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Connected medical devices experts highlight IoT remote monitoring

BOSTON — Healthcare facilities can advance their patient care with IoT remote monitoring if manufacturers understand how to develop and use connected medical devices.

Medical IoT remote monitoring “will change the way you do service, the way your customers perceive you, not just you, but your products. They become reliant on the network of things that you provide them, not just the transaction,” said Anthony Moffa, senior director of ThingWorx IIoT Platform at PTC.

IoT remote monitoring gives manufacturers access to real-time information from the field that is unfiltered and unbiased, which they can use to secure and maintain connected medical devices. Devices can transmit data back to manufacturers on key performance indicators — such as power settings or the number of times a device was turned on and off — that they can use to improve connected medical devices. Engineers don’t have an easy time observing their devices in the field consistently, but anyone can sit in front of their laptop and see how devices perform, said Paul O’Connor, director of medical development at Boston Engineering.

Moffa and O’Connor were among the experts discussing considerations for connected medical device manufacturers during the panel “How to leverage IIoT to improve medical device innovation and user insights,” which was held on Dec. 10. It was hosted by Boston Engineering, the Massachusetts Medical Device Industry Council and PTC.

[Medical IoT remote monitoring] will change the way you do service, the way your customers perceive you, not just you, but your products.
Anthony Moffaenior director, ThingWorx IIoT Platform at PTC

Here is a rundown of the event’s expert advice on how to address problems before IoT development begins, how to secure medical devices and the importance of identifying the needs that remote monitoring connected medical devices can address.

How to get started with remote monitoring for medical IIoT devices

Organizations often introduce IoT remote monitoring for connected medical devices with the intent to improve their products and differentiate themselves from the competition. Remote monitoring with IoT might have to overcome resistance.

“Somebody has to own [the project] and you have to have coordination between all your team members, so service, marketing operations, the R&D side; they all have to work together. If they don’t, it’s going to be an uphill battle,” Moffa said.

During IoT remote monitoring, developers should try to answer several questions:

  • Do you really know how your customers are using the product?
  • What settings do they actually use?
  • What is the optimal proactive maintenance schedule?
  • Do the components perform in a way that meets their needs?
  • How has device use changed since introduction?
  • Is the product over-engineered?

Developers can now track the data to answer these questions from around the world and apply the real-time insights and feedback to the next generation of the product.

“Think of your own product line and what you want to know about how your products are being used. Think about what you need first versus how [IoT remote monitoring technology] can help me,” O’Connor said. “You can test for years and not actually get real-time data on a global basis.”

Organizations might also see resistance from their customers. IT pros could see connected medical devices and remote monitoring as a threat to network security. The manufacturers must show how the device will bring value to the hospital, show how it’s secure and why it won’t put the network at risk, Moffa said.

Connected products typically have some built-in security processes. For example, all IT pros must make sure to encrypt communications and safely pair devices. When devices have basic security measures, adding remote monitoring security for post-market surveillance is a low security risk, said Elizabeth Couture, security software engineer at Geisel Software. Hackers won’t be particularly interested in data about what the current pressure on a sensor is or what firmware the device is running, which is the data that a device manufacturer would want from IoT remote monitoring. When manufacturers have continued access to deployed devices, they can increase the security of the product through processing device data with behavioral analytics to pick out deviations from the normal device use.

Create a culture of security

For something to be secure, the whole team must secure the product, including different engineering and support groups when it’s developed, designed and implemented outside of the facility.

“[Medical IIoT device manufacturers] need to have a culture of security. Security is not a thing you do once and then you are done with it. And it’s not a thing that you can slap on the end of the finished product,” said Elizabeth Couture.

Most hacks today are caused when attackers find bugs in widely used software from trusted organizations that are implemented on devices, said Couture. The organization that made the software announces that they have a fix for the bug, which makes applying updates critical. Organizations must plan how to update devices in the field, otherwise they will have a security hole that the entire internet knows about.

Steps to tackle security challenges
Follow these steps to prepare for security challenges.

Organizations must apply layered security and not treat medical devices as if they exist in a lockbox that no hacker will ever break into. A malicious actor should not be able to command the medical IIoT device to do dangerous things or access any patient data. By the time a medical device passes all Food and Drug Administration procedures, it’s usually 15 years old, Couture said.

“I wouldn’t trust a 15-year-old computer to buy it off the shelf. You have to be so sure that everything is safe, and that means that we need to assume that something will go wrong in the future,” she said.

When dealing with a larger number of connected medical devices, it’s important to make sure that devices have an incredibly narrow application to secure the multitude of endpoints that consumable items represent, Couture said. IT pros might be tempted to be lax on security for consumer devices, but they must tighten restrictions to prevent malicious actors from accessing the whole network through a device.

The best way to restrict application use on a medical device is to have very strict controls on the API, Moffa said. Limit the ability to use the device connection to go onto other networks, because as soon as a device connects to multiple different networks, malicious actors have a larger surface area to initiate a potential attack, he said.

Another way that organizations can improve their device security is to have other IT pros attempt to hack it. Smaller organizations might have to hire an outside expert if they don’t have people internally who focus on cybersecurity. Even having someone from a different group in an internal team attempt to hack a device will uncover security holes, Couture said.

“People used to approach cybersecurity as if ‘I am the best at building walls. I will build this wall around the product and everything is safe because I’m really good at that.’ But nowadays it’s not just about building good walls, it’s about learning the skills that a hacker would actually use to attack a product and attacking your product,” she said.

Keep the customer in mind, no matter the use of remote monitoring

Remote monitoring with IoT starts with user needs and adds value for them, said Raj Sivakumar, global product director at Hologic. Remote monitoring can improve the reliability of technology. When organizations use IoT remote monitoring for predictive maintenance, field engineers can identify when a component is going to fail and replace it without any downtime. With analytical tools, medical device users can take advantage of the device utilization rates to understand if their team uses the devices optimally or if they need more training.

“By adding IoT to this environment you’re able to increase the throughput of your technicians, because you can do some things remotely. You might walk a customer through a workflow on a screen, rather than physically,” Moffa said.

The data provided through remote monitoring gives engineers information for maintaining devices. IoT sensors can record the temperature and other variables that would inhibit or show the decline of medical devices. For example, without remote monitoring, an anesthesia machine in an operating room could fail when a patient is under. The patient must be moved to another room and hooked up to another machine. The time under anesthesia is increased, which means there is more risk for the patient. IoT predictive maintenance is critical from a risk management perspective in healthcare, Sivakumar said. If technicians know a machine will fail well ahead of time, they can apply this change. Eliminating downtime means patients spend less time in the hospital, which decreases their chances of getting sick from something they didn’t come in with.

“You could talk to people about the issues they have [with your device]. There’s no aversion to doing that; Everyone thinks it’s a good idea,” O’Connor said. “But it’s being able to define a starting point. Start small with something that you can control and have access to.”

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Promises for 5G in healthcare are great, but it’s still early days

Imagine a patient lying on an operating table, a robotic arm hovering above, transmitting real-time video to a doctor who is 300 miles away performing the operation.

Although it’s years away from reality, remote robotic surgeries like this may be possible, thanks to the high-speed, low-latency capabilities of the fifth-generation cellular wireless network, according to Chris Antlitz, a telecom analyst at consultancy Technology Business Research Inc.

“There are all kinds of different use cases for 5G in healthcare, some of them are a little more science fiction-y than others,” he said.

As with the arrival of previous generations of wireless networks, carriers like Verizon Wireless and AT&T are touting the benefits of a 5G network, including connecting more devices to the bandwidth, faster real-time connections and less buffering. The potential seems great, but it’s still early days. The network is only just being rolled out.

Analysts believe it will be at least three years before the 5G network gains traction and more widespread commercial availability, but even longer before it takes hold in healthcare. While healthcare CIOs don’t need to decide whether to invest now, experts say it’s not too soon to start planning and talking to carriers.

What is 5G?

There are all kinds of different use cases for 5G in healthcare, some of them are a little more science fiction-y than others.
Chris AntlitzTelecom analyst, Technology Business Research

5G is an upgrade to the current fourth-generation (4G) Long-Term Evolution (LTE) wireless network.

The 5G network will transmit data at a theoretical peak of 20 GBps, while 4G only reaches a peak speed of 1 GBps. Latency, or the delay before data transfer, is also expected to drop from 10 milliseconds with 4G to 1 millisecond with 5G. The new network will offer more available bandwidth, which means an uptick in the amount of data transmitted.

The 5G network will rely on small cells, or wireless transmitters and receivers, to transmit large amounts of data at high speeds over short distances. According to Verizon’s website, the carrier has spent the last several years building out small cell sites in towns and cities to enhance the current 4G LTE network, while also laying the groundwork for 5G. While cell towers provide coverage over long distances, small cells enable stronger coverage in more densely populated areas.

Small cell technology supports transmitting signals over millimeter wave spectrum, a high-frequency radio wave with a short range that the 5G network will use to transmit more data at faster speeds. Small cells are roughly the size of a mini fridge, according to Verizon, and are mounted on tall structures, like utility poles and rooftops.

“It’s going to be faster,” Antlitz said. “Your download times are going to get lower. There’s going to be less latency, so the buffering is going to be practically nonexistent when you’re downloading files or streaming.”

Rajesh Ghai, research director for IDC’s carrier network infrastructure research program, said 5G’s abilities to connect more devices and people together will affect some areas of healthcare, such as virtual reality. Yet these new capabilities will require 5G network slicing, which Ghai said won’t occur for the next two to three years.

Network slicing enables a carrier to offer customers a virtual network or a portion of the network to attain, in the case of 5G, greater speed and data capacity. Doing so would mean a healthcare organization could continue to be a 4G LTE shop but use 5G for specific use cases, he said.

5G could benefit existing capabilities in healthcare

The 5G network will enhance existing capabilities in healthcare, and Technology Business Research’s Antlitz believes CIOs should look to telemedicine as a “low-hanging fruit” and initial 5G use case.

“5G can revolutionize healthcare from that perspective,” Antlitz said. “It’s basically just video conferencing. It’s a real-time, high-resolution, no buffering type experience that you can’t get with 4G.”

5G features and benefits for healthcare

Jeff Becker, an analyst at Forrester Research, echoed Antlitz’s comments. He said telehealth is limited by low speeds and internet connectivity issues, especially in rural areas.

“We would see 5G as an opportunity to alleviate that problem,” he said. “Expanding access to high-speed internet to support telehealth is one area where you’ll see folks starting to get excited.”

Becker said another area of impact for 5G in healthcare is remote patient monitoring, which is closely coupled with telehealth.

Remote monitoring tools are already used today, but 5G will expand monitoring capabilities, Becker said. Today, patients with diabetes log their blood sugar levels over time and then bring the logs to their next appointment. Next-generation monitoring tools will feed data in real time into a healthcare organization’s cloud portal where it’s analyzed by AI algorithms. But because of the volume of data generated, the tools require more bandwidth, something 5G brings to the table, he said.

“In remote areas where we’re limited on how well we can stand up remote patient monitoring programs, there’s another area for opportunity,” he said.

Antlitz believes cutting the wire on medical devices such as X-rays and MRIs within a hospital environment is another potential use case, saying that it “opens up all kinds of different scenarios in terms of why 5G could be superior to how we’ve been processing and transmitting data that comes in from this equipment.”

According to a letter from the College of Healthcare Information Management Executives (CHIME), making medical diagnostic equipment mobile so that they can be taken to patients’ rooms will result in productivity gains. The letter, sent to a Senate subcommittee in February, detailed where CHIME officials foresee the greatest impacts of 5G in healthcare.

Making the impossible, possible

While telemedicine and remote patient monitoring may provide some of the first concrete use cases for 5G in healthcare, the new network is also being tied to more far-fetched capabilities as well, such as remote surgery.

IDC’s Ghai said doctors will potentially be able to operate on patients from remote locations, thanks to 5G’s promises of reduced latency, as well as instant high-definition image transmission.

Although more of a skeptic, Forrester’s Becker said the advancement in remote surgery could play a significant role in war zones or natural disaster areas where the hardwire infrastructure has been compromised.

Frost & Sullivan analyst Michael Jude was even more skeptical. He said healthcare organizations would be “crazy” to try remote surgery over a wireless network. Connection reliability rather than latency is a bigger issue, he said.

Although carriers say 5G will be more reliable than 4G, Jude said the required antenna density to perform something like a remote surgery would be “extraordinary,” and antennas would have to be built on “practically everything.”

“I would characterize telesurgery by wireless as being sometime in the not near future because I think it would be really hard to do with any kind of acceptable reliability,” Jude said.

Remote surgery isn’t the only sci-fi example of using 5G in healthcare. Layering artificial intelligence and virtual reality with a 5G network could further enable haptic technology, or artificial touch technology, Antlitz said.

If a small camera inserted into a patient’s brain transmits a 5G signal, AI algorithms can create a three-dimensional model of the brain in virtual reality, helping the doctor better identify anomalies such as tumors. Traditionally, doctors look at a two-dimensional screen, Antlitz said.

“With two-dimensional, you lose some of the depth perception and you can’t see certain things, like around corners, and the veins, their trajectories within that environment,” he said. “So it could improve patient outcomes dramatically.”

And yet despite the promises of 5G in healthcare and despite the new network’s potential impact on the industry, analysts caution CIOs: The road ahead is still long.

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Discover how Microsoft 365 can help health providers adapt in an era of patient data protection and sharing

For years, patient data management meant one thing—secure the data. Now, healthcare leaders must protect and openly share the data with patients and with other healthcare organizations to support quality of care, patient safety, and cost reduction. As data flows more freely, following the patient, there’s less risk of redundant testing that increases cost and waste. Legacy infrastructure and cybersecurity concerns stand on the critical path to greater interoperability and patient record portability. Learn how Microsoft 365 can help.

Impact of regulatory changes and market forces

Regulatory changes are a big driver for this shift. Through regulations like the 21st Century Cures Act in the United States, healthcare organizations are required to improve their capabilities to protect and share patient data. The General Data Protection Regulation (GDPR) in the European Union expands the rights of data subjects over their data. Failing to share patient data in an effective, timely, and secure manner can result in significant penalties for providers and for healthcare payors.

Market forces are another driver of this shift as consumers’ expectations of omni-channel service and access spill over to healthcare. This augurs well for making the patient more central to data flows.

There are unintended consequences, however. The increasing need to openly share data creates new opportunities for hackers to explore, and new risks for health organizations to manage.

It’s more important than ever to have a data governance and proactive cybersecurity strategy that enables free data flow with an optimal security posture. In fact, government regulators will penalize healthcare organizations for non-compliance—and so will the marketplace.

How Microsoft 365 can prepare your organization for the journey ahead

Modernizing legacy systems and processes is a daunting, expensive task. Navigating a digitized but siloed information system is costly, impedes clinician workflow, and complicates patient safety goals.

To this end, Microsoft Teams enables the integration of electronic health record information and other health data, allowing care teams to communicate and collaborate about patient care in real-time. Leading interoperability partners continue to build the ability to integrate electronic health records into Teams through a FHIR interface. With Teams, clinical workers can securely access patient information, chat with other team members, and even have modern meeting experiences, all without having to switch between apps.

Incomplete data and documentation are among the biggest sources of provider and patient dissatisfaction. Clinicians value the ability to communicate with each other securely and swiftly to deliver the best informed care at point of care.

Teams now offers new secure messaging capabilities, including priority notifications and message delegation, as well as a smart camera with image annotation and secure sharing, so images stay in Teams and aren’t stored to the clinician’s device image gallery.

Image of phone screens showing priority notifications and message delegation.

What about cybersecurity and patient data? As legacy infrastructure gives way to more seamless data flow, it’s important to protect against a favorite tactic of cyber criminals—phishing.

Phishing emails—weaponized emails that appear to come from a reputable source or person—are increasingly difficult to detect. As regulatory pressure mounts within healthcare organizations to not “block” access to data, the risk of falling for such phishing attacks is expected to increase. To help mitigate this trend, Office 365 Advanced Threat Protection (ATP) has a cloud-based email filtering service with sophisticated anti-phishing capabilities.

For example, Office 365 ATP provides real-time detonation capabilities to find and block unknown threats, including malicious links and attachments. Links in email are continuously evaluated for user safety. Similarly, any attachments in email are tested for malware and unsafe attachments are removed.

Image of a message appearing on a tablet screen showing a website that has been classified as malicious.

For data to flow freely, it’s important to apply the right governance and protection to sensitive data. And that is premised on appropriate data classification. Microsoft 365 helps organizations find and classify sensitive data across a variety of locations, including devices, apps, and cloud services with Microsoft Information Protection. Administrators need to know that sensitive data is accessed by authorized personnel only. Microsoft 365, through Azure Active Directory (Azure AD), enables capabilities like Multi-Factor Authentication (MFA) and conditional access policies to minimize the risk of unauthorized access to sensitive patient information.

For example, if a user or device sign-in is tagged as high-risk, Azure AD can automatically enforce conditional access policies that can limit or block access or require the user to re-authenticate via MFA. Benefitting from the integrated signals of the Microsoft Intelligent Security Graph, Microsoft 365 solutions look holistically at the user sign-in behavior over time to assess risk and investigate anomalies where needed.

When faced with the prospect of internal leaks, Supervision in Microsoft 365 can help organizations monitor employees’ communications channels to manage compliance and reduce reputational risk from policy violations. As patient data is shared, tracking its flow is essential. Audit log and alerts in Microsoft 365 includes several auditing and reporting features that customers can use to track certain activity such as changes made to documents and other items.

Finally, as you conform with data governance regulatory obligations and audits, Microsoft 365 can assist you in responding to regulators. Advanced eDiscovery and Data Subject Requests (DSRs) capabilities offer the agility and efficiency you need when going through an audit, helping you find relevant patient data or respond to patient information requests.

Using the retention policies of Advanced Data Governance, you can retain core business records in unalterable, compliant formats. With records management capabilities, your core business records can be properly declared and stored with full audit visibility to meet regulatory obligations.

Learn more

Healthcare leaders must adapt quickly to market and regulatory expectations regarding data flows. Clinical and operations leaders depend on data flowing freely to make data-driven business and clinical decisions, to understand patterns in patient care and to constantly improve patient safety, quality of care, and cost management.

Microsoft 365 helps improve workflows through the integration power of Teams, moving the right data to the right place at the right time. Microsoft 365 also helps your security and compliance posture through advanced capabilities that help you manage and protect identity, data, and devices.

Microsoft 365 is the right cloud platform for you in this new era of patient data protection—and data sharing. Check out the Microsoft 365 for health page to learn more about how Microsoft 365 and Teams can empower your healthcare professionals in a modern workplace.

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Author: Microsoft News Center

Social determinants of health data provide better care

Social determinants of health data can help healthcare organizations deliver better patient care, but the challenge of knowing exactly how to use the data persists.

The healthcare community has long-recognized the importance of a patient’s social and economic data, said Josh Schoeller, senior vice president and general manager of LexisNexis Health Care at LexisNexis Risk Solutions. The current shift to value-based care models, which are ruled by quality rather than quantity of care, has put a spotlight on this kind of data, according to Schoeller.

But social determinants of health also pose a challenge to healthcare organizations. Figuring out how to use the data in meaningful ways can be daunting, as healthcare organizations are already overwhelmed by loads of data.

A new framework, released last month, by the not-for-profit eHealth Initiative Foundation, could help. The framework was developed by stakeholders, including LexisNexis Health Care, to give healthcare organizations guidance on how to use social determinants of health data ethically and securely.

Here’s a closer look at the framework.

Use cases for social determinants of health data

The push to include social determinants of health data into the care process is “imperative,” according to eHealth Initiative’s framework. Doing so can uncover potential risk factors, as well as gaps in care.

The eHealth Initiative’s framework outlines five guiding principles for using social determinants of health data. 

  1. Coordinating care

Determine if a patient has access to transportation or is food is insecure, according to the document. The data can also help a healthcare organization coordinate with community health workers and other organizations to craft individualized care plans.

  1. Using analytics to uncover health and wellness risks

Use social determinants of health data to predict a patient’s future health outcomes. Analyzing social and economic data can help the provider know if an individual is at an increased risk of having a negative health outcome, such as hospital re-admittance. The risk score can be used to coordinate a plan of action.

  1. Mapping community resources and identifying gaps

Use social determinants of health data to determine what local community resources exist to serve the patient populations, as well as what resources are lacking.

  1. Assessing service and impact

Monitor care plans or other actions taken using social determinants of health data and how it correlates to health outcomes. Tracking results can help an organization adjust interventions, if necessary.

  1. Customizing health services and interventions

Inform patients about how social determinants of health data are being used. Healthcare organizations can educate patients on available resources and agree on next steps to take.

Getting started: A how-to for healthcare organizations

The eHealth Initiative is not alone in its attempt to move the social determinants of health data needle.

Niki Buchanan, general manager of population health at Philips Healthcare, has some advice of her own.

  1. Lean on the community health assessment

Buchanan said most healthcare organizations conduct a community health assessment internally, which provides data such as demographics and transportation needs, and identifies at-risk patients. Having that data available and knowing whether patients are willing or able to take advantage of community resources outside of the doctor’s office is critical, she said.

Look for things that meet not only your own internal ROI in caring for your patients, but that also add value and patient engagement opportunities to those you’re trying to serve in a more proactive way.
Niki BuchananGeneral manager of population health management, Philips Healthcare

  1. Connect the community resource dots

Buchanan said a healthcare organization should be aware of what community resources are available to them, whether it’s a community driving service or a local church outreach program. The organization should also assess at what level it is willing to partner with outside resources to care for patients.

“Are you willing to partner with the Ubers of the world, the Lyfts of the world, to pick up patients proactively and make sure they make it to their appointment on time and get them home,” she said. “Are you able to work within the local chamber of commerce to make sure that any time there’s a food market or a fresh produce kind of event within the community, can you make sure the patients you serve have access?”

  1. Start simple

Buchanan said healthcare organizations should approach social determinants of health data with the patient in mind. She recommended healthcare organizations start small with focused groups of patients, such as diabetics or those with other chronic conditions, but that they also ensure the investment is a worthwhile one.

“Look for things that meet not only your own internal ROI in caring for your patients, but that also add value and patient engagement opportunities to those you’re trying to serve in a more proactive way,” she said.

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Virtual nurse aims to reduce readmissions after discharge

“Are you a Red Sox fan?” nurse Elizabeth asked her patient with a curious look. “I would really like to see a game someday, but they don’t allow computers at Fenway Park.”

Elizabeth is a virtual nurse appearing on a screen. Starting a casual conversation, she can gradually explain discharge instructions to her patients, who converse by picking what they want to say in the chat boxes on the right side of the screen at each point of the conversation.

The virtual discharge nurse software is one example of how technology can help reduce 30-day readmissions in hospitals.

Readmission has long been a concern for healthcare providers because these rates impact patient outcomes and potentially reduce reimbursements from CMS. As a focus of inpatient clinical care, readmission comes out on top at 21.6% on the list of “areas most in need of improvement” concerning patient safety, according to a survey conducted by Health Catalyst, a data analytics and decision-support company.

To reduce avoidable return trips to the hospital, one factor to take into account is “effective communication and troubleshooting after the patient has gone home and try to head off problems that might cause complications and lead to readmission,” said Timothy Bickmore, a professor at the College of Computer and Information Science at Northeastern University. Although hospitals can track patients’ health conditions by text messages and phone calls, these may not be the most effective approaches.

Another effort hospitals could make is to ramp up patient education when they are discharged by employing automated software, in which case a virtual nurse can come into play. Bickmore developed the software behind Elizabeth the virtual nurse, and the program has been trialed at Boston Medical Center.

Elizabeth walks her patients through their discharge process by using sympathetic speech and animation. A typical interaction lasts about half an hour, much longer than the average eight minutes a human nurse spends with a patient on the same process, according to research conducted by Bickmore and Brian Jack, an associate professor at the School of Medicine at Boston University.

“Even for well-educated patients, [eight minutes] is probably not good enough,” Bickmore said. “For the one-third of U.S. adults who have low health literacy and difficulty reading medical instructions, they really need a lot more time.”

With Elizabeth, patients can choose “Excuse me?” or “Need more information” from the menu and let the virtual nurse repeat or elaborate information they don’t understand. The explanation by the virtual nurse can be in great detail for the sake of patient education, which includes the time to take medicine and its dose, how to take it, scheduling follow-up appointments and advice on buying an over-the-counter medicine that could have two different names in a pharmacy.

Virtual nurse software is not only a boon to patients, but also a resolution to nurse burnout.

“[The virtual nurse] would cast the patients’ comprehension and make sure they understood certain key information. And then it would print out a list of action items for the human discharge nurse to review afterwards and have more focused conversations with patients about their issues,” Bickmore said.

According to Bickmore and Jack’s trial of over 750 patients at Boston Medical Center, the software showed a high level of patient satisfaction. When asked whom they would rather receive discharge instructions from, most of the trial patients preferred getting it from a virtual nurse.

Virtual nurse software is not only a boon to patients, but also a resolution to nurse burnout. A randomized trial conducted by Jack in 2009 showed that to significantly reduce 30-day readmissions, a nurse needs to spend on average one hour with each patient explaining the discharge instructions. And shortly after discharge, nurses often need to call their patients to solve additional problems. If hospitals use automated discharge software, human nurses can focus on specific issues patients may have.

Regarding the possible improvements of the virtual nurse software, Bickmore would like to see it provide continuous services to patients at home.

“If we could put it on their smartphones, when they leave the hospital and have questions or problems, they can continue having the conversation. That is, of course, the ideal situation,” he said.

Bickmore’s software has not been produced commercially, although a couple of IT companies have pulled licenses to use the software.

News briefs: Study outlines best practices for patient matching

A new, revised document detailing best practices for patient matching between health information exchange partners was released earlier this month by The Sequoia Project, a nonprofit organization chartered to advance the implementation of secure health information exchange nationwide.

The document, titled “A Framework for Cross-Organizational Patient Identity Management 2018,” includes a case study that illustrates a healthcare organization’s patient-matching success rate improving from 10% to 95%; it also draws a patient-matching maturity model and lists “minimally acceptable” patient-matching practices for CIOs, CTOs and other technology leaders, according to a Sequoia Project news release. 

A Patient Identity Management Workgroup — created by The Sequoia Project and composed of multiple industry, academic and government experts — provided comments to develop final recommendations for improving patient identity management.

The workgroup also incorporated proposals supporting patient identifier challenges in pediatrics, as there is currently no widely employed naming system for newborns that have not yet been given a legal name. Some considerations listed in the document for handling pediatrics include standards adoption, information governance, process and technology, vendor capture of multiple birth indicator, birth order and mother’s maiden name, and creation of a medical record prior to the birth event.

If we can standardize, in practice, how EMRs and HIOs leverage existing standards, we will increase patient match rates dramatically, even in the absence of having a national unique patient identifier.
Eric HeflinCTO for The Sequoia Project

Patient matching is one of the most “significant challenges” to nationwide health information sharing, Eric Heflin, document lead author and CTO for The Sequoia Project, based in Vienna, Va., said in the release.

This paper provides a roadmap for advancing our national patient matching strategy,” Heflin said. “We hope to see organizations adopt these minimal practices and maturity model for patient matching with their external health information exchange partners. If we can standardize, in practice, how EMRs and HIOs leverage existing standards, we will increase patient match rates dramatically, even in the absence of having a national unique patient identifier.”  

HealtheConnect Alaska partners with NextGate to improve patient matching

A health information exchange organization known as HealtheConnect Alaska has selected the Enterprise Master Patient Index (EMPI) platform by NextGate, which provides patient matching and identity management services, as the foundation for enhancing its patient identity management.

According to a NextGate news release, NextGate’s EMPI will enable real-time patient matching across the health IT systems of more than 20 hospitals and 450 healthcare organizations within HealtheConnect Alaska’s network, which currently enables electronic medical records exchange for more than 500 participants statewide, including AARP Alaska, Premera Blue Cross Blue Shield of Alaska and the state of Alaska’s Department of Health and Social Services.

The EMPI platform will be able to deliver a comprehensive view of a patient’s medical record. Using patient-matching algorithms, records will be unified and duplicate copies of data will be eliminated, while each individual is assigned a unique identifier serving as a cross-reference for greater data exchange. The EMPI platform will provide an opportunity for HealtheConnect Alaska to empower participating physicians and hospitals with an extensive patient record at the point of care to enhance clinical decision-making.

“Effective coordination between providers hinges on the ability to view accurate data from across the network,” Laura Young, executive director of HealtheConnect Alaska, said in the release. “The EMPI platform will play a significant role in our transformational journey toward improved care team collaboration, workflow efficiency, and the creation of a more holistic and real-time portrait of patients.”

Cybersecurity firm publishes ‘Healthcare Hacking Trends on the Dark Web’

Cynerio, an Israel-based cybersecurity startup that launched earlier this year, recently published a study,  called “Healthcare Hacking Trends on the Dark Web,” which provides a look at the buying and selling of protected health information (PHI) in the dark web black markets.

PHI data illegally retrieved by hackers from healthcare organizations usually includes information such as Social Security numbers, birthdates, medical procedures and results and, in some cases, financial information, according to the study.

The study outlined what hackers tend to do with protected health information once they’ve acquired it, which includes selling it in bundles called fullz, which are personal information records that can be used for fraud and extortion, the study said.

Cynerio’s study concluded one of the main reasons healthcare providers’ databases are hacked is because most clinical systems are “poorly patched and communicate through unsecure channels,” which hackers take advantage of to retrieve sensitive information.

FDA permits marketing of AI algorithm to aid in detection of wrist fractures

The U.S. Food and Drug Administration (FDA) permitted the marketing last month of computer-aided detection and diagnosis software called Imagen OsteoDetect, which is designed to detect wrist fractures in adult patients. 

The diagnostic software uses an artificial intelligence algorithm to analyze two-dimensional X-ray images for signs of a common type of wrist fracture known as a distal radius fracture, according to an FDA news release. OsteoDetect is able to analyze wrist radiographs using machine learning techniques, allowing it to identify and highlight areas of distal radius fracture. The software marks the fracture’s location on the image, which can aid the provider in both detection and diagnosis.

“Artificial intelligence algorithms have tremendous potential to help healthcare providers diagnose and treat medical conditions,” Robert Ochs, acting deputy director for radiological health in the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health, said in the release. “This software can help providers detect wrist fractures more quickly and aid in the diagnosis of fractures.”