Coding errors and a lack of modern, interoperable technology complicated COVID-19 test reporting and tracking, and the federal government is considering options for upgrading and replacing outdated systems, including a proposal for a shared computing infrastructure. But funds allocated for modernization have gone unspent, and political resistance to digital immunization registries is growing, says Rebecca Coyle, the head of the American Immunization Registry Association.
Artificial intelligence analysis of socioeconomic, demographic and clinical data can identify patients with cancer who have a high risk of dying within 30 days, potentially enabling end-of-life planning and referrals to palliative and hospice care, according to a study in Future Medicine. "[A]ggressive, life-sustaining [end-of-life] care can conflict with patient preference and result in lower quality of life, family perceptions of poorer quality of care, and greater regret about treatment decisions," researchers wrote.
The first steps when setting up a remote patient monitoring program are getting clinicians and leaders on board, ensuring compatibility between EHR systems and remote data collection devices and identifying who will manage and support the integration, writes CDW's Gus Vlahos. Devices should be chosen with an eye toward patient usability and should be ready to use out of the box with minimal assistance.
Valley Behavioral Health's Slack Enterprise Grid system encrypts patient health information at rest and in transit on Slack's servers and is not integrated with the health system's EHR platform, making the messaging and collaboration system HIPAA-compliant, says Tyler Tait, Valley's chief information officer. Various channels are set up for care coordination, human resources inquiries, property management requests, IT assistance and general conversations, and employees are encouraged to share only essential patient information, and only in the proper channel.
UnitedHealthcare has developed an advocacy system using predictive analytics and machine learning to identify and support subscribers who might need help with social determinants of health and connect them to community-based social services at low or no cost. Eligible subscribers have accepted more than half of the insurer's social support offers, and all of its Medicare members were referred to the programs.
Health care services that have a Medicare local or national coverage determination must meet specific medical necessity criteria, and the specific patient complaint, sign or symptom making the service reasonable and necessary must be captured in claims. Medicare claim denials often result in zero payment instead of lower payment, and some clinical documentation integrity departments have dedicated teams for covered services as defined by NCDs and LCDs, writes Cheryl Ericson, a member of AHIMA's CDI, Quality and Revenue Cycle Practice Council.
The public health establishment's inability to clearly explain contradictory scientific views has helped fuel an epidemic of COVID-19 misinformation and propaganda, writes Renee DiResta, technical research manager at the Stanford Internet Observatory. The US needs a Wikipedia-style public health information system maintained and moderated by a community of experts in a broad range of fields, DiResta writes.
The proposed Immunization Infrastructure Modernization Act of 2021, which would improve public health IT systems and enhance the exchange of immunization records between and among governmental and nongovernmental entities in the public health sector, was unanimously approved by the House Committee on Energy and Commerce.
Network-connected medical devices function similarly to conventional IT devices, but there are significant differences in how they are used and maintained, and they have special cybersecurity demands, says Kurt Griggs, manager of information security at Mayo Clinic. Mayo uses a risk-based, proactive, repeatable strategy to secure connected medical devices, using approaches such as security life cycle profiles designed to limit and control risk before connecting devices to the network, Griggs says.
The National Security Agency, the FBI and the Cybersecurity and Infrastructure Security Agency say China-backed hackers are targeting health care institutions to steal data and technologies and using virtual private servers and common open-source or commercial penetration tools to avoid detection. The agencies recommend several preventive measures such as requiring multifactor authentication, immediately patching critical vulnerabilities and enhancing monitoring of email, network traffic and endpoint systems.