Google: using your health records to predict whether you’ll live or die

By Ethan Baron | [email protected] | Bay Area News Group PUBLISHED: January 30, 2018 at 10:57 am | UPDATED: January 30, 2018 at 11:22 am Dr. Google may not have much of a bedside manner — she’s an algorithm, after all — but if she says you’re soon to be “expired,” she claims to be about 95 percent accurate, and you might want to start planning that last meal. An elite team of computer scientists and medical experts from Google and three major U.S. universities believe they’ve found the best way yet to predict whether a hospitalized patient will end up leaving via the front doors or the loading dock at the morgue. As might be expected from research led by Google, the software for accomplishing this task relies on artificial intelligence, which has become a key focus in virtually all areas of the Mountain View company’s operations. In a just-released paper, not peer reviewed, the researchers claim their AI-based software, based on AI known as “deep learning,” does a better job at predicting patient outcomes than other methods currently available. “These models outperformed state-of-the-art traditional predictive models in all cases,” the paper said. To make its predictions, the software uses medical-records data including patient demographics, previous diagnoses and procedures, lab results and vital signs. Top of the list of outcomes predicted is “inpatient mortality,” in which the patient is reported as “expired.” But the software goes beyond the question of life and death, to answer questions important to patients as well as hospital administrators and bean counters. Unplanned re-admissions to the medical facility within 30 days are also covered, as well as probable length of stay and diagnoses, the latter of which is delineated using hospital billing codes. The paper covered the study of some 216,000 hospitalizations involving about 114,000 Continue Reading

Apple wants to store your health records on iPhone, Apple Watch

Apple is taking a new step to bring your life into one location. The tech giant has updated its Health app so users can upload their health records onto their phones and have them accessible on both phones and Apple Watches. The Health Records section of the app is currently in beta, or test, form released this week and is part of the iOS 11.3 beta, CNBC reported. Apple worked with hospitals to use Fast Healthcare Interoperability Resources, or FHIR, to transfer electronic records to the devices and to keep them secure. Apple Health will combine information and update it with the latest medical records. In the past, patients had to download their records and manually upload them into the program, The Washington Post reported. Many medical systems offer their own web portals, but the new app can combine the information into one source, according to The Washington Post. The app will show users their allergies, immunizations, lab results and medications in an easy-to-follow, timeline format that is encrypted and must be accessed by a passcode. A handful of hospitals, including Johns Hopkins Medicine, Cedars-Sinai and Penn Medicine, are allowing their patients to use the app as a portal to their records as part of the program’s introduction. Johns Hopkins Medicine - Baltimore, Maryland Cedars-Sinai - Los Angeles, California Penn Medicine - Philadelphia, Pennsylvania Geisinger Health System - Danville, Pennsylvania UC San Diego Health - San Diego, California UNC Health Care - Chapel Hill, North Carolina Rush University Medical Center - Chicago, Illinois Dignity Health - Arizona, California and Nevada Ochsner Health System - Jefferson Parish, Louisiana  MedStar Health - Washington, D.C., Maryland and Virginia OhioHealth - Columbus, Ohio Cerner Healthe Clinic - Kansas City, Missouri For more information, click here. Continue Reading

What is $2 billion buying Kansas and Missouri in prison health care? Few people know

Shermaine Walker’s son died of a rare fungal brain infection last year in a Kansas prison, and since then she’s been trying to find out whether the prison’s private health care contractor could have stopped it. That same contractor, Corizon Health, oversees inmate care in Missouri prisons. A state legislator there contends Corizon staff misdiagnosed his uncle’s cancer. He’s also asking how that happened. Corizon’s contracts with the corrections departments of Kansas and Missouri are worth almost $2 billion combined over 10 years — yet there’s little transparency about how that money is being spent. “In my time I’ve not experienced a specific report in terms of Corizon or their performance in their contracts,” said Kansas Rep. Russ Jennings, a Republican from Lakin who is chairman of the House Committee on Corrections and Juvenile Justice. Jennings said that’s not unusual for state contractors, but Corizon is not a run-of-the-mill vendor. As the largest for-profit prison health care provider in the country, Corizon is a lightning-rod for criticism from prisoners, their family members, the American Civil Liberties Union and others who say it takes public money and provides little care. All in an effort, they say, to maximize its profits. Hundreds of inmates in Missouri and Kansas have filed suits against the company alleging substandard care. Susan Lawrence, a physician from California and expert witness in correctional medical malpractice cases, said Corizon, like most prison health care companies, has a bad reputation. “I have never heard of one that people say, ‘You know, they do a really, really good job,’ ” Lawrence said. “They’re private, their goal is to make money, so they put policies in place that aren’t necessarily (intended) to benefit the patient,” she said. The company says they’re providing high-level care in difficult Continue Reading

Snooping nurse forces Palomar to notify 1,300 patients of records breaches

Palomar Health will notify 1,309 patients that one of its former nurses inappropriately accessed their medical records while they stayed at Palomar Medical Center Escondido during a 15-month period from Feb. 10, 2016, through May 7, 2017. According to a short statement the North County health provider released Friday morning, information accessed in most cases included patients’ first and last names, dates of birth, genders, medical record numbers, diagnoses, treatment locations, medications and allergies. Breaches were more potentially severe for four patients who will be offered free identity-protection services because computer logs show access to parts of Palomar’s electronic medical records system that house social security numbers, health insurance coverage details and financial information. Derryl Acosta, the health system’s spokesman, said the employee voluntarily resigned during an internal investigation. Acosta said that there is no evidence that the former employee did anything with the information that she viewed or that any records were removed from the hospital. An audit of access logs, he said, revealed a pattern of prying for no good medical reason. “The nurse was inappropriately snooping in records, whether they were assigned to that nurse or not. These were records they shouldn’t have been looking at,” Acosta said, adding that, in all cases, affected patients were either assigned to the nurse or to another nurse working in the same unit. The advent of electronic health records, and the need to give bedside professionals such as nurses and doctors broad access so that they can effectively do their jobs, has opened a new privacy minefield in hospitals nationwide, said Matthew Fisher, a health law specialist at Mirrick, O’Connell, DeMallie & Lougee in Worchester, Mass. Health privacy law, Fisher said, is very clear that broad electronic access is not a fishing license. “You can’t just go Continue Reading

Children’s Aid Society opens new center in Bronx to serve  medical, dental and mental health needs of 4,000 youth

The Children’s Aid Society will unveil its new Bronx headquarters on Wednesday -- a state of the art community health center. The $13.5 million, 40,000- square-foot facility just south of Crotona Park at 910 E. 172nd St., will address children’s medical, dental and psychological needs. “One thing that the space also offers us, is the ability to provide real, coordinated services for our most vulnerable children,” Children's Aid Society president and CEO Richard Buery said. “To have them all under one roof, allows for better coordination, communications and collaboration among all those professionals.” For example, a child who comes in with a toothache but also has an undiagnosed mental health issue could have both treated at the center, Buery said. “There’s a real power in having all these folks on a team working under one roof,” he said. The community health center will serve about 4,000 Bronx youth annually - about 400 in foster care run by the Children’s Aid Society--and double the group’s capacity for providing care to Bronx children. The new HQ boasts a teen-only waiting room and electronic patient health records. Michael Wagner, director of permanency for the Children's Aid Society’s adoption and foster care program, said children in foster care will especially benefit from the new center. The site will also house a medical foster care program for kids with disabilities or chronic illnesses whose parents aren’t able to take care of them. The program, created in the 1980s to care for babies born to crack-addled moms, places sick and disabled children in foster homes. The nonprofit, which advocates and supports New York City children, has about a dozen other sites in the Bronx, including a teen center, early childhood education programs and a recently- opened charter school. “We really want to be in the business of helping to create true Continue Reading

VUMC starts ‘gigantic’ switch to Epic records system

Vanderbilt University Medical Center will move its electronic health records to a new software system designed by Epic Systems — a transition that will take about two years, require dozens of new jobs and possibly rental space to train employees.The transition will ultimately impact every patient who comes into a Vanderbilt affiliated facility, as well as every employee.The transition from design to implementation is akin to changing the engine of a jetliner in the middle of a flight, said Dr. Kevin Johnson, chair of biomedical informatics and chief informatics officer for VUMC. The cost was not released by Vanderbilt Friday.The goal is to have the new system operating in 2018. Epic, based in Verona, Wis., has managed VUMC's registration and outpatient billing since 1995.The timeline is reasonably ambitious for a system the size of VUMC, said attorney Andy Norwood, partner at Waller law firm.Changing a hospital’s electronic medical record and electronic health record system is "a very very big undertaking. It's not like going from Word to WordPerfect," Norwood said. "It’s in the 'gigantic' category."The health system created its current software system with McKesson, which decided to discontinue the system in 2018. That prompted VUMC to find another.VUMC wants to provide a seamless and more efficient system for patients and clinicians."The coolest thing we’re going to do with the new software is we’re going to have our patients experience one bill — we’re really committed to that," said Johnson.Johnson said the system will enable Vanderbilt to better connect with hospitals around the country and the world. Epic will allow Vanderbilt clinicians to electronically get patients' health records from other doctors and hospitals that use the Epic software.For patients an easy way to access medical records is the holy Continue Reading

Bellevue Hospital tipped-off to safety inspection; discharged patients, massaged records

Alerted to "surprise" safety inspections, a top Bellevue Hospital official ordered some patients discharged and warned supervisors to make sure all records were complete, the Daily News has learned. An internal e-mail shows executives ordering a last-minute cleanup, believing the independent Joint Commission on Accreditation of Healthcare Organizations was about to show up. At the time, the commission was performing unannounced surveys at several hospitals run by the city's Health and Hospitals Corp. in response to a Daily News series on coverups of medical mistakes, records show. Dr. Eric Manheimer, the head of patient safety at Bellevue, sent the heads-up e-mail to Bellevue staffers a day after the Joint Commission began inspecting other HHC hospitals. He wouldn't say who gave him the tip, only that he "became aware" of the inspections from "colleagues" in HHC. A spokeswoman for the Joint Commission declined to comment on what they've found or how they felt about Manheimer's preemptive e-mail. The commission has yet to visit Bellevue. The spokeswoman confirmed the survey team has visited four other HHC hospitals since city Controller William Thompson and Public Advocate Betsy Gotbaum demanded an inquiry following The News' series in July. The News found dozens of examples of medical mishaps that weren't reported to the state, as well as instances where patient records were altered, fictional or lost. The Bellevue e-mail makes clear the hospital's top staff was concerned about being ready before the team showed up. The concern began shortly after a Joint Commission team paid an unannounced visit to Kings County Hospital in Brooklyn Sept. 10. The next day a team performed a surprise review at Metropolitan Hospital in Harlem. That day, Manheimer sent an e-mail to more than 20 Bellevue staffers that was titled "JCAHO visit," noting that the reviews were "a likely response to the flurry of media attention to the Public Hospital system over Continue Reading

Health Department offering Wall Street-style bonuses to doctors who improve patients’ health

Despite the gloomy economy, the city Health Department is offering Wall Street-style bonuses to doctors who boost their patients' health by the end of the year. Under a privately-funded pilot program, more than 50 medical practices can earn up to $100,000 for improving the heart health of poor patients, health officials told the Daily News. With $4 million from the Robin Hood Foundation, the agency will monitor approximately 472 doctors at 107 practices that use electronic health records. Half will qualify for the cash incentives. "Our hope is that we will be able to continue this, and if we can show good results we can extend it to everybody," said Farzad Mostashari, who is overseeing the project at the Health Department. Some anti-poverty advocates question the timing of the bonuses, saying there are better ways to help needy New Yorkers during desperate times. "We are in a crisis and we should deal with the crisis of getting Medicaid and health insurance for the poor," said Community Service Society President David Jones. "I think this is a great idea," Jones added. "I just don't think now is the time." The Health Department sliced nearly 10% off this year's budget and an additional 19% off next year's spending, and took heat for closing 44 free dental clinics this spring. The Robin Hood funding is tied to the experimental program and can't be used to plug other budget holes. Under the nine-month trial, doctors can earn up to $200 a patient for reducing their blood pressure and cholesterol levels, enrolling patients in quit-smoking programs and asking them to take aspirin daily. Each doctor can earn up to $20,000, and the ceiling for a practice is $100,000. The extra money is collected for making strides with those who are uninsured, on Medicaid or diabetic. Dr. Olusanya Rufai, who applied for the program and has a practice in Bedford-Stuyvesant, Brooklyn, said he's motivated by the competition, not the cash. "It's almost Continue Reading

Health records going high-tech, 28 hospitals to share electronic info

Doctors at a number of Bronx hospitals and health-care organizations will soon have instant access to the latest patient medical records when a new electronic medical information system has a trial launch later this month. The Bronx Regional Health Information Organization will start up with six hospitals and health-care institutions able to update and view electronic medical records of patients who sign on to participate. "You can deliver better care, more timely care, more complete care if you have better medical records," said Barbara Radin, executive director of the Bronx RHIO. An additional 22 borough hospitals, health centers, nursing homes and home health service organizations initially will only be able to view records, but eventually will also contribute medical records such as lab results and new prescriptions. The information system will allow doctors to access patient information if they have been treated or received tests and prescriptions at any of the other participating hospitals, clinics or nursing homes. The member health organizations and a grant from the New York State Department of Health are funding the nonprofit organization. The Bronx RHIO, part of a national push to create electronic medical record systems, aims to improve health care and save money by reducing medical errors, avoiding duplicate testing on patients and getting a clearer picture of disease rates in specific populations, as well as disparities in health care and treatment outcomes. Patient consent is required. The information is protected by security software and only accessible to authorized users. Every information request by a user will also be tracked. Verona Greenland, president of Morris Heights Health Center, praised the new system because many of its patients receive treatment from so many institutions. Radin of the Bronx RHIO agreed. "The way care is delivered nowadays, it doesn't always happen at one place with one doctor," she said. With the Continue Reading

Why U.S. doctors are quitting: The feds’ awful electronic health records mandate explains a lot

A bout a decade ago, a doctor friend was lamenting the increasingly frustrating conditions of clinical practice. “How did you know to get out of medicine in 1978?” he asked with a smile. “I didn’t,” I replied. “I had no idea what was coming. I just felt I’d chosen the wrong vocation.” I was reminded of this exchange upon receiving my med-school class’s 40th-reunion report and reading some of the entries. In general, my classmates felt fulfilled by family, friends and the considerable achievements of their professional lives. But there was an undercurrent of deep disappointment, almost demoralization, with what medical practice had become. The complaint was not financial but vocational — an incessant interference with their work, a deep erosion of their autonomy and authority, a transformation from physician to “provider.” As one of them wrote, “My colleagues who have already left practice all say they still love patient care, being a doctor. They just couldn’t stand everything else.” By which he meant “a never-ending attack on the profession from government, insurance companies, and lawyers . . . progressively intrusive and usually unproductive rules and regulations,” topped by an electronic health records (EHR) mandate that produces nothing more than “billing and legal documents” — and degraded medicine. I hear this everywhere. Virtually every doctor and doctors’ group I speak to cites the same litany, with particular bitterness about the EHR mandate. As another classmate wrote, “The introduction of the electronic medical record into our office has created so much more need for documentation that I can only see about three-quarters of the patients I could before, and has prompted me to seriously consider leaving for the first time.” You may have zero sympathy for doctors, but think about the extraordinary loss Continue Reading