Literature Review

Breaking the barriers in information sharing: Changing the discussion from legal risk to C-suite opportunity N2K; by Rick Howard; 9/16/24 In the evolving landscape of cybersecurity, sharing information among institutions is critical to bolster defenses against increasingly sophisticated threats. Cooperation between organizations can strengthen everyone’s defenses, but such an approach requires openness and transparency, something that many organizations have been reluctant to do. ... The C-suite – comprising top executives such as the CEO, CFO, CIO, CISO, and others – plays a critical role in shaping an organization's approach to cybersecurity. In the context of information sharing, the C-suite's role is pivotal in driving the cultural and operational changes necessary to transition from a risk-averse stance to one that recognizes the strategic value of collaboration and information exchange. One of the most successful initiatives that C-suite leaders can champion is participation in industry-specific Information Sharing and Analysis Centers (ISACs). ... [Following discussions include:] The business case for information sharing ... Enhanced risk management ... Cost savings and resource efficiency ... Compliance and legal benefits ... Innovation ... Professional Development ... Challenges to information sharing ... Legal and regulatory complexities ... Risk of exposure and misuse ... Trust issues among organizations ... Technical barriers ... Cultural and organizational obstacles ... Sharing information ... Categorize information by sensitivity ... Assess recipients ... Vet the data ... Monitoring and oversight ... Engaging in industry-wide collaboration ... Real world examples - Health-ISAC and the faulty CrowdStrike update ... The path forward ... [Click on the title's link for the full article and a whitepaper.]

Leadership in the age of AI: At the crossroads of humanity and technology Forbes; by Dr. Adil Dalal, DBA; 9/9/24 It has only been 200 years since the First Industrial Revolution and the mass adoption of what we now call technology... The Second Industrial Revolution in the late 19th and early 20th centuries, marked by great progress in mass production, ... emphasizing the importance of machines over humans and managers over employees. ... Today, the world stands on the precipice of the Fourth Industrial Revolution with artificial intelligence, which is not just reshaping industries but also redefining the very essence of leadership and decision-making. ...  A technology-driven leader [TDL] who prioritizes novelty over humanity can pose significant risks, potentially leading to societal downfall. ... A human-centric leader [HCL] prioritizes the well-being, growth and empowerment of people, steering humanity toward greatness. ... So is there an ideal Technology Age leader who can lead humanity through this historical moment? Yes! ... They must embody and demonstrate the following three qualities:

The biggest threat in health IT and RCM Becker's Hospital Review; by Randi Haseman; 9/6/24 Are organizations adopting AI technology too quickly or too slowly? And what's the future of payer relationships? ... As part of an ongoing series, Becker's is talking to healthcare leaders who will speak at our conference. ... Question: What is the biggest threat in health IT and RCM right now? [Responses from 47 executives featured in this article address the following and more: payer programs; modernizing legacy systems while ensuring data security and compliance; cyber-crime / cybersecurity; relieving provider and staff burden thgouth clinical workflows; state and federal legislation; human error; Gen AI 'mission-creep'; extended systems downtimes; the velocity of technical disruption; more ...]

Doctors use problematic race-based algorithms to guide care every day. Why are they so hard to change?Stat email and article; by Katie Palmer, Usha Lee McFarling; 9/3/24Doctors use clinical algorithms every day to make decisions about the care they provide to patients. This math determines things like our surgical risk or likelihood of disease using factors such as blood pressure, age, weight, surgical history, and, often, our race. But one of these is not quite like the others — for years, clinicians have pushed back against the use of race in clinical algorithms. Publisher's note: Interesting article, although accessing full article may require subscription.

A.L.S. stole his voice. A.I. retrieved it. DNYUZ, originally posted in The New York Times; 8/15/24Four years ago, Casey Harrell sang his last bedtime nursery rhyme to his daughter. By then, A.L.S. had begun laying waste to Mr. Harrell’s muscles, stealing from him one ritual after another: going on walks with his wife, holding his daughter, turning the pages of a book. “Like a night burglar,” his wife, Levana Saxon, wrote of the disease in a poem. ... Last July, doctors at the University of California, Davis, surgically implanted electrodes in Mr. Harrell’s brain to try to discern what he was trying to say. ... Yet the results surpassed expectations, the researchers reported on Wednesday in The New England Journal of Medicine, setting a new bar for implanted speech decoders and illustrating the potential power of such devices for people with speech impairments.

Which parts of healthcare are off limits to AI? Becker's Health IT; by Giles Bruce; 8/9/24 The AI physician will not see you now — or ever, for that matter. As artificial intelligence proliferates in healthcare, health system leaders told Becker's that human providers will always be part of the medical field, with their — AI-aided — treatment recommendations being discussed with patients and family members. "Any patient care decisions ... should be made by patients and their caregivers or family members, obviously in consultation with their physician or provider," said Joe Depa, chief data and AI officer of Atlanta-based Emory Healthcare. ... Robots — or AI — will simply never take the place of that human touch, health system leaders say.

Alzheimer’s prognosis models should expand data sources McKnights Senior Living; by Kristen Fischer; 8/12/24 Integrating data from nursing home electronic health records and claims in addition to the minimum data set — data required for nursing home residents — could be better than just relying on the MDS sources to produce an accurate prognosis for nursing home residents with Alzheimer’s disease and related dementias, according to a report published Thursday in the Journal of the American Geriatrics Society. ... The authors of the report noted that a recent review of prognostic models for late-stage ADRD found that assessments commonly used to evaluate prognosis-based eligibility for hospice weren’t reliable. ... Only 15% of people enrolled in hospice have a primary diagnosis of ADRD. That’s because it’s challenging to estimate the six-month prognosis required to be eligible for hospice, and dementias have a prognosis of 12 to 18 months when they are in the late stage, the authors pointed out.

Cleveland Clinic names first Chief AI OfficerCleveland Clinic press release; 7/29/24Cleveland Clinic has appointed its first Chief Artificial Intelligence Officer to direct the use of AI across the health system. Ben Shahshahani, Ph.D., a technology executive with more than 20 years of experience in AI and machine learning, will serve as Vice President, Chief Artificial Intelligence Officer, starting Aug. 12, 2024.Publisher's note: Hospice implications...?

Empowering patient access, protection, and choice: The 21st Century Cures Act eight years on Healthcare Business Today; by David Navarro; 7/26/24 The 21st Century Cures Act, signed into law in December 2016, marked a significant shift in the healthcare landscape by focusing on patient empowerment through enhanced access to medical records, stringent privacy protections, and increased choices in healthcare options. Eight years later, this landmark legislation continues to revolutionize the interaction between patients, providers, and the healthcare system. Recently, The U.S. Department of Health and Human Services (HHS) issued an updated ruling to the Act to establish penalties for healthcare providers who engage in information blocking. This rule, aims to deter practices that prevent or discourage the access, exchange, or use of electronic health information (EHI).

Following the CrowdStrike outage, healthcare stresses the importance of prevention HealthCare Brew; by Cassie McGrath; 7/25/24... [The recent CrowdStrike outage] affected millions across all sorts of industries, from healthcare to travel. ... However, amid the chaos, what has largely gone untold are stories of the companies that emerged unscathed. And within those unaffected companies lies a lesson for others, according to Andrew Molosky, president and CEO of Tampa-based Chapters Health System. ... “We’ve really focused on business continuity, redundancies, safety nets, and understanding of the difference between cybersecurity as a task and cybersecurity as a cultural commitment of your organization,” Molosky said. ... These investments, Molosky said, included protocols for documenting on paper, using a backup application that provides patient information when electronic medical records and other systems are offline, and allowances for bringing in personal devices to use if company devices go down. 

HIMSSCast: Improving patient safety and employee retention with best incident reporting practicesHealthcare IT News; by Andrea Fox; 7/26/24 By modernizing systems and improving leadership and culture to embrace reporting, healthcare organizations can better address the top 10 patient safety concerns for 2024, says Heidi Raines, founder and CEO of Performance Health Partners. Ultimately improving the quality of care healthcare systems deliver and preventing harm requires a degree of self-reflection. Along with digital transformation, putting an easy-to-use incident reporting system in place can help healthcare organizations address today's chief patient safety concerns, including medication errors, care delays, workplace violence and preventing patient falls, said Raines.

Can Artificial Intelligence speak for incapacitated patients at the end of life? JAMA Internal Medicine; by Teva D. Brender, MD; Alexander K. Smith, MD; Brian L. Block, MD; 7/22/24 Viewpoint: Imagine meeting with the daughter of a critically ill patient. The patient (her mother) had a cardiac arrest, is in multiorgan failure, and cannot communicate. The daughter is uncomfortable making decisions because they are estranged and never discussed what her mother would want in this type of situation. The patient has no advance directive or alternative surrogate. Now imagine this meeting taking place in a future where the mother’s medical visits have been audio recorded. Furthermore, you have access to an artificial intelligence (AI) algorithm that can identify and play excerpts of the mother talking about what mattered most to her. You and the daughter listen to these recordings together. Then you share that another algorithm, trained on 7 million patient records, predicts that the mother’s chance of walking again is less than 5%. ...

Keeping staff members safe and sound by optimizing security technology Security; by Paul Sarnese; 7/12/24 Nobody wants to invest in technology, only to have it go the way of the stationary bike that sits unused in the corner of a room. That holds true for healthcare organization leaders who are looking to invest in staff safety alarm systems that can help avert potentially dangerous situations. With workplace violence against caregivers increasing 115% since 2021, many healthcare organizations are, indeed, looking to protect workers from harm — and to shield their organizations from resultant financial distress.Editor's Note: Workplace violence and staff safety continues to trend as a root cause for nursing and other healthcare strikes across the nation. Examine your organization's Incident Reports and QAPI initiatives. What needs to be addressed?