Mike Miliard

When developing, funding, scaling and evolving innovation projects, it's key to gain insights from around the world – and to keep consumer top of mind, HIMSS innovation expert Ian Hoffberg says.

With a rare near-unanimous vote, the United States Senate passed The Opioid Crisis Response Act of 2018 on Monday evening. It's a massive bill comprising a wide array of proposals drawn from five Senate committees, and has many implications for the use and funding of health IT. Senate Majority Leader Mitch McConnell, R-Kentucky, called the bill – drawn up using input from more than 70 senators and passed by 99-1 vote – a "landmark" piece of legislation meant to combat the nationwide opioid epidemic from all angles. The legislation comes amid an ongoing opioid crisis in the U.S. as policymakers and technology vendors are working to address the issue, while hospitals are piloting apps to find blindspots in prescription drug monitoring programs and using mobile technologies to write fewer prescriptions. It contains funding for stopping the flow of illegal opioids from other countries, and for supporting local programs for prevention, treatment and recovery. The bill also seeks to spur research and development of new non-addictive painkillers and stem "doctor shopping" by boosting prescription drug monitoring programs. It also has funds to give behavioral and mental health providers the tools they need to offer treatment and recovery – including potential electronic health record incentives – and for hospitals to better care for infants with neonatal abstinence syndrome. The legislation's sponsor, Senate HELP Committee Chairman Lamar Alexander, R-Tennessee, said he is working to combine the Senate bill and a similar House version passed in June "into an even stronger law to fight the nation’s worst public health crisis, and there is a bipartisan sense of urgency to send the bill to the President quickly." The Senate bill contains many new proposals specifically related to information technology. Among them, it would: Call for the U.S. Department of Health and Human Services to "develop best practices for prominently displaying substance use treatment information in electronic health records, when requested by the patient." Enable the Centers for Medicare and Medicaid Services to test various models that "provide incentive payments to behavioral health providers for the adoption and use of certified electronic health record technology to improve the quality and coordination of care through the electronic documentation and exchange of health information." Require physicians to prescribe Part D-covered controlled substances electronically and direct CMS specify a list of exceptions and outline the penalty for failure to comply when the e-prescribing requirements. Require that prior authorizations related to Part D e-prescriptions use a standard format to improve the way the authorizations are processed. Provide support for states and localities to improve their Prescription Drug Monitoring Programs and "implement other evidence-based prevention strategies, encourages data sharing between states, and supports other prevention and research activities related to controlled substances." Reauthorize HHS's NASPER grant program, allowing states to "develop, maintain, or improve PDMPs and improve the interoperability of PDMPs with other states and with other health information technology." Authorize new program through the Substance Abuse and Mental Health Services Administration for the establishment of comprehensive opioid recovery centers. "These entities may utilize the ECHO model, which supports care coordination and services delivery through technology." Give support for states to collaborate on strategies to improve care substance-exposed infants, including the development and upgrades of new technology and monitoring systems to more effectively implement plans of safe care. Require CMS to set up an online portal to enhance communication between the agency, Medicare Advantage plans with prescription drug plans, stand-alone drug plans and Medicare Drug Integrity Contractors.   .jumbotron{ background-image: url("http://www.himss.org/sites/himssorg/files/u351641/opioid-collection-hero-712.png"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Opioid Crisis: Tech fights epidemic Learn how tech is being used to battle abuse. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

The ongoing saga of athenahealth and Elliott Management continues. Shares of the cloud-based health IT company fell sharply Tuesday morning on news that the hedge fund – which has recently been seen as the most likely candidate to acquire the company after a long and contentious courtship – has reportedly recoiled from the $160 share price. While activist investor Paul Singer may finally be throwing in the towel after many months of pressure on the Watertown, Massachusetts company, he may also simply be angling for a lower price. Reports earlier this month, in fact, indicated that EHR rival Cerner and insurer UnitedHealthcare are not interested in athenahealth. Now, athenahealth seems willing to be patient and weigh its options, having extended the due date for a final bid by 10 days, according to the New York Post. Elliott Management had indicated its willingness to pay the $160 share price, a total of some $6.9 billion, for the company in May. But by June – when athenahealth founder and CEO Jonathan Bush was forced to step down after allegations of past domestic violence – at least one Wall Street observer wondered whether the sale process might eventually drag on so long that Elliott would rescind its offer, likely knocking the share price back down to the $135-$140 range. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

Five roles to develop and four rules to follow for effective and secure data governance in the age of AI, analytics, pop health and precision medicine.

The analytics platform, built using open APIs, aims to enable a collaborative environment to speed development of targeted treatments for patients.

Data-driven partnerships with skilled nursing facilities helped the Ohio health system improve care outcomes and lower costs.

University of California San Diego researchers have created a new biometric technology they say could help securely identify children and and even newborns with just the wave of a finger. The tech, funded in part by the Bill and Melinda Gates Foundation, is not yet commercially available, but UC San Diego researchers hope it will be within a year. They say it could be a help in many different scenarios: tracking vaccinations, delivering care during natural disasters, helping prevent human trafficking, resettling refugees and reuniting migrant children with their families. The portable device, called ION, is a non-contact optical scanner. It enables imaging of fingers and palms, stored scanned prints as encrypted templates that can then be shared securely with laptops and mobile devices. Previous biometric tools have unsuccessfully attempted to extrapolate adult technologies to fingerprinting children, but the UC San Diego innovation was to use human-centered design to develop the tool from the ground up with infants, caregivers and stakeholders in mind, said Eliah Aronoff-Spencer, MD, assistant professor of medicine, UC San Diego School of Medicine. The tech was specifically created to accommodate the size, movements and behaviors of an infant. (It also works on adults.) "Not only did we take into account the child's physiology and reflexes, but also what would be culturally acceptable in different countries," Spencer explained. "For example, in some areas, facial photography is shunned, but photography of hands is acceptable." ION allows for "quick, accurate fingerprinting that may eliminate the need for paper identification and improve health care and security for millions," he said. "Globally, infant and childhood identification is needed for healthcare delivery, especially in remote or resource-limited areas, as well as for supporting efforts in disaster relief, human trafficking, migration and refugee settlement." Other enhancements to the technology under development at UC San Diego include abilities to measure health biometrics and clinical data such as temperature, pulse, breathing and oxygen. "Accurate identification of a child to enable timely vaccinations can improve care, reduce disease burden and save lives," said Spencer. "Imagine the ability to assist refugees displaced by war or natural disasters to establish their identity so they can access needed food, aid and care." IRB-approved clinical trials are currently underway at UC San Diego and with collaborators in Mexico, and officials say early results have  shown more than 99 percent accuracy on re-identification after registration as early as two days after birth, with 90 percent accuracy for registration on the first day of birth. Researchers plan next to do further studies with the ION device in Africa and South Asia. "We want to continue to validate the platform, work through workflow, security and ethical issues, and, with funding, make the technology available on a staged basis to non-governmental organizations and government programs at local and national levels," said Spencer. .jumbotron{ background-image: url("http://www.healthcareitnews.com/sites/default/files/u1576/securityforjumbotron.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Healthcare Security Forum The Boston forum to focus on business-critical information healthcare security pros need Oct. 15-16. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

Oakland, California-based Alameda Health System has named its new chief information officer. Mark Amey will relocate to the Bay Area from San Diego, where he was most recently associate CIO at University of California San Diego Health. Alameda Health appointed Amey in the same week that Sanford Health named former VA Secretary David Shulkin, MD, as its chief innovation officer. Much like Shulkin, Amey brings considerable familiarity with electronic health record implementations. Alameda cited its work to roll out a $200 million Epic EHR across the five-hospital public health system as among the reasons it brought Amey onboard. Amey has been working in health IT for more than two decades. Before his stint at UC San Diego, he served as Chief Technology Officer during another Epic rollout at Lucile Packard Children’s Hospital-Stanford Health. Prior to that, he also held CIO positions at University of Southern California Health, Ascension Health and Adventist Health. In San Diego, his day-to day responsibilities included oversight of its infrastructure teams, the project management office and security operations. It was at UCSD that Amey helped transition its on-premise Epic system to a hosted cloud model. The mover not only helped the health system be more agile and maintain disaster recovery capabilities, he explained at the time, but "by creating greater operational efficiencies, we can invest more time and resources in patient care." Other areas of expertise include management of outsourced IT vendors, conversion of services to in-house operations and more. "I am excited to join Alameda Health System at this pivotal time in the history of the organization," said Amey. "Having gone through similar projects in the past, I know this implementation will transform the care we provide, including the exchange of information and communications with patients and medical colleagues." Alameda Health partners with five other health systems in the Bay Area on an interoperability project designed to reduce emergency department usage but also boost the ED care that is delivered. With its new Epic rollout, it's hoping to spur easier data sharing among its own five hospitals. "Mark’s in-depth knowledge and impressive experience align with the future direction of Alameda Health System," said Alameda's CEO Delvecchio Finley in a statement. "As CIO, we are confident he will guide the organization through a smooth transition to electronic health records that will enhance our commitment to serve our patients with highest-quality care." Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

Mercy Technology Services, the IT division of the sprawling St. Louis-based health system, has developed a new cloud-based imaging platform and is commercializing it for other hospitals to deploy. The picture archiving communication system comprises best-of-breed enterprise viewer, vendor neutral archive, workflow orchestrator, speech recognition and reporting, according to Mercy, bundled as a secure software-as-a-service model aimed a small and midsize hospitals. It's aimed as a way to help hospitals drive efficiency with their imaging processes, replacing outdated and far-flung PACS systems, that require radiologists to spend too much time tracking down imaging reports or switching between stations. Cloud-based PACS can allow for big time savings and cost efficiencies at cash-strapped small hospitals, such as the one in rural Kansas we reported on this past month, which was able to cut its imaging costs in half. Mercy, which operates 40 hospitals of various sizes across four states, consolidated its own imaging platform with help from MTS, distilling nine legacy PACS systems into a single hosted technology. The system, which combines server-side image processing from Visage, a workflow orchestrator from Medicalis and speech recognition from Nuance, has helped radiologists at the health system decrease turnaround time for their reports by up to 50 percent. Mercy is a longtime health IT leader, and one of the earliest adopters of Epic. Its technology knowhow over the years has enabled it to innovate new advances in telehealth, advanced analytics and more as it has scaled up its infrastructure. It's also allowed it to be able to share its expertise and tools with other providers. Its Epic accreditation enables allows it to share Epic and other technology with smaller hospitals. "We're a little bit unique from the standpoint that Mercy sells its IT services to other providers," Mercy CIO Gil Hoffman told Healthcare IT News in 2017. "We have commercialized our IT, and that has taken a lot of work, bringing some other health systems not only into our Epic services but our hosting services as well." Now, as the latest example of its ability to commercialize and host IT systems for other hospitals, MTS will offer this PACS-as-a-service, whether bundled or by the component, to hospitals across the country. "Having everything together and viewable with the click of a button – all prior studies, all modalities – means radiologists aren’t waiting and neither are patients," said Steve Bollin, Mercy’s vice president of radiology support services, in a statement For his part, Hoffman touted the PACS as an efficient and affordable platform, developed as a result of Mercy's own efforts to innovate its technology and workflows. .jumbotron{ background-image: url("https://www.healthcareitnews.com/sites/default/files/u2231/Innovation-month-jumbotron.jpg"); background-size: cover; color: white; } .jumbotron h2{ color: white; } Focus on Innovation In September, we take a deep dive into the cutting-edge development and disruption of healthcare innovation. Twitter: @MikeMiliardHITN Email the writer: mike.miliard@himssmedia.com

The AHA's new initiative aims to help health systems navigate the complex imperatives of value-based care with new ideas, market intelligence, cybersecurity help and more.