Bill Siwicki

Cabell Huntington Hospital also diminished the average sepsis-related hospital length of stay with machine learning-generated clinician alerts.

E-prescribing vendor DrFirst deploys cloud-based drug knowledge to support Nebraska's PDMP.

Experts are anticipating the wrath of cybercriminals targeting the hundreds of thousands of IoT devices already deployed in 2018 and beyond.

Michigan, like much of the rest of this country, is in the midst of an opioid crisis. The number of opioid prescriptions, individuals in substance use disorder programs and, worst of all, opioid-related drug overdose deaths have all increased from 2011 to 2015 in the state. Michigan has turned to health IT to try to accomplish two goals: prevent overprescribing and over-dispensing by health professionals, and improve patient care for individuals suffering from substance use disorders. “We are attempting to prevent overprescribing and over-dispensing in two ways,” said Kim Gaedeke, acting deputy director of the Department of Licensing and Regulatory Affairs for the State of Michigan. “First, equipping Michigan physicians and dispensers with real-time patient data to be viewed prior to prescribing and dispensing schedule 2-5 controlled substances and dissuading overprescribing through disciplinary and enforcement actions.” [Also: Senator proposes bill to incentivize states to share PDMP data with law enforcement] Michigan health officials selected specialized vendor Appriss Health for its substance use disorder system NarxCare. The vendor works with 46 states that are sharing PDMP data across state borders to inform physicians and pharmacists at the point of care of a patient’s Rx history to avoid overprescribing or those who are doctor shopping. NarxCare provides participating physicians and dispensers with an abundant amount of patient history and data to help determine the degree to which the patient is at risk for substance use disorder, Gaedeke added. This helps inform a health professional’s clinical diagnosis.   "In the past, it would take health professionals on average 5-10 minutes to pull up a patient report. The state has experienced a return on its investment with an annual savings of roughly $1 million in staff costs." Kim Gaedeke, State of Michigan “Additionally, we are able to use individual and statewide prescription and dispensing data to determine overprescribing and over-dispensing by health professionals,” she said. “The state uses this data to follow up with disciplinary actions against health professionals who are overprescribing or over-dispensing.” [Also: Joining opioid fight, North Carolina signs on to PDMP data sharing collective] The second way Michigan is attempting to prevent overprescribing and over-dispensing is through the system’s ability to determine the degree to which a patient is susceptible to substance use disorder and, if necessary, provide ways to help that patient. “The additional resources can be presented within the health professional’s clinical workflow,” Gaedeke said. “This assures that the patient immediately receives appropriate assistance during a visit. This technology has helped transform the traditional model of a Prescription Drug Monitoring Program to a more robust clinical, care management, analytical and prevention tool.” The NarxCare technology fits into the clinical workflow by being integrated into a physician’s electronic health record system or a pharmacist’s dispensation system. This direct integration of the systems allows for the physician or pharmacist to stay in the software, and if the same patient is also in the state’s PDMP, called MAPS for Michigan Automated Prescription System, the patient’s data in MAPS automatically appears in the health professional’s EHR or pharmacy dispensation system without requiring the practitioner to log in and out of two separate interfaces. “Once the provider clicks to view on the NarxCare report, the practitioner can see the full data set of the patient such as risk scores, Medical Morphine Equivalent, and history of schedule 2-5 controlled substances that have been prescribed and dispensed to the patient,” Gaedeke explained. “In addition, it includes any red flags such as whether the patient has gone to multiple doctors or pharmacies in a short period of time to obtain the same prescriptions, indicating possible substance use disorder or drug diversion.” Based on an interactive visualization of usage patterns to help identify potential risk factors, the physician or dispenser can determine the appropriate course of action for treatment, she said. Since implementing the Appriss Health technology in April 2017, Michigan has documented a decrease in the number of Michigan residents receiving an opioid prescription and decrease in the rate of doctor shopping by patients, she said. She added the state expects a drop in the total number of controlled substance prescriptions filled in Michigan from 2016 to 2017 once the data is tabulated and finalized. “Additionally, the improvement in technology has increased the number of health professionals using the new MAPS/NarxCare platform,” she explained. “The increase in the number of users further contributes to aggregated data that is collected and analyzed to better inform clinical diagnoses by individual health professionals and potential enforcement actions by our department.” The state’s Department of Licensing and Regulatory Affairs, where MAPS is housed, has also experienced overall efficiencies with the new system compared to the old system by instantly providing data in real time along with system reports in less than half a second for its users, she added. “In the past, it would take health professionals on average 5-10 minutes to pull up a patient report,” she said. “The state has experienced a return on its investment with an annual savings of roughly $1 million in staff costs. Prior to replacing the state-maintained system, the state went from 13.5 FTEs to now 4.25 FTEs.” And ultimately, Gaedeke said, with the innovations and efficiencies created with the new MAPS/NarxCare platform, the Department of Licensing and Regulatory Affairs has been able to better identify licensed health professionals who are overprescribing, over-dispensing and diverting drugs, which has allowed for improved regulatory actions and in many cases more swift action taken by the department and its licensing boards. “Technology plays a vital role in our fight against the opioid epidemic and substance use disorders in Michigan overall,” she said. “Technology allows health professionals to go beyond their individual instincts or preconceived notions by providing them with access to comprehensive real-time data with a single click in their existing electronic health records.” Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com

Northwell threw down two challenges and in return got several hackathon participants set up to interview for summer internships along with bright ideas to build on innovations that emerged from the event.

The research evaluated how AI-based personalized physiology analytics could be applied to wearable biosensor data to predict when a patient might be at risk of hospitalization.

Nevada Governor Brian Sandoval will invite an additional 40,000 Nevadans on March 15 to enroll in the study and have their DNA sequenced for in-depth research.

Patients and physicians both are ready to engage with one another using digital tools, according to a new Ernst & Young national survey released at HIMSS18 this week. The survey found 54 percent of consumers said they are comfortable contacting their physician digitally and further expressed interest in using technology such as at-home diagnostic testing (36 percent), using a smartphone or connected device for information sharing (33 percent) and video consultations (21 percent). There is widespread agreement among physicians that digital technologies and data sharing will contribute effectively to the overall well-being of the population, the survey found. And 83 percent of physicians believe that increased patient-generated data from connected devices would benefit the overall quality of care and enable more personalized care plans. Further, 66 percent of physicians said that increased use of digital technologies would reduce the burden on the healthcare system and its associated costs, and 64 percent think it would help reduce the burden on doctors and nurses and have a positive impact on the critical issue of burnout, the survey said. “The health sector today is ripe for disruption, and these findings reinforce the need for organizations to rethink how and where care is delivered to consumers,” said Jacques Mulder, U.S. health leader at Ernst & Young. “Both consumers and physicians are empowered by emerging technology and are hungry for better, more connected experiences. This demand paves the way for nontraditional players to make an impact on the industry, and is another indicator that health in entering an era of convergence.” Creating incentives for data sharing is a critical piece of the puzzle, the survey discovered. While only 26 percent of consumers are interested in sharing lifestyle information with their physician, those numbers make a big jump when you add in incentives. Consumers said that reduced waiting times (61 percent) and cost savings (55 percent) provided the biggest incentives to increase digital engagement with their physicians. What’s more, despite hesitation in sharing dietary and exercise information, 26 percent of consumers indicated that the ability to receive tailored diet and exercise plans would also encourage engagement with digital technology, the survey found. “What we see from these results is that consumers and physicians are ready for increased digital interaction,” said Rachel Hall, principal and advisory health digital offering leader at Ernst & Young. “If you look at the health sector today, we see a lot of point solutions designed to address a particular aspect of health or wellness. While this is a great start, what we are missing are solutions to support health and disease management on a broader level.” To find success in this landscape, the industry needs more interoperable data that is source agnostic, the right analytic tools, and a focus on consumer-centric designs, she added. The consumer portion of the survey polled 2,455 U.S. consumers aged 18 and older nationwide. The physician portion of the survey polled 347 physicians nationwide. .jumbotron{ background-image: url("http://www.himss.org/sites/himssorg/files/u351641/HIMSS-sign5-jumbotron.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Full HIMSS18 Coverage An inside look at the innovation, education, technology, networking and key events at the HIMSS18 global conference in Las Vegas. Twitter: @SiwickiHealthIT Email the writer: bill.siwicki@himssmedia.com

Validic launches a remote care monitoring platform, Veta Health unveils a data-driven system that syncs with EHRs, and the Medici for Doctors app uncorks a new communication feature.

GenomeWeb and Oracle Health Sciences reveal key survey results; WuXi NextCODE and Google Cloud partner; and 2bPrecise and The Innovation Institute collaborate on pharmacogenomics.