Key to information sharing? Giving patients ownership of their data

Cletis Earle, CHCIO, VP, CIO Penn State
Health  Image courtesy – Penn State Health

When Cletis Earle, CHCIO, stepped into his new role at Penn State University as senior vice president and chief information officer he was hit with the major disruption in plans with the COVID-19 pandemic. Instead of implementing information technology (IT) initiatives across Penn State Health and Penn State College of Medicine, Earle led his team of professionals in developing an agile fast response to the challenging IT needs of the institutions caused by the pandemic. Previously Earle had served as VP and CIO for Kaleida Health and St. Luke’s Cornwall Hospital in Newburgh/Cornwall, NY. He began his healthcare IT career as a support manager at Brooklyn Queens Health Care Inc. in Brooklyn, NY, eventually taking on roles as director of technology and vice president and chief information officer and privacy officer within the organization. Earle is a member and former chairman of the College of Healthcare Information Management Executives and is a frequent speaker at healthcare IT conferences. He also serves as an ambassador on the HIMSS Global Health Equity Network Advisory Task Force. PARCA eNews spoke to Mr. Earle by phone to get his perspectives on future directions healthcare information technology.

Registration for now open for RSNA 21

Annual Meeting Nov. 28-Dec. 2

PARCA eNews – Sept. 21, 2021 – The 107th Scientific Assembly and Annual Meeting for the Radiological Society of North America is set to kick off Nov.28 at the massive McCormick Place convention center in Chicago, IL. 

The in-person conference will continue through Dec. 2, while online attendees will have until April 30, 2022 to view any and all of the meeting programs.

Unlike years past, the Covid-19 pandemic has changed things a bit. All attendees will be required to show proof of vaccination and wear a mask for all exhibition space and meeting rooms. 

Big conferences learning to live with pandemic restrictions forge ahead

HIMSS 21 drew more than 17,000 despite pandemic

PARCA eNews – Sept. 12, 2021 – Kudos to HIMSS for taking the risk of holding one of the largest in-person medical conferences amid what looked like at the time, a waning pandemic.

Held Aug. 9-13 in Las Vegas, it looked to have been perfectly timed. Cases and deaths from COVID-19 had plummeted from the peaks of November and December 2020, vaccinations had surged and people had begun to think we might be seeing the light at the end of the tunnel.

Providers planning for permanent deployment of telemedicine

PARCA eNews – Sept. 2, 2021 – As the pandemic grinds on the use of telemedicine is emerging as a mainstay for healthcare delivery among many providers and patients. Health systems are beginning to incorporate it into planning beyond the emergency implementations spurred by the pandemic.

A group of Stanford Department of Medicine researchers looked into their own institution’s implementation of telemedicine and published their findings in the Aug. 30, 2021 Journal of the American Medical Informatics Association.

Cloud computing and AI are key to healthier communities

Image posted on LinkedIn

PARCA eNews – Aug. 23, 2021 – Interoperability, cloud computing and artificial intelligence are keys to improving patient outcomes and providing the preventative healthcare that will increase efficiency and lower healthcare costs in the future, according to Phoebe Yang, general manager for nonprofit healthcare at Amazon Web Services.

In an interview in Healthcare IT News, Yang said that interoperability and AI/machine learning can help physicians predict health issues for individuals and across populations, and cloud computing combined with Fast Healthcare Interoperability Resources (FHIR) is playing a driving role in data interoperability by helping de-identifying patient data to allow large-scale analysis while upholding privacy.

Publicly available AI algorithm proves useful for spotting actionable radiology findings

PARCA eNews – Sept. 12, 2021 – A publicly available artificial intelligence algorithm for detecting and flagging "actionable" radiology reports proved superior to three other methods for distinguishing actionable from non-actionable reports.

The study by researchers let by Yuta Nakamura at the University of Tokyo appears in the Sept. 11 journal, BMC Medical informatics and Decision Making. The goal is to use AI to more rapidly detect and refer radiological findings to clinicians.

AI may be highly useful for cutting turnaround times for abnormal chest x-rays

Image credit – nature Scientific Reports

PARCA eNews – Sept. 12, 2021 – In a study of artificial intelligence capability to distinguish normal from abnormal x-rays, researchers were able to show that AI reduced the turnaround time and prioritize abnormal x-rays by as much as 28 percent. In other words, when asked to flag suspicious x-ray results for the radiologist to review, AI was able to do it faster.

The AI study by researchers at Google Health took a different approach than most AI algorithms studies. Instead of training the algorithm to spot specific diseases, such as breast or lung cancer, the Google investigators tapped six international data sets from x-ray studies in India, China and United States using a total of 248,445 de-identified patient x-rays to simply distinguish normal from abnormal findings.

FDA ok’s SpinTech’s STAGE platform for rapid brain imaging

PARCA eNews – The US Food and Drug Administration (FDA) has given 510(k) clearance to SpinTechMRI’s latest magnetic resonance imaging software device, STAGE (STrategically Acquired Gradient Echo), a post-processing software platform.

The software enables comprehensive, quantitative brain imaging with enhanced visualization in significantly less time than conventional MRI. STAGE allows MRI techs to acquire 16 brain imaging contrasts, including 10 enhanced contrast qualitative outputs and 6 quantitative outputs in just 5 minutes, according to a SpinTechMRI press release.

Google launches healthcare data engine to boost interoperability

PARCA eNews – July 22, 2021 – Google Cloud launched and extension of its healthcare data services offering with a private preview of its Healthcare Data Engine to power an end-to-end solution for healthcare organizations.

In a press release, the company says its data engine builds on and extends the core capabilities of the Google Cloud Healthcare API.

Healthcare data breaches continue unabated

PARCA eNews – Aug. 23, 2021 – The US Department of Health and Human Services Office for Civil Rights data shows that healthcare data breaches involving more than 500 records continues on an average rate of two per day.

The OCR is currently investigating over 830 such breaches dating back to September 2019.

Over this past summer millions of patient records have been compromised with the highest numbers of breached records reported by Forefront Dermatology, S.C. (2.4 million), St. Joseph’s/Candlier Health System in Georgia (1.4 million), University Medical Center Southern Nevada (1.3 million) and UF Health Central Florida (700,981).

When hiring a consultant look for one who is independent

Henri ‘Rik’ Primo’s 40 years’ experience in healthcare IT and medical imaging spans the earliest development of PAC systems to the latest innovations in interoperability and enterprise imaging. His career parallels the digitization of healthcare information, and his pioneering contributions at the likes of Philips, AGFA and Siemens were key to major technology shifts in the digital imaging. He worked on the early implementations and product launch of Philips digital subtraction technology for angiography, the creation and launch of the Gyroview 2000 MRI advanced visualization system, and the first rollout of an archive CD product that featured “SPI” or standard product interconnect, a pre-DICOM interface that allowed Siemens and Philips MRI workstations users to share MRI images. At AGFA he worked on the creation and product launch of IMPAX the first PACS system that was using common off-the-shelf hardware (COTS). His 20-year career at Siemens included 10 years as chair of the Imaging Informatics Division for NEMA - (National Electrical Manufacturers Association) in addition to his work on strategic relationships with universities, consultants, and regulatory bodies in the realm of digital technology and transformation. Today, he is an independent consultant to major imaging informatics clients and serves on a number of HIMSS-SIIMS Enterprise Imaging collaborative workgroups. PARCA eNews spoke to Mr. Primo by phone about his remarkable career and  and what to look for in a consultant.

HiMSS 21 in-person convention set for Las Vegas, Aug 9-13

PARCA eNews – July 9, 2021 – It’s back to in-person attendance at one of the biggest healthcare conventions in the US. 

CIOs and senior executives, providers and payers, IT and PACS professionals will once again gather in person for HiMSS 21 in Las Vegas for the first time in a year-and-half due to the pandemic.

Too big for a single venue HiMSS 21 will take over Venetian-Sands Expo Center, Caesars Forum Conference Center, and Wynn Las Vegas.

Patient ID Now coalition applauds House action calls on Senate to follow suit

PARCA eNews – July 29, 2021 – The US House of Representatives removed the ban on research into developing a national patient ID for the third year a row. A move that the Patient ID Now coalition praised as a bi-partisan step toward greater patient safety.

In a press release, the coalition used the passage in the House to call on the US Senate, where the bill has floundered each of the past three years, to follow suit and pass the bill.

The coalition is made up of major healthcare organizations including American College of Surgeons, the American Health Information Management Association (AHIMA) the College of Healthcare Information Management Executives (CHIME), Healthcare Information and Management Systems Society, Inc. (HIMSS), Intermountain Healthcare, and Premier Inc.

SIIM offering virtual conference on AI in medical imaging Sep 19-20

Special $100 member rate for early registration by Aug. 29

PARCA eNews – July 21, 2021 – Staying in the loop with all that is going on in medical imaging is hard enough, keeping up with rapid evolution of artificial intelligence and machine learning in radiology and other medical imaging application is even challenging.

CISA issues alert about Phlips VUE PACS vulnerability

PARCA eNews – July 6, 2021 – The Cybersecurity and Infrastructure Security Agency (CISA) issued an alert today regarding significant security vulnerabilities for Philips Vue PACS. The alert pertains to several versions of the platform’s software and lists 15 specific vulnerabilities including two that are considered critical on the Common Vulnerability Scoring System.

Historic agreement allows healthcare collaboration between UAE and Israel

PARCA eNews – July 11, 2021 – The United Arab Emirates and the Department of Health for the capital city Abu Dhabi announced in a press release a strategic agreement with Israel’s Sheba Medical Center aimed at creating a framework for developing and improving healthcare services in the country.

In a memorandum of understanding the Abu Dhabi Department of Health and Sheba Medical Center will enter into collaborations for the exchange of knowledge, best medical practices and methodologies.

PARCA founder Herman Oosterwijk featured on new SIIM podcast

PARCA eNews – July 12, 2021 – Herman Oosterwijk has been instrumental in the development of medical imaging as it is used in clinical practice today.

As an engineer/technologist, Herman has served as educator and ultimately as an advocate in developing and guiding the standards that make storing, archiving and sharing of medical images such a dynamic part of current day medical practice.

2020 HIMSS cybersecurity survey reveals startling numbers

PARCA eNews — July 12, 2021 – Healthcare IT security budgets remain low despite increasing threats, a new HIMSS cybersecurity survey reveals.

These are just a few highlights of the HIMSS survey of 168 US based healthcare cybersecurity professionals that was conducted during the pandemic year 2020.

• More than 70% of healthcare organizations experienced significant cybersecurity incidents in the previous 12 months
• Less than 6% of healthcare IT budgets is allocated to cybersecurity
• 89% of initial point of compromise occur through email
• 57% of significant security incidents result from phishing
• 20% of significant incidents involved ransomware

While the overall results suggest healthcare organizations are improving their security, there is growing concern that the efforts may not be enough to keep pace with rapidly evolving threats.

You can read HIMSS Cybersecurity Survey on their website and download the report in a PDF.

ONC announces timeline for TEFCA going live in 2022

PARCA eNews – July 13, 2021 – The Office of the National Coordinator for Health Information (ONC) announced its timeline for the Trusted Exchange Framework and Common Agreement (TEFCA), which aims to develop a nationwide network for the exchange of health information.

Taking the plunge into independent consulting

Mohannad Hussain, Medical Imaging 

As the second in a series looking at leveraging PACS administrator skills and expertise into new career possibilities, PARCA eNews talked with Mohannad Hussain, who took his expertise in DICOM, HL7 and PACS at both AGFA and Philips to launch a consulting business on his own. Having started in software development and project management, he later became focused on medical imaging informatics and found that to be a career calling. He has worked on a number of award-winning products, bringing innovative solutions to solve problems in healthcare and beyond. One of his passions is integrating systems in healthcare such as EHR/EMR, RIS, PACS, VNA, Universal/Enterprise zero-footprint viewers, VR/Reporting, AI/ML algorithms, Business Intelligence and Analytics to simplify workflows, automate steps, drive quality improvement for healthcare providers. Mohannad has spoken at a number of conferences in North America and overseas on a range of topics related to software development and health/imaging informatics. He is an evangelist for standards such as FHIR, DICOMweb and IHE profiles. He is the project manager for the annual SIIM Hackathon. His other passions include knowledge sharing/training and contributing to open-source software. While he has been consulting for 14 years, it was only recently that he made the plunge to full-time independent consulting. He began his company Techie Maestro in 2008 and went full-time in 2021.

Volunteer for SIIM – Accepting Applications Until June 2

SIIM recruiting volunteers for a variety of opportunities

PARCA eNews – May 18, 20221 – Are you looking to enhance your career, learn more about medical imaging and informatics, or just want to connect with others in the medical imaging field, then the Society for Imaging Informatics in Medicine (SIIM) is looking for you. The organization is accepting applications for volunteers through June 2.

RSNA to return to McCormick Place for annual meeting Nov. 28, 2021

PARCA eNews – May 17, 2021 – Live annual meetings are back! The Radiological Society of North America announced today that it will hold its 107th Scientific Assembly and Annual meeting at McCormick Place in Chicago Nov. 28 to Dec. 2, 2021.

“We have heard from many of our regular attendees and exhibitors that they are excited and ready to get back to Chicago for the RSNA meeting, and we look forward to welcoming them,” said RSNA president Mary C. Mahoney, M.D in a press release. “We are planning a robust in-person scientific assembly and technical exhibition, along with a virtual meeting component to enhance attendees’ meeting experience.”

Healthcare information advocacy groups raise concerns around proposed HIPAA rules changes

Image credit – HHS.gov

PARCA eNews – May 13, 2021 – The department of Health and Human Services (HHS) has issued several proposed rule changes largely aimed at improving data sharing for care coordination, however, several patient information advocacy groups, including CHIME have voiced concerns about the changes pointing to conflicting regulations between federal and state regulations, according to a report in the HIPAA Journal.

The advocacy groups are calling for changes the would align HIPAA Privacy Rule with the 21st Center Cures Act, particularly around federally assisted substance use disorder (SUD) treatment programs so that the HHS changes would more closely match those of state health data privacy laws. The issue is that providers are facing so many regulations that confusion could ultimately result in new privacy and security risks.

Hardening Cybersecurity of your supply chain

PARCA eNews – May 5, 2021 – Strengthening ICT supply chains requires an ongoing, unified effort between government and industry, says the US Cybersecurity & Infrastructure Security Agency (CISA).

In March 2020, SolarWinds unwittingly sent out software updates to its customers that contained hacked code that gave the hackers access to many SolarWinds customers’ network.

End of road for ONC Interoperability roadmap

PARCA eNews – May 4, 2021 – The Office of National Coordinator announced that it is sunsetting the Interoperability Roadmap ahead of schedule, due in part to successes in achieving the goal.

In a May 4, 2021 blog post on the HealthIT.gov website, Steven Posnack, Deputy National Coordinator for Health Information Technology at ONC announced that the Roadmap released in final form in 2015 will no longer guide policy development on information blocking, reducing provider burden, and nationwide electronic information exchange.

Study finds wide variation in embargo periods blocking patient access to imaging

PARCA eNews – May 4, 2021 – In a US News & World Report telephone survey of 83 hospitals conducted between 2019 and 2020, over 90% of hospitals offer online patient portal to access medical imaging, however the amount of delay or the embargo period for access varied greatly.

The purpose of such embargoes is to allow clinicians an opportunity to first receive, review and discuss with the radiologist, however, there is no standardized length for such embargo periods. The survey results were published May 4, 2021 in the journal Radiology.

Coalition launches guide for national patient ID

PARCA eNews – April 30, 2021 – Patient ID Now, a coalition of healthcare organizations including the Healthcare Information and Management Systems Society, Inc. (HIMSS) published its strategy for developing a national patient identification system April 27, 2021.

The Framework for a National Strategy on Patient Identity: A proposed Blueprint to Improve Patient Identification and Matching is intended to guide the creation of a national system for patient identification to ensure patient matching and safety.

No more PACS according to new FDA classifications

Image – An Agent-Based Infrastructure for Secure
Medical Imaging System Integration
by Kamran Sartipi

PARCA eNews – April 20, 2021 – The FDA issued a final rule on its Medical Device Classification Regulations to conform with medical software provisions of the 21st Century Cures Act.

That act excluded certain software functions from the definitions of medical devices. In doing so, the FDA reviewed and changed its regulations for eight classifications of medical devices and in the process renamed PAC systems to Medical Image Management and Processing System or MIMPS.

Leveraging PACS skills and expertise to broaden your career

Sjoerd van Schie

This is the first in a series looking at using PACS administrator skills and expertise to leverage career possibilities. For this article PARCA eNews spoke with Sjoerd van Schie, District Service Manager for precision diagnosis and image-guided therapy at Phillips Healthcare. As service manager for Hitachi, Europe before PACS were a thing, Sjoerd was introduced to DICOM and he became early expert and advocate for DICOM at the company. He served as technical consultant for Hitachi in Zurich and then Technical Director for Hitachi in The Netherlands, Belgium and Luxembourg That experience propelled him to becoming the DICOM specialist at Hitachi, America based in Ohio. He has since leveraged that experience to serve in a variety of management positions at Carl Zeiss x-ray Microscopy in San Francisco and now at Phillips Healthcare in Los Angeles.

ACR names PARCA founder Herman Oosterwijk for Global Humanitarian Award

PARCA eNews – Feb. 5, 2021 – The American College of Radiology Foundation named PARCA founder Herman Oosterwijk its Global Humanitarian for non-radiologists for 2021.

The foundation announced the award in a letter to Herman, citing his commitment and dedication in support of Rotary International projects that provide imaging to hospitals and clinics in dozens of developing countries around the globe.

CISA issues emergency alert to organizations running Microsoft Exchange

Threat to healthcare research traced to China

PARCA eNews – March 9, 2021 – The Cybersecurity and Infrastructure Security Agency (CISA) issued Emergency Directive (ED) 21-02 March 2, 2021 requiring federal civilian departments and agencies running Microsoft Exchange on-premises products to update or disconnect the products from their networks until updated with the Microsoft patch released yesterday.

SIIM21 Annual meeting May 24-27

Registration is Now Open!

Join Imaging Informaticists from around the world virtually May 24-27 for discussions of the critical issues facing imaging and informatics professionals as we begin to emerge from the pandemic.

Sectra PACS named best in KLAS

PARCA eNews – March 17, 2021 – Sweden-based Sectra has once again been named a "Best in Klas" award winner for customer satisfaction in the Canada and Europe. It is the eighth year in a row for the Linköping company.

The company also won awards in the U.S. for large (300,000 studies) and small (under 300,000) PACS systems. The company scored above industry average in three categories:

Electronic exchange of patient data increasing but non-electronic methods persist

PARCA eNews – Feb. 21, 2021 –The decade-long effort to increase interoperable exchange of electronic health information seems to be paying off, according to the latest report from the Office of the National Coordinator for Health Information Technology.

UVM Medical Center shares lessons learned after ransomware attack

Credit – University of Vermont

PARCA eNews – March 22, 2021 – Last fall, the University of Vermont Medical Center suffered a system-wide shutdown of its network due to a ransomware attack that prompted federal agencies including the HHS and FBI to issue a warning about cyber criminals targeting healthcare systems.

After the organization finally repaired the damage and recovered the network operations an assessment of the system’s cybersecurity measures found several shortcomings that could have at least minimized the damage. They shared their lessons learned in an article in the March 2021 ACR Bulletin.

What PACS certifications do I need, CIIP vs PARCA?

Repirnted from OTech blog posted 08 Feb 2021  PACS administrators or as they are also called, Imaging Informatics Professionals (IIP), have been around for about 20 years, ever since providers started to realize that it takes a dedicated support staff to manage the PACS system and be responsible for its data integrity and operation.  In 2004 a certification agency, the PACS Administrators Registry and certification Association, aka PARCA, was formed to provide a proof of a certain level of proficiency witnessed by passing a certification exam. Not that long after that, the American Board of Imaging Informatics, akaABII, was formed in a partnership between ARRT and SIIM, providing another certification called CIIP.

How has the COVID-19 pandemic changed priorities in medical imaging?

In light of the sea change in healthcare brought about by the COVID-19 pandemic, PARCA eNews is taking a different approach to its first issue of 2021. Instead of the usual Q&A with a single leader in PACS administration and healthcare IT, we decided to contact a variety of thought leaders from industry, academia and professional organizations to ask a single question – How has the COVID pandemic changed priorities for enterprise imaging and imaging access for radiology departments not just during the pandemic but into the future? Below are quotes obtained by email or excerpts from articles written by the contributors on this topic.

It was clear very early in the pandemic that the systems which had access to data fared better than the ones that did not. Also, during the year, we have seen a remarkable reprioritization of many of the perquisites of digital transformation – like interoperability and increased emphasis on analytics. This is no surprise. Data became more “real-time” as the months wore on and more granular in nature as attempts were being made to manage smaller and smaller geographies to avoid the significant economic effects associated with global country shutdowns. – excerpt from HealthcareIT News article by Dr. Charles Alessi, chief clinical officer at HIMSS

NY Governor Cuomo moves to improve telehealth

Photo credit – NY State media services

PARCA eNews – Jan. 13, 2021 – Governor Andrew Cuomo of New York announced legislation to expand and improve telehealth in the state following the experience of people seeking healthcare during the COVID-19 pandemic.

"While New York State has been on the cutting edge of promoting telehealth for its residents, the adoption of telehealth by both patients and providers has been slow," Governor Cuomo said in a press release. 

HITAC issues recommendations for merging clinical and administrative data

Image in Images folder PARCA Credit HITAC History

Credit – HITAC History

PARCA eNews – Jan. 11, 2021 – In a blog post by Michael Wittie and Thomas Mason of the Office of the National Coordinator, the Health Information Technology Advisory Committee (HITAC) issued 15 recommendations for advancing the goal of merging clinical and administrative data based on findings from the Intersection of Clinical and Administrative Data (ICAD) Task Force.

The Task Force was formed to examine the barriers to allowing patients, caregivers and clinicians the information needed for prior authorization for treatment and healthcare services. Clinicians have reported that getting such data has been a major burden.

ONC issue Cures Act final rules updated

PARCA eNews – Jan. 5, 2021 – With the compliance dates approaching for the 21st Century Cures Act: Information Blocking, Interoperability, and the ONC Health IT Certification Program Final Rule ONC has created additional resources to assist the health IT developer community including a consolidated view of key dates, criterion-by criterion resource for the 2015 Edition Cures Update, and a comprehensive explanation of requirements for certified application programming interface (API) requirements.

HHS proposes changes to HIPAA regulations

PARCA eNews – Dec. 20, 2020 – The Department of Health and Human Services (HHS) posted a proposal for relaxing some of the regulations around patient privacy in an effort to improve care coordination and case management among a patient’s providers. The 350-plus page document was posted on the HHS site on Dec. 14, 2020.

“Our proposed changes to the HIPAA Privacy Rule will break down barriers that have stood in the way of commonsense care coordination and value-based arrangements for far too long,” said HHS Secretary Alex Azar said in press release. “As part of our broader efforts to reform regulations that impede care coordination, these proposed reforms will reduce burdens on providers and empower patients and their families to secure better health.”

CISA, FBI and HHS warn of stepped up cybersecurity attacks on Healthcare

PARCA eNews – Dec. 10, 2020 – Increased cybersecurity activity targeting healthcare and public health agencies in the form of ransomware and malware attacks prompted a cybersecurity advisory from The Cybersecurity and Infrastructure Security Agency (CISA), Federal Bureau of Investigation (FBI) and the Department of Health and Human Services (HHS) in late October and early November.

Healthcare data breaches up 25 percent

Total number of compromised records down 30 percent in 2020

PARCA eNews – Jan. 22, 2021 – There were 642 large data breaches involving more than 500 records reported by healthcare providers, health plans, healthcare clearing houses and related businesses according to a report in the HIPAA Journal.

That represented a 25% increase over than 2019, which was also a record-breaking year based on data collected by the HHS Office for Civil Rights (OCR), which published the raw data on its website.

45 million medical images found online with no protection

PARCA eNews – Dec. 20, 2020 – More than 45 million medical imaging files, including x-rays, CT scans, were found to be freely accessible on the internet by analysts for CybelAngel, a digital risk protection company.

Their report published in December 2020 confirms a similar finding in a joint report by a German public broadcaster Bayerischer Rundfunk and ProPublica last September that found millions of records were unprotected by passwords or basic security precautions.