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As the Office of the National Coordinator for Health IT comments period drew to a close, a number of organizations weighed in about how to improve electronic health records platforms.

As suicides increase and the opioid crisis continues, Congress, HHS and others need to do more to enable data sharing for at-risk patients.

The company will showcase its new Rapid Response Analytics product at the conference and discuss trends including digital health and the practical uses of artificial intelligence.

It’s pivotal for organizations to institute an ongoing program that promotes a state of continuous improvement, keeping pace with new functionality, one HIMSS19 speaker says.

Also: Allscripts introduces new EMEA VP, MD role; NHS App programme director joins NHS trust; England explores the use of predictive analytics in reducing deaths from suicide; Eurostat releases new data on finding health information online.

The Sydney Children’s Hospital Network has taken a pioneering approach to telehealth for physiotherapy, with the department leading the hospital network in the use of video to improve its patient- and family-centered approach. By using telehealth in its Hospital in the Home (HITH) specialised service, the department has, by far, provided the most number of telehealth sessions across the whole hospital network, according to its Senior Physiotherapist, Cloe Benz. HITH is clinical care that reduces the length of stay in hospital or in some instances, avoids an admission altogether. Benz told HITNA that physiotherapy via telehealth, especially in pediatrics, has generally been limited in Australia but that the hospital embarked on a journey to navigate to new borders and demonstrate to other services that big changes can be made and succeeded in within a pediatric physiotherapy population. “It’s significantly hampered by the fact that physiotherapists, as their name suggests, like to be physically available. That has given a lot of skepticism to the use of telehealth in our line of work,” she said. “But we have rolled out the program at Randwick and Westmead for a little over a year and have experienced many improvements in our patient- and family-centered approach.” Through the program, the hospital provides access to specialist care and treatment from home using telehealth, as an alternative to institution-based care. “Children with chronic respiratory conditions need a very high level of care, in addition to a consistent level of physiotherapy as part of their monitoring and treatment program. So we run a program where kids are admitted to our service and they are seen with what is equivalent to the amount of time they would be seen if they were in hospital.” she said. This involves physiotherapists setting up a daily timetable with patients’ families. The first daily visit involves a personal visit for observations and checks, while the second daily session is done via video call. [Read more: What are the barriers to widespread telehealth adoption? | Data from telehealth to play “critical role” in consultations] “Most chronic respiratory pediatric patients have two physiotherapy sessions that they are meant to do every day of their lives. This is a huge battle for both the children and their parents,” Benz said. “So, the ability of telehealth is for us to be able to access these patients at home and provide support while they’re trying to do these sessions. It means that patients and their families can have expert advice, support and feedback, while we make sure what they’re doing is done in the most effective and efficient way possible.” CHALLENGES BATTLED THROUGH But rolling out telehealth to a pediatric patient base had its own set of challenges. “We had to put in a relative age group that we consider is most appropriate for telehealth. We start our telehealth sessions with kids aged between eight and 18 years. We found that children under that age aren't able to engage appropriately with the therapists across a video call,” Benz explained. Because of the nature of their work, the department also had to put in some risk-related considerations such as the requirement for adult consent to be in the telehealth program and for an adult over the age of 18 to be present with the child during the session. “Because we were dealing with children, parents initially felt anxious and apprehensive about setting up these programs. We needed to educate them on the safety of using our telehealth solution,” she said. “We use a program provided by NSW Health called healthdirect, which doesn’t record any of the information from the caller’s side – the only information that the program records is who the therapist is, in addition to what time they entered and ended the call.” Benz added that the caller’s details are initially required to be input into the system at the time of call in order for the therapist to know who’s on the call, but that information is then purged from the system as soon as the call is over in order to keep confidentiality. Another issue that the department initially faced was delays in engagement as a result of patients and their families joining the program later than expected. “When we used to schedule a telehealth session, we wouldn’t re-engage with the family until they call in. Because of that, families used to only start the computer at the stipulated session time and by the time they sign in or get out of any technical difficulties, many minutes get wasted,” she said. “Our families then provided us with feedback that they preferred to get a reminder message a few minutes before their appointment to make sure they’re on time. We rolled that out and now, deliver on a more streamlined process.” FUTURE POTENTIAL According to Benz, the telehealth feature has resulted in better patient engagement and responsibility for their own healthcare. [Read more: Standard bearers: The RANZCR’s journey to establish teleradiology protocols | Call for Medicare to catch up, as the momentum of telehealth uptake grows] “They engage better than they would stuck in a bed all day if they were in a hospital setting. Telehealth requires a more active engagement, and for them to be more proactive about their health, rather than taking a more traditional, passive approach to recovery,” she said. “And there are many different areas within acute care that can deliver on potential using telehealth, and I’ll be talking about this at HIMSS19.” Benz also expects more regional reach with the use of telehealth, both in terms of patient care as well as smaller regional healthcare providers following the hospital’s footsteps. “We expect telehealth to be used on a much bigger scale. Nearly all of the patients that walk through our doors have a smartphone, or at least, one person within a family does. So the access of video, across the world, is huge and health is only just getting on to how much we can do with video to provide a better, more congruous service.” Benz will be speaking about the Sydney Children’s Hospital Network’s telehealth journey and the potential of the technology for other healthcare areas at the upcoming HIMSS19 conference in Orlando. Her session is on February 13,  at 2.30-3.30pm, and is titled Virtual Acute Care: Pediatric Physiotherapy with Telehealth.

Last week, the House Committee on Health in the Philippines House of Representatives chaired by Rep. Angelina Tan approved a substitute bill seeking to establish the National eHealth Systems and Services that shall deliver health services through cost-effective and secure information and communications technology (ICT). WHY IT MATTERS The landmark measure provides for an organised and structured application of electronic health or "eHealth" integrated in the regular workflow of healthcare facilities. Specifically, it seeks to utilise ICT to deliver health services which has the potential to be profitable, improve quality, change the conditions of practice, and improve access to healthcare, especially in rural and other medically underserved areas. The bill also aims to facilitate the exchange and access to secured personal health information, ensure harmonisation or integration, alignment, and interoperability among various eHealth initiatives, and facilitate inter-agency and inter-sectoral coordination at various levels of governance in both public and private sectors. The measure mandates the Department of Health (DOH) as the lead agency to implement the Act and provides for the creation of an inter-agency and multi-sectoral National eHealth Steering Committee to serve as an executive body of the Philippine eHealth System and Services (PNeHSS). Among the changes approved and introduced in the substitute bill is the provision for public-private partnership of eHealth Services. The bill mandates the DOH to promulgate the rules regarding the participation of the private sector in the provision of eHealth services and solutions, including public-private partnerships and other suitable arrangements. An additional provision on research and development was also introduced and will be accomplished through the formulation of expanded eHealth research priority areas under the National Unified Health Research Agenda (NUHRA) as well as the establishment of knowledge hub and research centers for eHealth that study, among others, capacity building, health technology assessment, knowledge management, standards development, and research utilisation. The approved bill also details violations of the Act and corresponding liabilities and penalties. For instance, the unauthorised processing of personal information shall be penalised by imprisonment ranging from one to three years and a fine of P500,000 to P2 million. The unauthorised processing of sensitive personal information shall be punished by imprisonment of three to six years and P500,000 to P4 million. Other violations include accessing personal information and personal sensitive information due to negligence; improper disposal of personal information and sensitive personal information; procession of personal information and personal sensitive information due to negligence for unauthorised purposes; unauthorised access or intentional breach; concealment of security breaches involving sensitive personal information; malicious disclosure; and unauthorised disclosure. Any person who commits a combination or series of these acts shall be subject to imprisonment ranging from three years to six years and a fine of P1 million to P5 million. THE LARGER TREND According to the official eHealth website by the DOH, two main challenges of the Philippines’ health system are access to health care services, and access to real time information for decision making. 70% of the population living in rural areas are still struggling with no or limited access to quality inpatient and outpatient care services. Delayed access to timely, reliable, accurate, and complete health information contributes to the challenges faced by decision makers. This condition is further exacerbated by various health data coming from disparate systems that use differing formats, lacking harmonisation, and putting additional strain on already compromised data quality. Based on the Philippines eHealth Strategic Framework and Plan 2014-20, the DOH envisions that “By 2020, eHealth will enable widespread access to health care services, health information, and securely share and exchange client’s information in support to a safer, quality health care, more equitable and responsive health system for all the Filipino people by transforming the way information is used to plan, manage, deliver and monitor health services.” With the proposed National eHealth Systems and Services Act approved, there is some progress made in the governance component of the eHealth vision but much of the real work will lie in the establishment of the necessary foundations – infrastructures, standards, rules and protocols for the effective implementation of eHealth services, processes and solutions. ON THE RECORD “The Department of Health welcomes the new version of this Act because the future of health is being designed with eHealth, the use of information communications technology in health,” DOH Assistant Secretary Enrique Tayag said. He also suggested that the measure should more clearly provide that private entities are free to use ICT in their delivery of health services.

The ANA integrates its educational programs in one information system to design better offerings and help learners. Health systems can learn from the group's experience.

Candidates for the role should be able to share electronic health record best practices with DoD, oversee change management and training efforts and monitor budgets, officials say.

The theme of the 10th Annual event is Looking Back, Leaping Forward.