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By leveraging the historical data included in the records, healthcare providers can target patients, populations more than ever.

Healthcare practices used on the International Space Station are serving as model for caring for people in some of the most deprived and isolated parts of the world, according to an article published last month in the World Health Organization. Several of the systems used to ensure healthcare for astronauts working in cramped and isolated space station have been studied and implemented in undeveloped areas, Alfred Papali, MD, wrote in “Providing healthcare in rural and remote areas: lessons from the International Space Station.” Papali, with the Division of Pulmonary and Critical Care Medicine at the University of Maryland School of Medicine, shows how the space station astronauts ensure their health while circumnavigating the globe in space by employing three essential services — task-shifting, point-of-care ultrasound and telemedicine services. NASA has mitigated the risk of medical emergencies aboard the space station by training the crew medical officer and by using on-board ultrasound and an Earth-based telemedicine consultation. Space flight, though, presents several challenges, such as engineering and space constraints, limited bandwidth for data transmission, a lack of advanced diagnostic equipment and the absence of a physician. How space station crewmembers overcome these challenges may present a model to Earth-bound programs. For space flight task-shifting, a crew medical officer receives about 60 hours of preflight training, similar to the level of a paramedic in the United States. The WHO cited task-shifting as a key element in cost-effective access to antiretroviral medications, and  nurse practitioners and physician assistants are providing a wide variety of medical services where doctors are scarce, Papali wrote. Additionally, NASA-funded studies in remote locations around the world have had a direct impact on the development of the space station’s ultrasound program. Likewise, the space station’s extensive use of telemedicine is leading to advances of the technology on Earth. Medical data and ultrasound images are routinely transmitted to ground-based flight surgeons for diagnostic and training purposes. Data transmission is not continuous, however, and as in the developing world the connection can be very slow or completely absent. Judicious use of limited technological resources is necessary in any location, Papali wrote. To address this issue, just-in-time educational modules have enabled crewmembers to perform complex ultrasound examinations despite the time lag in communications between the space station and the ground. “These modules could be adapted to terrestrial environments with limited connectivity,” Papali explained. “In addition, NASA has tested virtual remote guidance (i.e. recorded instructional videos for use by crew members using wearable technology) as a means of overcoming connectivity barriers; this technique will soon be used in Haiti to study remote guidance of endotracheal intubation.” It is worth noting also that health services developed and used in space differ in important ways from those used on Earth. “The great challenge for emergency care on Earth will be whether such services can be developed across diverse and fragmented health systems in a coordinated fashion to optimize outcomes, reduce costs and minimize duplication,” Papali wrote. Nonetheless, the services developed for the spaced station can show the way from continued innovation in health services. Twitter: @HealthITNews

The move comes almost a year after Mayo first announced it would replace its existing electronic health record system with one from Epic.

While 66 of the 100 largest hospitals in the United States offer consumers mobile health apps, only 2 percent of patients are using them, according to a new report published on Wednesday by Accenture that also found that failure to focus apps on services consumers want most could cost each hospital more than $100 million a year in lost revenue. In its “Losing Patience: Why Healthcare Providers Need to Up Their Mobile Game” report, the consultancy found that 38 of those top U.S. hospitals have developed health apps in-house rather than by hiring a mobile app vendor.  By not aligning their functions and user experience with what patients expect, many of these mobile health apps are failing to win over more patients. For example, only 11 percent of the hospital apps offer at least one of the three most desired functions: access to medical records; the ability to book, change and cancel appointments; and the ability to request prescription refills, Accenture found. Significantly, about 7 percent of patients have switched healthcare providers because of a poor experience with online customer service, including mobile apps, Accenture said. Accenture suggested that as consumers bring their service expectations from other industries into healthcare, providers will likely see higher switching rates on par with the mobile phone industry (9 percent), cable TV providers (11 percent) or even retail (30 percent). “In many cases, we’re seeing hospitals only offering a subset of things in their mobile apps — view labs, look up some basic forms,” Brian Kalis, managing director of the health practice at Accenture, told Healthcare IT News. “A lot of what is offered is around core medical record pieces versus easy appointment scheduling and such. It’s just static information, not personalized or tailored to an individual.” When developing new mobile health apps, or when revamping existing mobile apps, hospitals must adopt a patient-centric approach, Kalis said. “Moving to a person-centered approach will help hospitals understand what the mobile experience should be in terms of how patients interact in mobile and what they want,” Kalis said. “From there, hospitals might work more closely with electronic medical records vendors, advocating for a better experience and more flexibility in tailoring that experience. And hospitals might choose a custom solution, more for the patient-facing piece, and work on building out a digital engagement platform on their own to provide more control over and flexibility of the experience.” Further, hospitals should engage with prominent digital and mobile health companies that offer unique solutions — such as ZocDoc and InstaMed Go — to understand areas of great interest to consumers and how they fit into the healthcare ecosystem, Kalis said. When it comes to the question of buy versus build, Kalis suggested with mobile health it’s not a matter of either/or. Instead, it should be both. “Hospitals can work with emerging digital health disruptors in the mobile space and Internet of Things space; this can be done parallel with building solutions in-house,” he said. “It’s about the pace and scale of change: As you work on putting together a better experience for people on your own, or in collaboration with an electronic medical records vendor, there will always be a new set of solutions out there that is evolving. Collaborating with companies behind such solutions will further inform solutions built up within the enterprise.” As the pace and scale of mobile health technology continues to grow faster and larger, hospitals must keep up. “Mobile engagement is becoming increasingly critical to the success of every hospital in the digital age,” Kalis said. “Consumers want ubiquitous access to products and services as part of their customer experience, and those who become disillusioned with a provider’s mobile services, or a lack thereof, could look elsewhere for services.”  Twitter: @SiwickiHealthIT

Men, on average, earned $126,262, compared to $100,762 for women in the survey of 1,900 healthcare professionals that includes CEOs, CIOs, IT project managers and other titles.

The $157 million program will assess the housing instability, hunger and violence facing underprivileged patients, with the hope of directing patients to community-based services

Navigant Consulting has acquired revenue cycle-focused McKinnis Consulting Services for $49 million in cash and $3 million in common stock, the companies announced on Monday. The deal means more than 70 of McKinnis’ consultants will join Navigant, and all three McKinnis founders, James McHugh, Timothy Kinney, and John Morris, will join Navigant’s revenue cycle leadership team.  Chicago-based McKinnis Consulting Services offers revenue cycle assessment services to clients including academic medical centers, health systems and physicians groups. Navigant is a global firm with clients in the healthcare, energy and financial services industries offering professional services in areas including financial planning, risk management and business process management. “The McKinnis transaction is purpose-driven to expand our RCM capabilities at a time when health system margins are under greater scrutiny,” said David Zito, managing director and Navigant healthcare segment leader.  “The McKinnis professionals, which include the firm’s founders, further complement our ability to help clients navigate through the disruptions in the healthcare sector.” McKinnis has worked with major health systems including Indiana’s Parkview Health, which it helped manage through its Epic electronic health records integration, and John Muir Health in California, which it helped overhaul its revenue cycle systems. In fact, Mckinnis said it helped John Muir see a 98 percent increase in self-pay yield, 9 percent increase in third-party liability yield and a 20 percent increase in point-of-service cash collections. Twitter: @BethJSanborn

NantHealth on Tuesday announced plans to acquire Boston-based NaviNet, wrapping up what it called a 10-year plan for the tech firm, CEO Patrick Soon-Shiong, MD, said. Under terms of the deal, NantWorks, a holding company, and its majority-owned subsidiary NantHealth, are buying NaviNet for an undisclosed sum. The deal gives NantHealth entry into the payer market and strengthens its personalized medicine goals. NaviNet is known for its payer-provider collaboration technology. NantVentures, the private equity arm of NantWorks participated in the financing. “The acquisition of NaviNet completes our 10-year vision at NantWorks and NantHealth to integrate and coordinate our complex healthcare ecosystem from the knowledge domain, to the care delivery domain and now to the payer domain, as a single sign-on, seamless, cloud-based, secure adaptive learning system for patients, payers, and providers,” Soon-Shiong, founder and CEO of NantHealth, said in statement. The billionaire entrepreneur is quoted in the Los Angeles Business Journal as saying a public offering for NantHealth, which had been planned for last year, had been delayed pending the acquisition and integration of NaviNet. The acquisition continues NantHealth’s vision of delivering on whole health systems integration and revolutionizing the patient-clinician experience by bringing real-time molecular and evidence-based insights to the point of care, he said. NaviNet has a customer base of more than 40 health plans and nationwide network of more than 450,000 users. Its All-Payer Access provider portal connects more than 450 commercial and government plans via NaviNet Open, its payer-provider collaboration platform. “This cloud-based system allows provider access to over 90 percent of covered lives in the United States and will serve as a transformative platform for the communication of cutting-edge knowledge to all,” said Soon-Shiong. “By combining NaviNet Open’s applications – eligibility and benefits from more than 450 commercial and government plans, referrals, authorizations, document exchange, claims management, and more – with NantHealth’s interoperability, decision support and connectivity platforms and with NantOmics supercomputer predictive modeling platforms, we are now poised to be the nation's leading healthcare collaboration network by transforming the payer-provider relationship to evolve from transactions to interactions and finally to collaboration,” he added NantHealth will be able to leverage NaviNet’s nationwide network across more than 170,000 active provider offices and 2,000 hospital settings to reach more doctors with genomics, decision support and connectivity solutions to enable better care coordination at lower costs for patients. “Our dream was to address the cognitive overload that faces clinicians today especially in the complexity of cancer, and support community oncologists as well as major academic centers,” he said. “Finally, we have the infrastructure in place to make this a reality.” Twitter: @HealthITNews

The money allocated to VistA comes within $6 billion in discretionary spending for projects including cutting its huge backlog of disability claims

The rule change enables providers to show the identities of patients subject to a federal mental health prohibitor for gun possession.