting in the cancellation of thousands of appointments and operations, as well as the urgent relocation of patients from impacted emergency centers. In April 2017, Erie County Medical Center lost access to 6,000 computers due to a ransomware attack, which resulted in six weeks of manual operations and a recovery process that ultimately cost the medical center $10 million.
Unfortunately, security technologies can only do so much to protect your organization against an attack. Ransomware typically spreads through phishing emails or by visiting an infected website. Even the most advanced antivirus and anti-ransomware solutions can’t stop Fully UnDetectable (FUD) threats that were conceived by cybercriminals to directly evade existing security layers and harm data. In fact, the majority of ransomware victims have some traditional Anti-Virus and Anti-Malware protection in place and yet still fall prey to attacks.
Even if your organizations has backups, you may be surprised to find that you are still vulnerable. Today, many criminals do reconnaissance on their victim’s network and compromise backups before deploying the encrypting malware to increase the odds that the organization will pay the ransom.
But paying the ransom doesn’t always work out either. A study by the CyberEdge Group shows that of the 39 percent of ransomware victims who have paid, less than half recover their data. It also leaves the victimized organization vulnerable to another attack. If the root cause of the breach is not corrected, another day can bring another ransom request.
Ultimately, it is up to your organizational leaders to decide whether or not to pay. Healthcare organizations are a favorite target of cybercriminals because they are more likely to pay up when computer downtime can introduce life or death consequences. Regardless of your position on paying cybercriminals a ransom, the best strategy is to avoid being placed in a compromised position in the first place. But how?
Obviously, all healthcare organizations want to avoid being a ransomware victim, but cybersecurity is a complex problem that requires multiple layers of defenses. Small to medium size healthcare organizations are particularly vulnerable since many believe they don’t have adequate financial or technical resources to defend themselves against the onslaught attacks.
Industry experts estimate that a company with 50 employees may have to spend upward of $50,000 to deploy sophisticated endpoint technologies such as antivirus, anti-malware software and firewalls to keep intruders out and then thousands of dollars each year to keep everything up to date. Even when making this investment in security, it doesn’t guarantee a breach won’t happen. Just one wrong click by an employee is all it takes.
5 Ransomware Prevention Tips to Help Employees
In the face of this rapidly-growing threat, healthcare organizations should take concrete steps to deploy the technologies needed to protect systems from ransomware attacks. But employees need to educated on how ransomware is distributed and taught how to be cautious when clicking on online advertisements or email links, visiting a new website, and opening attachments from unfamiliar or suspicious senders.
Being a healthcare professional is an honor, but it’s not without its challenges. Most providers are required to work long hours with few breaks to provide adequate coverage to their patients. The fluctuating workload and constant exposure to life, death and everything in between essentially takes a toll both physically and psychological on healthcare professionals. Working in such a fast-paced, high-demand atmosphere almost non-stop can lead to employee burnout.
When doctors, nurses, or supporting staff becomes physically and emotionally exhausted as a result of work-related stress and pressures, it’s only a matter of time before there is a decline in their performance. Healthcare providers become overwhelmed and are unable to provide the high-quality of care and treatment their patients deserve. This puts the organization, provider, and patient at risk. Some, even become so consumed that they quit, leaving medical practices and hospitals understaffed (which creates higher risks for burnout in other staff who have to pick up the slack).
To minimize the risk of burnout in your healthcare organization, it is imperative to develop a workplace environment that supports the well-being of your staff. First, knowing when an employee is on the verge of a breakdown or burnout is vital. Some signs might include:
Emotional or physical fatigue
Overly sensitive or insensitive to emotional information
Lack of empathy or sympathy for their patients
Withdrawal or isolation
Lack of concentration
Careless or increased mistakes
Poor decision making
Drug or alcohol abuse
Frequent call outs
Get them help
The idea here is preventative measures but in the event that you notice a staff member struggling or experiencing the above-mentioned destructive behaviors like substance abuse, knowing where to send them for help is ideal. This includes recommending an addiction treatment center in Los Angeles or some other city where they can get affordable, confidential help with their addiction or dependency issues.
Other ways to help your providers
Healthcare organizations have a responsibility to ensure their providers are physically and mentally capable of providing adequate services to their patients. A major part of this means providing a working environment where staff members well-being is a priority and they feel supported, heard, and encouraged. Here are some things you can do:
Offer solutions to their problems
Your employees need to know that they have someone they can turn to if there are problems in the workplace. Upper management and/or the HR department need to not only make themselves available to listen but must be willing and ready to provide assistance where they can. Whether that’s helping them to resolve a conflict with a coworker, looking into more advanced technology to improve productivity and decrease their workload, or updating breakrooms to make them more accommodating, it is the responsibility of the organization to make sure that they are meeting the needs of their providers.
By Sean Otto, vice president of business development, Cyient.
The approval of electrocardiogram’s (EKG) through the FDA that enables atrial fibrillation detection right from a patient’s watch band is just one example of how the digitization of medical devices, a part of the Internet of Things movement, is leading product development and innovation in medicine. However, while medical devices built on a connected services platform include components for data storage, security, accessibility, and mobile applications, along with advanced analytics, successfully implementing artificial intelligence to drive actionable intelligence remains a challenge from an execution perspective.
According to Gartner, 85 percent of data science projects fail. Successful integration of data science into medical device development requires a rethinking around the role of data science in product design and life-cycle management.
Viewing data science as a product
While data science is rightly defined as the process of using mathematical algorithms to automate, predict, control or describe an interaction in the physical world, it must be viewed as a product. This distinction is necessary because, like any medical product, data science begins with a need and ends with something that provides clear medical utility for healthcare providers and patients.
It is erroneous to restrict the realm of data science to just the designing of algorithms. While data scientists are good at fitting models, their true value comes from solving real-world problems with fitted data models. A successful algorithm development process in data science includes business leaders, product engineers, medical practitioners, and data scientists collaborating to discover, design and deliver. For instance, a typical data science integration with a medical device product would include many of the following activities:
Identifying the medical need
Identifying proper data variables
Developing the right analytic models
Designing analytic algorithm integrations
Performing testing and verification
Deploying beta versions
Monitoring real-time results
Maintaining and updating algorithms
Considering data science as a product or feature of a product provides organizations with a different paradigm for execution focused on a tangible outcome. Data scientists are trained to develop accurate models that solve a problem, but the challenge many companies face is operationalizing those models and monetizing their outputs. Furthermore, conceptualizing data science as a product will ensure companies focus on its implementation, rather than just its development.
Advanced analytics: Part of the process, not an afterthought
Designing intelligence (even AI) into a connected medical device first depends on whether the data is being used to make a real-time decision or report on the outcome of a series of events. Most companies don’t realize the layers of advanced analytics that create actionable intelligence. By understanding these layers, which range from simple rule- and complex rule-based analytics to asynchronous event rules, complex event processing, and unsupervised learning models, companies can move quickly into developing mature analytics that have an impact from day one. As a company matures its analytics system from descriptive and diagnostic to predictive and prescriptive, it should also evolve to include strategic opportunities to provide business value, including automating decisions that can be delegated to a smart decision-support system.
Successful integration involves viewing advanced analytics as an architecture and not as a single solution to be implemented. The best way to make sure that you are successful in analytic development is to follow a continual process of discovery, design and delivery. For instance, data science architecture may begin with a business question, requiring you to determine if you have the right data and can actually leverage that data in the existing IT system. If you don’t answer this basic question, you will have challenges fully vetting the analytic opportunities available to you.
Recognizing common challenges in data science execution
Data science execution is often impaired by common missteps, like incongruence between customer and business needs and solving technical problems when it’s too late to have a positive impact. Another significant mistake from the business side is treating data science like a one-time accomplishment and not realizing it is a continuous process, or like a software development process with an unwarranted fixation on tools rather than skills and capabilities.