News Blog

Healthcare organizations' employees pose cybersecurity risk
Wednesday, April 19, 2017

Despite the growth in ransomware and phishing attacks, including several well-publicized events that have resulted in data systems being held hostage, healthcare organizations are only moderately concerned that a breach will affect patient care, according to a new survey.

The study, conducted by HIMSS Analytics for telecommunications company Level 3 Communications, revealed that just one-third of those surveyed said they were very concerned that a security breach would affect patient care in 2017. Already this year, more than 1.7 million patient records have been affected by breaches.

"We thought there would be a higher level of concern," said Chris Richter, Level 3's senior vice president of global security services, "but there wasn't." That's because organizations think they're already doing enough to mitigate risk, he said. The HIMSS Analytics data somewhat mirrors concerns raised by a recent survey by KLAS Research and the College for Healthcare Information Management Executives, which found that fewer than half of surveyed organizations have a vice president or C-suite executive leading cybsecurity efforts, and just under two-thirds talk about security quarterly at board meetings.

As cyberattacks continue to grow more sophisticated, healthcare systems must continue to strengthen their security. Among other things, providers are turning to cyber threat intelligence, which aims to identify threats before breaches occur, and DDoS mitigation, according to the HIMSS survey. The KLAS-CHIME study showed that 55% of respondents rely on encryption to secure their networks, followed by antivirus/malware systems at 42%. Providers are also using following the National Institute of Standards Technology Cybersecurity Framework, a collection of security guidance for private sector companies.
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Providers confront growing demand for instant access
Wednesday, April 19, 2017

Kim Dearnley couldn't call in sick after waking up recently with a sore throat.
As a computer trainer, she had limited sick days.
So she turned instead to the internet, where she found that the wait time was just 20 minutes at an Advocate Clinic at a Walgreens in her Chicago neighborhood.
She booked the appointment, made the five-minute walk, and was seen by a nurse within five minutes.
Dearnley, 30, lauded the convenience. "It's easy to get a same-day appointment at any time," she said. As for her primary-care physician, who was a half-hour bus ride away: "Good luck getting a same-day appointment unless you're there when they open and are put on the waitlist."

Dearnley's choice is increasingly the norm for a millennial generation that wants instant access to healthcare. They're also looking for a healthcare encounter that is frictionless, convenient and defined by good customer service. The younger generation—and many tech-savvy older Americans—are no longer willing to put up with the long wait times and inconvenient access points traditionally offered by large hospital systems and office-based physician networks.
And that is presenting a big challenge to major health providers such as Advocate, a Chicago-based healthcare system with a dozen hospitals and 1,500 employed physicians. It is among the many major players now looking to establish new access points for younger healthcare consumers, who give less weight to name brands or personal referrals than previous generations.

But many are late to the game. When it comes to meeting the new consumer expectation for speed and convenience, traditional players such as Advocate face mounting competition from stand-alone urgent-care centers, in-pharmacy health clinics and telehealth consultations. In some cities, there's even a return of on-demand home visits.

"As other players in the market begin to identify consumerism as an opportunity, they begin to accelerate their strategies," said Kelly Jo Golson, chief marketing officer for Advocate Health Care. "We don't want to be left behind."The fear of falling behind is pushing the healthcare industry toward broader adoption of instant access, said Kathy Hempstead, senior adviser to the executive vice president at the Robert Wood Johnson Foundation. "There tends to be a sort of groupthink in healthcare, and I imagine that all the major systems are going to make these changes."

The new model requires healthcare consumers be treated well and have a good experience. But judging by the numbers, few systems are succeeding today.

Only 32% of millennial respondents in a 2016 Accenture survey said they were "treated very well" in the healthcare system, compared to 35% of Generation X, 51% of baby boomers, and 72% of the silent generation. Millennials were also the least likely to find getting care to be convenient.
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Retail Clinics Create Stiffer Competition and Greater Fragmentation; Review 2017
Wednesday, April 19, 2017

Retail clinics are a convenient way for patients to visit a walk-in health care clinic. These clinics are located inside retail stores such as supermarkets and department stores. They are sometimes referred to as convenient care clinics. These clinics offer benefits similar to that offered by traditional clinics. They are usually staffed by nurses and physician assistants. Retail clinics provide medical services such as treatment for flu, cold, dehydration, fever, cough, diagnostic services, vaccination, laboratory tests, physiotherapy, and treatment for injuries.
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The real ROI of immunizations
Wednesday, April 19, 2017

Vaccinating my patients almost killed my practice last year. I didn’t have to read the 2012 American Academy of Pediatrics (AAP) article to know that the actual cost of providing vaccinations, including purchase and storage, is 17% to 28% more than the price we pay for the vaccine. That has been the case for most of my 20 years in independent practice.
The problem is that the cost of recommended vaccines has skyrocketed while the reimbursement (based on wholesale prices that are not available to my small-volume clinic) often doesn’t even cover the vaccines’ purchase price. Vaccinations are now the second-most expensive item—after payroll—for most practices of my size, and based on data from the AAP study, reimbursement can be up to 47% less than the actual purchase cost to the practice. How did we get here?
In 2015, when we were recommended to provide the already-expensive PCV13 pneumonia vaccination to all seniors, the price my clinic paid for that vaccine suddenly increased. Now it is almost 40% more than prior to the Advisory Committee on Immunization Practices recommendation. The same thing happened in 2005 when TDaP boosters were recommended for all adults, and again in 2016 when the HPV vaccine indication was extended for all children.
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The key to making virtual visits a digital success
Wednesday, April 19, 2017

Ami Bhatt, MD, a cardiologist at Massachusetts General Hospital, had her first video visit three years ago, with a patient who lived on the island of Nantucket. The man, who had atrial fibrillation and a long surgical history, found it difficult to travel to Boston for checkups.
Bhatt found it disconcerting to treat the patient remotely at first. But after a few video visits with him and his family, Bhatt discovered that she felt comfortable with the setup. The patient was able to come into the office for tests, she notes, but it was much easier for him to do the follow-ups from home.
Since then, virtual visits have become a regular feature of Bhatt’s practice. She does two to seven of them per week—and some of her colleagues at the hospital have followed suit.
“The patient satisfaction for virtual visits has been through the roof,” says Bhatt, director of outpatient services for cardiology and head of the department’s telemedicine program. “And the physician satisfaction we’ve seen here has been great as well…Telemedicine is not a replacement for in-person visits, but it’s definitely an addition to our armamentarium of how to care for patients.”
Telemedicine made a splash in the consumer space via services that let people consult with doctors other than their own from their smartphones. Now it is poised to sweep through major healthcare systems.
While few private practice doctors are doing virtual visits with their patients yet, it is a trend they should be aware of, because the competition from hospital-employed doctors is about to get a lot more intense in some areas as the latter start using telemedicine.
Here’s what’s happening in this burgeoning field, where it’s going and what independent physicians need to know about it.
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Online Reviews Gauge Patient Satisfaction Tips from author of 'The Totally Wired Practice'
Wednesday, April 19, 2017

In this edition of "The Wired Practice," Ron Harman King of Vanguard Communications discusses why patient satisfaction is much more important than bedside manner, and the three steps to address online complaints.

To Watch:   ...

G.O.P. Bill Would Make Medical Malpractice Suits Harder to Win
Wednesday, April 19, 2017

WASHINGTON — Low-income people and older Americans would find it more difficult to win lawsuits for injuries caused by medical malpractice or defective drugs or medical devices under a bill drafted by House Republicans as part of their plan to replace the Affordable Care Act.
The bill would impose new limits on lawsuits involving care covered by Medicare, Medicaid or private health insurance subsidized by the Affordable Care Act. The limits would apply to some product liability claims, as well as to medical malpractice lawsuits involving doctors, hospitals and nursing homes.
Sean Spicer, the White House press secretary, said the bill would limit “frivolous lawsuits that unnecessarily drive up health care costs.”
But Democrats and plaintiffs’ lawyers said it would take rights away from people served by federal health programs, including those harmed by horrific medical mistakes.

In renewing their effort to devise a replacement for the Affordable Care Act, Republicans say one chief aim is to slow the growth of health spending. Representative Robert W. Goodlatte, Republican of Virginia and the chairman of the House Judiciary Committee, said the malpractice limits would reduce health costs, increase access to care and save taxpayers billions of dollars.
The nonpartisan Congressional Budget Office estimates that the bill would reduce federal budget deficits by almost $50 billion over 10 years. Under the bill, the budget office said, doctors would slightly decrease the use of diagnostic tests and other services that they perform to reduce their exposure to lawsuits. Doctors have long said such “defensive medicine” adds to the cost of care.
But Representative Jamie Raskin, Democrat of Maryland, said the bill would deny full restitution to many victims of medical malpractice. Representative Steve Cohen, Democrat of Tennessee, said the bill’s restrictions would apply even in cases of “egregious medical error,” such as when a foreign object is left inside a patient’s body or surgery is performed on the wrong body part.
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You know CPR. Now firefighters want you to treat shooting and bombing victims
Wednesday, April 19, 2017

The images they were about to see would be gruesome: a woman bleeding out at the Boston Marathon, a video of a terrorist repeatedly stabbing a stranger. But the speaker asked the audience not to avert their eyes.
“You have to move past the fear, the terror, the disgust, and be very clinical about this and get to work,” said Rancho Cucamonga Fire Capt. Patrick Lewis.
For the last year, Rancho Cucamonga’s fire and law enforcement officials have teamed up to teach civilians how to triage and tie tourniquets on shooting victims, in the same way CPR is taught in case of emergencies.
They believe that people armed with these skills can save lives because they’re often the first ones at a crime scene. Many of those injured in the Boston Marathon bombing survived in part because bystanders started creating makeshift dressings and tourniquets before paramedics showed up, experts say.
“Who’s going to make the biggest difference? You guys,” Lewis told the group gathered on a recent Thursday evening.
Teaching civilians these battlefield techniques acknowledges what Lewis described as a sad reality: the near inevitability of shootings and terrorism.
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GAO: Medicare policies hampering telehealth, remote patient monitoring use
Wednesday, April 19, 2017

While telehealth and remote patient monitoring can help improve healthcare outcomes for Medicare beneficiaries, payment and coverage restrictions are creating barriers that are hampering the utilization of these technologies.
That’s the core finding of a new audit by the Government Accountability Office.
Auditors reported that Medicare providers use telehealth services for a small proportion of beneficiaries and relatively few services. And, when it comes to remote patient monitoring, the GAO said the number of Medicare beneficiaries who use this service is unknown due to insufficient data.
The Medicare Access and CHIP Reauthorization Act of 2015 included a provision for GAO to study telehealth and remote patient monitoring. Toward that end, GAO auditors interviewed representatives from nine stakeholder associations—six provider, two patient, and one payer association—in putting together their report to congressional committees.
“With regard to factors that create barriers, the selected associations most often cited concerns over payment and coverage restrictions,” states the GAO’s report. “Officials from a provider association reported that Medicare’s telehealth policies for payment and coverage lag behind other payers due to the program’s statutory and regulatory restrictions. In particular, these restrictions limit the geographic and practice settings in which beneficiaries may receive services, as well as the types of services that may be provided via telehealth and the types of technology that may be used.”
Further, officials from another provider association described coverage as the single greatest barrier to the use of telehealth, adding that Medicare’s restrictions on the types of services covered by the program have prohibited its broader use. When it comes to remote patient monitoring, officials from another provider association stated that Medicare’s valuation methodology for services results in low payment rates for remote patient monitoring, which these officials said remains a principal barrier to the use of these services.
Similarly, infrastructure requirements were called out as a “very significant or somewhat significant” barrier to the use of both telehealth and remote patient monitoring in Medicare. For example, officials from one provider association and both patient associations interviewed by auditors described access to sufficiently reliable broadband Internet service as a barrier to telehealth use.
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New system finds stolen health data on the Dark Web
Wednesday, April 19, 2017

With health data breaches reaching epidemic proportions, healthcare organizations are resigning themselves to the fact that losing sensitive data to hackers is inevitable. It’s no longer a question of if they will become victims of data theft, but when it will happen.
A popular destination for such data is the Dark Web, the nefarious online marketplace where it is bought and sold. However, the problem is that the average breach takes more than 200 days to discover—long after the damage has occurred.
But, one vendor claims they can shorten detection times from months to just hours and notify organizations when their data shows up on the Dark Web. Baltimore-based Terbium Labs claims to have the world’s first fully private, fully automated data intelligence system—called Matchlight—that instantly locates stolen data on the Dark Web as soon as it appears.
“Matchlight knows the instant your information appears some place it shouldn’t,” declares the Terbium Labs website. “We create private fingerprints of your sensitive data, allowing us to monitor for breaches securely. Matchlight’s automated system constantly scans the Dark Web allowing us to quickly alert you when and where your data appears so you can take action.”
Danny Rogers, co-founder and CEO of Terbium Labs, contends that no matter what organizations do their data is always at risk from motivated cyber criminals, especially in the healthcare industry where there is so much valuable data floating around.
“If you take somebody’s healthcare record, you have a lot of information about them that can be exploited, which is why we tend to see them sold at a much higher premium.”

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