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October 25, 2013 / Issue 46

In this issue:

Decision support tool among Cleveland Clinic’s Top 10 medical innovations of 2014

Review: Refinements make Apple's Mavericks well worth the upgrade

HITECH: Now what? Latest developments in privacy and security in focus at AHIMA convention Oct. 26-30

Experts to detail critical healthcare privacy and security strategies at AHIMA

Smartphones may help nursing home docs spot drug mishaps

How music can boost our workouts

Most Popular Last Issue: Top 10 myths of security risk analysis


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Innovations

Decision support tool among Cleveland Clinic’s Top 10 medical innovations of 2014

A bionic retina, capable of restoring rudimentary sight in patients after years of near blindness, is the No. 1 medical innovation for 2014 at the Cleveland Clinic’s annual Innovation Summit. The top 10 medical innovations expected to have the biggest impact in the coming year were announced Oct. 16 to the roughly 1,400 doctors, researchers and industry leaders attending the summit in downtown Cleveland. Here are this year’s Top 10 innovations:

1. Retinal prosthesis system
This year, the Food and Drug Administration approved the use of a tiny implant that can help detect light in the eyes of people who have gone blind due to diseases like macular degeneration and retinitis pigmentosa (RP). The Argus II Retinal Prosthesis System was approved in February for severe RP, a group of inherited diseases causing retinal degeneration.

2. Genome-guided solid tumor diagnostics
Genomics has been used for years to help predict if post-surgery chemotherapy is necessary for breast cancer patients. Now, after a larger study validating the technique in prostate cancer was published earlier this year and the genetic analysis technology is more widely available, cancer researchers believe they are poised on the threshold of a new era in their field.

3. Responsive neurostimulator for intractable epilepsy
About one-third of the more than 2 million Americans with epilepsy will end up having seizures that do not respond to medical treatments. The device, which received the backing of the FDA’s neurological advisory panel in February, is surgically implanted under the skin on the skull and analyzes electrical patterns coming through leads that are placed on the patient’s brain in the area that is causing seizures. Seizure triggers can be picked up by the device and short-circuited with quick electrical pulses.

4. Direct-acting antiviral oral hepatitis C drugs
The FDA is close to approving an all-oral treatment for hepatitis C, which affects more than 3 million people nationwide. The drug, called Sofosbuvir, would be the first of a new generation of drugs that could drastically cut down the time it takes to treat the disease.

5. Perioperative decision support system
Anesthesiologist David Brown, now chair of the Clinic’s Anesthesiology Institute, was flying his private plane over Texas about a decade ago when he suddenly had an idea: why not have a system in the operating room sending out alerts and offering advice about performance measures the same way he was receiving information from his airplane computers and air traffic controllers? Almost as soon as he landed, he started writing up his idea for this computer-based decision support system, and now, a Clinic spinoff company, Talis Clinical, is readying the system for use in other hospitals around the country.

6. Fecal microbiota transplantation
Fecal transplants – depositing feces from a healthy person into the colon of someone who is sick – are proving surprisingly effective at treating intestinal infections. Research shows that more than 90 percent of patients with recurrent C. diff – infections that do not respond to antibiotics – get better after fecal transplants.

7. Relaxin for acute heart failure
A new treatment called serelaxin, a synthetic version of the naturally-occurring hormone human relaxin-2, may soon be available to improve symptoms and reduce the risk of death from the condition. Human relaxin-2 is found in both men and women, and is responsible for the increased volume of blood pumped by the heart during pregnancy.

8. Computer-assisted personalized sedation system
Earlier this year, the FDA granted pre-market approval (which requires clinical studies) to a device that would automate the sedation of patients undergoing colon-cancer screenings, saving money on the use of anesthesiologists.

9. TMAO assay: novel biomarker for the microbiome
In a lab at the Cleveland Clinic’s Lerner Research Institute, cardiologist Stanley Hazen has been on the trail of a new biomarker for heart disease that may help identify people who are at risk of heart attack, stroke and death even when traditional risk factors and other screening tools fail.

10. B-cell receptor pathway inhibitors
B-cells, a type of immune cell responsible for producing antibodies to fight off infection and maintain long-term immunity, can also become cancerous and lead to conditions such as Hodgkin’s lymphoma and leukemias.

Read the full Cleveland.com article. >

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Apple operating system (iOS)

Review: Refinements make Apple's Mavericks well worth the upgrade

There isn't one thing that jumps out with Apple's new Mac operating system, known as Mavericks – and that's a good thing.

Mavericks has plenty of modest refinements that add up to a system well worth the upgrade -- even if Apple weren't giving it away for free.

Many years ago, Web surfing changed dramatically when the Opera browser offered a way to open multiple Web pages in tabs instead of separate windows that cluttered the computer desktop. Most browsers soon followed.

That concept now comes to file management as part of Mavericks, which Apple released Tuesday for new Macs and older ones running Snow Leopard, Lion or Mountain Lion. You can now use tabs rather than separate windows for various folders, disks and networked servers.

The change may seem cosmetic, but it saves time.

To further assist with file management, Mavericks lets you assign one or more tags to files. It's similar to the approach Google's (GOOG) Gmail uses to organize email.

Mavericks also has features that reflect a world in which people use multiple devices.

You can access your tags when you use another Mavericks computer, though not iOS devices such as iPhones and iPads yet. If you're sending a document using an Apple app, tags get stripped to preserve privacy.

Stored passwords are now shared as well, along with credit card information. Apple e-books also sync.

Read the San Jose Mercury News article. >

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AHIMA News

HITECH: Now what? Latest developments in privacy and security in focus at AHIMA convention Oct. 26-30

For years, the final compliance date for the Health Information Technology for Economic and Clinical (HITECH) Act’s sweeping updates to the Health Insurance Portability and Accountability Act (HIPAA) Privacy and Security rule was a dominant narrative in the healthcare industry – and especially within the health information management (HIM) privacy and security circles.

Now that the Sept. 23 deadline has passed, the focus has shifted to real-time implementation challenges of the new requirements while maintaining compliance. The Final Rule provides patients increased access to their health information, which allows them to play a more active role in managing their healthcare. Discussions of these developments along with burgeoning privacy and security topics will take center stage at the American Health Information Management Association's (AHIMA) 85th Annual Convention and Exhibit Oct. 26-30 in Atlanta.

“We are excited to bring together thought leaders from across the healthcare spectrum for an important conversation about the complex and fast-changing world of privacy and security,” says AHIMA CEO Lynne Thomas Gordon, MBA, RHIA, CAE, FACHE, FAHIMA.

On Oct. 29, Kirk J. Nahra, JD, Wiley Rein LLP, will present, “Next Generation Privacy and Security Issues.” “I expect there will be pressure to implement more rigorous security standards for breaches; this will likely include a call for broader encryption and for enforcement and adverse notice publicity to put real pressure on developing better practices,” Nahra says.

The explosive growth in mobile devices provides patients greater access and control over their health information, but also highlights evolving privacy and security technological tensions.

Nahra will also highlight the role of health information exchanges and health insurance exchanges in his AHIMA Convention presentation.

AHIMA’s Angela Dinh Rose, MHA, RHIA, CHPS, FAHIMA, director of HIM Practice Excellence, will participate with Adam Green, JD, MPH, of Davis Wright Tremaine in a wide-ranging question and answer session on the final HITECH Omnibus Rule on Oct. 30. In addition, Green will present, “Managing the Privacy and Security of Your Patient Portal” on Oct. 28.

Read daily AHIMA convention coverage at http://journal.ahima.org/2013/10/16/ahima-convention-coverage/. HMT will also have AHIMA coverage in this newsletter next week.

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AHIMA News

Experts to detail critical healthcare privacy and security strategies at AHIMA

FairWarning executive Chuck Burbank will co-present a session at the 2013 AHIMA Conference titled “HIPAA Privacy and Security Enforcement: Expert Advice for those Preparing and Responding to the OCR Audit Program.” In this educational track, Chuck Burbank and Ryan Redman from Wolters Kluwer will address the background, challenges, best practices, and a real-world example of the OCR Audit Process. Tuesday, Oct. 29, 2013, 5:00 p.m. A412AB Building A.

Additionally, Shallie Bryant, assistant manager HIPAA Privacy & Security, of CaroMont Health, a leading care provider and FairWarning customer will present “Seven Strategies for a Successful Patient Privacy Monitoring & Compliance Program.” In this educational track, Shallie will address the changes in the healthcare industry, including the rapid adoption of electronic health information systems and mounting mandates for privacy auditing. Tuesday, Oct. 29, 2013, 3:15 p.m. A412AB Building A.

Other presentations in this session block include: “It’s 7:00 a.m.; Do You Know Who is Sharing Your Health Information? ROI and HIE,” Tuesday, Oct. 29, 2013, 7:00 a.m. A312 Building A.

HITECH Omnibus Rule Panel,” Wednesday, Oct. 30, 2013, 10:30 a.m. A412AB Building A.

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Rx

Smartphones may help nursing home docs spot drug mishaps

Doctors who use their mobile device to look up drug information while prescribing medications for patients in nursing homes can help prevent adverse drug events, a new study says.

Researchers found that almost 90 percent of doctors said they avoided at least one potentially harmful drug reaction in the previous month. They said additional drug events could be avoided if more doctors took advantage of the drug-reference software that is available on the devices.

"Most U.S. nursing homes do not have electronic medical record systems and, as a result, physicians frequently do not have access to current medication information at the point of prescribing," lead investigator Dr. Steven Handler, an assistant professor of biomedical informatics, geriatric medicine and clinical and translational sciences at the University of Pittsburgh School of Medicine, said in a university news release.

"The lack of accurate and timely medication information can lead to adverse drug events and drug-drug interactions," Handler said. "Our hypothesis was that if physicians could look up drug information first, many of these mistakes could be avoided."

In conducting the study, the researchers surveyed more than 550 nursing home doctors about whether they owned a mobile device. If they did, they were asked how and when they used it, as well as what type of drug reference software they used and how often.

Read the full Newsday article. >

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Personal Health

How music can boost our workouts

Making music – and not just listening to it – while exercising makes the exercise easier, a remarkable new experiment finds, suggesting that the human love of music may have evolved, in part, to ease physical effort.

Researchers and exercisers have long known that listening to music alters the experience of exercising. But to date, no one had thought to investigate whether creating – and not merely hearing – music might have an effect on workouts.

For the new study, researchers at the Max Planck Institute for Human Cognition and Brain Sciences in Leipzig, Germany, and other institutions began by inventing an electronic kit that could be integrated into the internal workings of weight-training machines, transforming them into oversize boom boxes. Once installed into stair-stepper and weight machines, the kit would produce a range of propulsive, electronic-style music with a variety of sound levels and rhythms, depending on how the machine’s weight bar or other mechanisms were manipulated during workouts.

As the 63 healthy men and women volunteers strained, their machines chirped and pinged with a thumping 130 beats per minute, the sound level rising or falling with each individual’s effort and twining with the rhythms created by the other two exercisers. “Participants could express themselves on the machines by, for instance, modulating rhythms and creating melodies,” said Thomas Hans Fritz, a researcher at the Max Planck Institute who led the study.

Throughout each workout, the researchers monitored the force their volunteers generated while using the machines, as well as whether the weight lifters’ movements tended to stutter or flow and how much oxygen the volunteers consumed, a reliable measure of physical effort. Afterward, the scientists asked the volunteers to rate the tolerability or unpleasantness of the session, on a scale from 1 to 20.

Tabulated afterward, the results showed that most of the volunteers had generated significantly greater muscular force while working at the musically equipped machines than the unmodified ones. They also had used less oxygen to generate that force and reported that their exertions had felt less strenuous. Their movements were also more smooth in general.

Read the full NY Times article. >

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Most Popular Last Issue: HIPAA

Top 10 myths of security risk analysis

As with any new program or regulation, there may be misinformation making the rounds. The following is a top 10 list distinguishing fact from fiction.

1. The security risk analysis is optional for small providers.
False. All providers who are “covered entities” under HIPAA are required to perform a risk analysis. In addition, all providers who want to receive EHR incentive payments must conduct a risk analysis.

2. Simply installing a certified EHR fulfills the security risk analysis MU requirement.
False. Even with a certified EHR, you must perform a full security risk analysis. Security requirements address all electronic protected health information you maintain, not just what is in your EHR.

3. My EHR vendor took care of everything I need to do about privacy and security.
False. Your EHR vendor may be able to provide information, assistance and training on the privacy and security aspects of the EHR product. However, EHR vendors are not responsible for making their products compliant with HIPAA Privacy and Security Rules. It is solely your responsibility to have a complete risk analysis conducted.

Read the rest of the debunked myths in the HealthIT.gov article. >

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                    October 2013 HMT digital book

 


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