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Health Share of Oregon and analytics specialist Health Catalyst announced an arrangement to jointly create a tool that predicts the risk of opioid abuse. 

More than a decade ago, healthcare information technology leaders – concerned about electromagnetic interference (EMI) from mobile electronics – banned cellphones in patient care areas. While there was little empirical evidence documenting such interference with medical devices, apocryphal anecdotes and a precautionary attitude led to the bans. Today, following studies by the Mayo Clinic and other researchers that showed almost no harmful effects from interference, those bans have largely disappeared. Cellphones have become ubiquitous, and they now share the patient room with a host of healthcare IT devices: Computers, monitors, peripherals, smartphones and tablets are all frequently operating within 6 feet of the bedside and exam table, according to a recent study by HIMSS Media1. As IT devices in the hands of patients and providers crowd the point of care, the question of EMI and its potential impacts on nearby medical devices – and patients – is being raised once again. There are new concerns about the impact of wireless technologies such as Wi-Fi and Bluetooth. And experts are also resurrecting worries about the risks of leakage currents when non-FDA-approved equipment is not properly grounded. Consumer-grade concerns Unlike medical devices that undergo rigorous electronics instrumentation testing to meet the International Electrotechnical Commission’s 60601 and, more specifically, 60601-1-2 standards, commercially produced desktops, laptops and tablets are not required to meet similar emissions standards. “These products are designed for consumers and office environments, not clinical settings,” explained Raja Bhadury, head of HP’s care delivery portfolio. “The risk of electrical shock, burns and even cardiac arrhythmias due to leakage current from improperly grounded IT products is not fully understood.” As such, these IT devices are usually not rigorously tested for clinical environments. “Besides, considerable investment is needed to design products to meet these higher emissions standards, and it takes time to go through the certification testing.” Juuso Leinonen, project engineer at the nonprofit ECRI Institute, said the patient safety-focused organization is aware of only isolated incidents in which high-powered radio transmitters (namely, two-way radios) interfered with the function of some fluid warmers operated in close proximity. “Overall, most consumer-grade equipment is low-powered, which seems to mitigate the concern with EMI,” Leinonen said. “At least at present, we do not have reports to support this being a significant issue in the healthcare setting.” But leakage current, on the other hand, poses a threat for certain types of patients, as it has for decades. In 2004, authors Leonard Eisner, Robert M. Brown and Dan Modi provided a primer on leakage current standards for Medical Device + Diagnostic Industry readers. “Leakage current is one of the most stringent, yet telling, parameters of possible danger to patients or caregivers,” they wrote more than a decade ago. “This is especially true for patients with weakened immune systems.” Proactively weighing the risks Good data on any negative impacts caused by leakage current have been hard to come by. One reason for the lack of empirical evidence is patients’ vulnerable state at the onset. It can be difficult to determine whether leakage current or an already weakened organ causes problems with immune-compromised or cardiac patients. Despite the lack of firm research in this area, healthcare providers would be wise to proactively weigh the risks of EMI in their current IT equipment infrastructure, especially with a growing fleet of consumer IT equipment residing in patient rooms, edging ever closer to patient beds. That review includes assessing purchasing plans and guidelines, scrutinizing potential equipment and working with vendors to ensure patient safety at all times.  Specifying a “minimum separation distance” (MSD) between IT devices with radio transmitters and sensitive medical devices can also help reduce risk. Researchers from Concordia University in Montreal found that when hospital staff comply fully with a MSD policy of even one meter, they can operate devices in the same room as the patient and medical equipment without posing a danger2.                              “The reality is, there’s always some risk,” Bhadury concluded. “PC vendors must work with their healthcare customers and regulatory agencies to assess the risk and make thoughtful design choices to address the risk.” References HIMSS Media, Creating a Patient-Safe Technology Environment: a HIMSS Custom Research Report. Prepared for HP. October 2017. “Can personal devices interfere with hospital care?” Science Daily, June 16, 2015, https://www.sciencedaily.com/releases/2015/06/150616123921.htm jQuery(function() {jQuery('#parallax-ad-container').hide();});

DeSalvo, who also served as Assistant Secretary for Health at HHS, will be a professor in Dell Med's Department of Internal Medicine, with a secondary appointment in the Department of Population Health.

The Russia-based security firm is claiming the government denied the company basic due process and has harmed their reputation and commercial interests without evidence of wrongdoing.

HHS Office for Civil Rights offers new perspective on the privacy law relating to mental health and substance abuse.

Hospital and health system execs discuss hurdles they’re facing as they move into the new year.

With 10 pilots in development, products will get to market with real data and added value for hospitals and payers.

The global ransomworm attack crippled over 300,000 devices in more than 150 countries in May, including 16 branches of the U.K. National Health Service.

Computers and workstations on wheels (WoWs) were designed to help clinicians spend less time working from nursing-station desktops and more time at the point of care. The reality, however, is that the ideal has yet to be fully realized. All too often care team workflows remain fragmented because of the need to access patient data and clinical information from multiple disparate systems. This fragmentation not only breaks down the fundamental human flow of care, but it also leaves patients with the perception the clinician is more focused on the technology than on them. “There are solutions that help facilitate dialog between clinicians or patients. However, there are multiple factors that contribute to that success,” said Nancy Beale, MSN, RN-BC, vice president of clinical systems and integration at NYU Langone Health Systems. Some of those factors relate to the complexity of software in use, Beale continued. “If they have to navigate through multiple systems for a single workflow, like an office visit or rounding on a patient, how integrated is the data between systems? Also, what are the form factors they’re using to access those systems? Is their hardware placed in a position to facilitate communication between a patient and physician?” Some electronic medical records systems still require access through a WoW or desktop, but in recent years more healthcare organizations have been migrating to tablets and smartphones, which appeal to clinicians’ inherently mobile workstyles. In turn, vendors now provide more mobile apps that integrate with the EHR and other clinical communications systems, such as patient monitoring devices, alerts and nurse call. The goal is to consolidate myriad hard and soft functionalities on one device, so caregivers can return to a natural workflow. However, some organizations’ mobile rollouts have been bumpy, and adoption rates are below expectations. This is especially true when clinicians are not included in IT discussions that impact them, or they aren’t adequately trained on the chosen solution. Additionally, deploying mobile technologies that still rely on disparate systems can slow the time spent documenting or retrieving relevant patient data because the clinician must open and close multiple apps that aren’t unified into one communications platform. Lighter options that carry more data heft One reason clinicians have been quick to latch on to mobile technologies stems from how they use them in their personal lives. But consumer-grade systems and devices aren’t typically designed for healthcare environments. Everything from hardware and accessories that hold up to infection control protocols to HIPAA-compliant messaging and devices must be considered.  “Being able to use the phone to be fully functional for a workflow without having to add cumbersome pieces that make it heavier and less user friendly is essential to success and adoption,” Beale said. That includes deploying mobile solutions that can take in verbal information as well as map to discrete data within an EHR instead of always requiring the clinician to be the heavy-lifter; that is, forcing the user to manually add or extract data from disparate systems instead of using an integrated solution that includes voice-enabled dictation. It’s important for healthcare IT teams to deploy and continually manage applications within a mobile device for greater usability and security. As such, a best practice is to ensure data is never stored on the device to prevent potential patient privacy violations. It’s also important to perform usability testing with clinical end users and partner tightly with all stakeholders. Keep it simple; keep it ‘app’ropriate Simplicity and thoughtful integration are important. It makes little sense to encourage clinicians to swap their so-called fat tool belts for slimmer tablets and phones requiring just as many apps. “In the long term, you want clinicians not to have to navigate between multiple systems,” Beale said. Reducing the number and size of form factors and unifying myriad applications often yields more efficient communications, collaboration and coordinated care. Providers spend less time adding or extracting data from EHRs and more time talking with patients and families. When well implemented, this more unified mobile clinical-communication approach repairs previously fragmented clinical workflows – and makes for a better patient experience. 

The San Francisco Health Network affiliates also achieved increases in patient and physician satisfaction rates.