viernes, 30 de octubre de 2015

DLS|HEALTHCARE NEWS|October 29, 2015 || Centers for Disease Control and Prevention (CDC) Healthcare News Update

DLS|HEALTHCARE NEWS|October 29, 2015



A Weekly Compilation of Clinical Laboratory and Related Information
From The Division Of Laboratory Systems


October 29, 2015


News Highlights

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  • Summary of Notifiable Infectious Diseases and Conditions — United States, 2013
  • U.S. Task Force Urges Broader Screening for Type 2 Diabetes
  • The Association for Molecular Pathology Announces 2015 Award Recipients
  • FDA Inspection Reports Detail Problems at Theranos
  • Make No Mistake — PT Referral Not Allowed
  • HHS to Fund Development of Diagnostics for Health Emergency Threats
  • Scrutinizing the Vitamin D Paradox in African Americans
  • Designer Antibodies May Rid Body of AIDS Virus
  • Antibody-Coated Reduced Graphene Oxide Films Efficiently Capture Tumor Cells
  • 2015 Sexually Transmitted Diseases Treatment Guidelines
  • Doctors, Not Parents, Are the Biggest Obstacle to the HPV Vaccine
  • Nobel-Winning Drug 'Tackles Malaria'
  • Industry Must Address Access to, Security of Genomic Data
  • KLAS: Top EHR Executives Agree to Publish Interoperability Metrics
  • HHS Moves Forward with Healthcare IT Interoperability Road Map
  

View Previous Issues - Healthcare News Archive


Leading News

Summary of Notifiable Infectious Diseases and Conditions — United States, 2013
The Summary of Notifiable Infectious Diseases and Condition—United States, 2013 (hereafter referred to as the summary) contains the official statistics, in tabular and graphic form, for the reported occurrence of nationally notifiable infectious diseases and conditions in the United States for 2013. Unless otherwise noted, data are final totals for 2013 reported as of June 30, 2014. These statistics are collected and compiled from reports sent by U.S. state and territory, New York City, and District of Columbia health departments to the National Notifiable Diseases Surveillance System (NNDSS), which is operated by CDC in collaboration with the Council of State and Territorial Epidemiologists (CSTE). This summary is available at:http://www.cdc.gov/mmwr/mmwr_nd/index.html. This site also includes summary publications from previous years.

U.S. Task Force Urges Broader Screening for Type 2 Diabetes
Doctors should screen overweight and obese adults between 40 and 70 years old for abnormal blood sugar levels and type 2 diabetes, according to new recommendations from the U.S. Preventive Services Task Force. People with elevated blood sugar (glucose) levels should then be referred to intensive behavioral counseling that emphasizes healthy eating and regular exercise, the guidelines say.  "People with abnormal blood glucose have a higher risk for progression to [type 2] diabetes. By finding abnormal blood glucose early, you may prevent that pathway by starting lifestyle interventions early," said Dr. Michael Pignone, a task force member and professor of medicine at the University of North Carolina at Chapel Hill. As many as 86 million American adults have abnormal blood sugar levels. Without lifestyle changes, between 15 and 30 percent of them will develop type 2 diabetes within five years, according to background information in the guidelines.

Meat Is Linked to Higher Cancer Risk, W.H.O. Report Finds
An international panel of experts convened by the World Health Organization concluded that eating processed meat like hot dogs, ham and bacon raises the risk of colon cancer and that consuming other red meats “probably” raises the risk as well. But the increase in risk is so slight that experts said most people should not be overly worried about it. The panel did not offer specific guidelines on red meat consumption. But its conclusions add support to recommendations made by other scientific groups like the federal government’s dietary guidelines advisory committee, which has long discouraged the consumption of red and processed meat. And the report could also influence health agencies such as the European Food and Safety Commission.

The Association for Molecular Pathology Announces 2015 Award Recipients
The Association for Molecular Pathology (AMP), the premier global, non-profit organization serving molecular diagnostic professionals, announced its 2015 award winners for the Award for Excellence in Molecular Diagnostics, the Jeffrey A. Kant Leadership Award, and the AMP Meritorious Service Award. Brian J. Druker, MD, Director, Knight Cancer Institute, Oregon Health & Science University, will receive the AMP Award for Excellence in Molecular Diagnostics. Barbara A. Zehnbauer, PhD, Acting Director, Division of Laboratory Program, Standards, and Services, Centers for Disease Control and Prevention, will receive the Jeffrey A. Kant Leadership Award. The award is granted to a selected AMP member who has demonstrated exceptional leadership in the accomplishment of the mission and vision of AMP. “Dr. Zehnbauer is a highly involved, long-time member of AMP. She currently serves as the Editor-in-Chief of AMP’s official journal and The Journal of Molecular Diagnostics.” Roger D. Klein, MD, JD, Medical Director of Molecular Oncology, Cleveland Clinic Foundation, will receive the AMP Meritorious Service Award.

 

Laboratory Testing / Diagnostics

FDA Inspection Reports Detail Problems at Theranos
In mid-September, the embattled upstart blood testing company Theranos received two inspection forms from the Food and Drug Administration -- a notice that inspectors had discovered objectionable conditions that they believed were in violation of federal law. The seriousness of the two FDA reports are hard to assess because large sections are blacked out. But the reports of two facilities, inspected over a three-week period at the end of August and beginning of September, raise new questions about practices at the company. They show federal inspectors deemed Theranos had misclassified its Nanotainer blood collection device as a low-risk medical device, had kept inadequate records, not done quality audits, and not handled consumer complaints correctly.

Theranos Chief Yields to Calls for Proof of Blood Test’s Reliability
Bowing to criticism, the founder and chief executive of the beleaguered medical testing company Theranos said that the firm would publish data validating the accuracy and reliability of its tests. At a conference sponsored by the Cleveland Clinic, the chief executive, Elizabeth Holmes, suggested that presenting the data would be more effective than trying to rebut articles in the news media that she said unfairly attacked the company. “Data is a powerful thing because it speaks for itself,” she said.

Make No Mistake — PT Referral Not Allowed
Amy Daniels, MT (ASCP), senior manager of investigations for CAP accreditation programs, is determined to put an end to the problem of proficiency testing referrals. “These incidents of PT referral that are occurring—they’re not caused by people trying to cheat,” she says. “That is not at all what’s driving this. What’s driving it is misconceptions on how PT is handled within the laboratory. No one means to screw up. No one’s trying to cause problems in the lab. These are honest, innocent mistakes. But they have serious consequences,” such as laboratories being put on probation, Medicare payments being canceled, and CLIA certificates being revoked.
To go back to basics briefly: Per the Centers for Medicare and Medicaid Services and the CAP, laboratories are not permitted to communicate about proficiency testing samples with each other, refer PT samples to each other, or accept PT samples from each other. In Daniels’ words, “A CLIA number is issued to a laboratory with a physical address, and all of the laboratory’s proficiency testing has to be done within those four walls. Once PT leaves that CLIA number, then you’ve broken the rules.”

HHS to Fund Development of Diagnostics for Health Emergency Threats
The U.S. Department of Health and Human Services announced its intention to fund research and development projects related to the development of molecular diagnostics that can help protect the U.S. population against key health emergency threats. The HHS is specifically seeking next-generation sequencing-based methods and tools that can quickly identify seasonal and novel influenza viruses and diagnose infections in CLIA laboratories. It is also looking for diagnostics that can identify antiviral drug-resistant flu viruses, as well as ones that can be used at home or in a point-of-care setting. The HHS is also interested in bio-threat agent diagnostics such as anthrax infection assays that are portable and designed for use by non-professionals, as well as high-throughput systems that are optimized for use with widely used instrument platforms. Also eligible for HHS funding are studies characterizing pathogen or disease-specific biomarkers with diagnostic potential, in addition to studies examining the effectiveness of diagnostic assays in special populations including immunocompromised, pregnant, or diabetic individuals. Additional details about the funding can be found here and here. .

For Now, First Still Last in Primary HPV Testing
Not long after the FDA approved a primary HPV screening algorithm for women age 25 and older, in April 2014, things began to stir on the Western front—specifically, in Bellingham, Wash., where Northwest Pathology is based. “We started offering it pretty much right after the FDA approved it,” says Ryan Fortna, MD, PhD, director of molecular pathology at the regional,   independent anatomic pathology group. Though he hasn’t tracked the numbers closely, he estimates primary HPV testing now accounts for maybe five percent of the lab’s overall women’s health testing. The algorithm is based on use of the Roche Cobas HPV assay. Mark Stoler, MD, says that based on what he’s hearing from laboratory and clinical colleagues, the algorithm has “slow but steady adoption.” Dr. Stoler, professor emeritus of pathology and clinical gynecology, University of Virginia Health System, Charlottesville, says he knows of a few local clinicians who have started using it, and he’s heard of other large institutions that are close to starting or are at least discussing whether to offer it.

Glucose or HbA1c? The Answer Is Both
The two most prevalent diagnostic tests used today are the fasting plasma glucose (FPG or “glucose”) test and the hemoglobin A1c (HbA1c) test. Debates have been ongoing for some time about which test is best for an accurate diagnosis of diabetes and ongoing diabetes monitoring. The answer is: both. It is important to understand what each type of test measures and how to properly employ each test to help diabetes patient management. HbA1c is a measure of longer-term glucose metabolism. Glucose in the serum reacts with an amino acid group on hemoglobin to form glycated hemoglobin. Hemoglobin A1c is defined as that product of reaction of glucose with the N-terminal amino acid of the hemoglobin beta chain. Hemoglobin A1c results are expressed as a percentage of total hemoglobin. Individuals with HbA1c levels of less than 5.7 percent are considered normal; levels of 5.7 percent to 6.4 percent are considered prediabetic; and levels ≥ 6.5 percent HbA1c are diagnostic of diabetes. HbA1c is not impacted by fasting, stress, or exercise and it can be done with a sample taken at any time (non-fasting).

Sizing Up Estimated Glomerular Filtration Rate
In assessing the use of glomerular filtration rate (GFR) to evaluate kidney function during routine clinical care, some estimated GFR (eGFR) equations are more effective than others, a study found. Results were published in AACC’s journal, Clinical Chemistry.
Clinicians and laboratories alike routinely use (GFR) estimating equations to evaluate kidney function in patients. Clinical guidelines recommend …eGFR based on serum creatinine (eGFRCr) as the initial diagnostic test, and either a measured clearance or eGFR based on either serum cystatin C (eGFRCys) or serum cystatin C and creatinine (eGFRCr-Cys) as a confirmatory test, authors Andrew S. Levey, MD, and John H. Eckfeldt, MD, PhD, explained in an accompanying editorial. Such guidelines apply to all adult patients. 

Study Finds Metamark's Prostate Cancer Test Offers Benefits beyond Current Standards of Care
Researchers from the Fred Hutchinson Cancer Research Center have published a health economic analysis of Metamark's Promark prostate cancer test that found the test offers an increase in quality-adjusted life-years (QALY) and a decrease in costs to the healthcare system compared to the current standard of care. Detailed in a paper published in The Oncologist, the study found that addition of the Promark to existing National Comprehensive Cancer Network treatment guidelines for prostate cancer provided a .04 increase in QALY (from 14.62 to 14.66 years) while reducing lifetime treatment costs $730 (from $32,595 to $31,865). Only one in seven men diagnosed with prostate cancer will progress to metastatic disease over their lifetime. However, roughly 90 percent of low-risk prostate cancer patients in the U.S. will undergo aggressive treatment, typically radical prostatectomy. This treatment pattern is changing, however, as more urologists are opting for active surveillance as opposed to treatment.

Flexible Ordering May Unravel Pay Snags for Respiratory Panels
The advantages of molecular respiratory viral panels are accompanied by a challenge for laboratories that find it difficult to secure payment for testing that can cost hundreds of dollars, depending on the number of pathogens involved. These respiratory panels can create complications for laboratories that must juggle several platforms to meet clinician needs, spare patients from unnecessary out-of-pocket costs, and responsibly use lab resources. A newly cleared flexible respiratory testing panel could offer laboratories another approach.
“With traditional culture methods—and this is what payers are used to, as well as clinicians—you generally tested a small number of pathogens and then reflexed to more specific organisms when it was necessary,” Charles Root, PhD, said during a CAP TODAY webinar presented in cooperation with Nanosphere. “We’re now in a much different situation where we can test a lot of pathogens almost instantly in large screening panels. . . . But now the payers are saying, ‘Well, do I really need all that, or do I want to pay for it?’”

 

Research and Development

Scrutinizing the Vitamin D Paradox in African Americans
A study that used a novel direct method to compare serum free 25(OH)D in black and white individuals found nearly identical levels among the races, suggesting that targeted screening for low total serum 25(OH)D in African Americans might not be necessary. The results, which were published inThe Journal of Clinical Endocrinology & Metabolism (JCEM), follows on the heels of a previous study in the New England Journal of Medicine (NEJM), which determined that African Americans have superior bone health despite having lower levels of total serum 25-hydroxyvitamin D [25(OH)D] and vitamin D-binding protein (VDBP) than whites. Researchers have referred to these findings as the “vitamin D paradox in African Americans.”

Designer Antibodies May Rid Body of AIDS Virus
Anti-HIV drugs have extended life for millions of people, but they have never eliminated the virus from anyone. That’s because HIV integrates its genetic material into the chromosomes of some white blood cells, helping it escape notice of the immune system. Two new studies show that artificial antibodies could “redirect” the immune response to these latently infected cells and help drain those HIV reservoirs in the body. But this creative strategy also carries risks. “The rationale is sound, and the data are exciting, but we will need to move carefully,” says Steven Deeks, an HIV/AIDS clinician at the University of California, San Francisco (UCSF), who tests cure strategies. “There really is zero room for error.” Several previous studies have explored whether drugs can shock cells that are infected with latent HIV to make new viruses, setting them up for the kill by the natural immune response. But this new work ups the ante by designing so-called bispecific antibodies that both promise to reverse latency and then do the mop-up work. “The dual activity makes this an attractive new approach,” says Sharon Lewin, a HIV cure researcher who directs the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia. “It’s exciting.”

Antibody-Coated Reduced Graphene Oxide Films Efficiently Capture Tumor Cells
An extremely sensitive and selective method using graphene films to mimic the cell microenvironment could enhance capture of circulating tumor cells (CTCs). Reporting in the upcoming issue of Advanced Materials, scientists from the Chinese Academy of Sciences showed that reduced graphene oxide (rGO) films, which have been coated with antibodies, can efficiently capture CTCs from whole blood samples. Importantly, the modified rGO films could efficiently isolate CTCs that are present in concentration as low as 10 CTCs per mL of blood sample, all without the use of a complex microfluidic approach.

An Easy Test for Sickle Cell Disease
Using a 3D printed device, the team – led by UConn assistant professor of mechanical engineering Savas Tasoglu – has created a novel testing platform that can accurately diagnose and monitor sickle cell disease in the field or at a remote clinic, using just a few drops of blood. The platform is contained in a lightweight, compact box that can be attached to a common Android smartphone. The key to the new device is magnetic levitation. Sickle cells, because of their unique crescent moon or sickle-like shape, tend to be denser than healthy red blood cells and therefore levitate or float at a lower height when the cells are placed in a paramagnetic solution and subjected to a magnetic field, says UConn graduate student Stephanie Knowlton, the article's first author.

Researchers Use Gene Editing to Produce Red Blood Cells in Laboratory
A team of scientists at the Dana-Farber/Boston Children's Cancer and Blood Disorders Center have manufactured red blood cells in a laboratory by combining the latest methods in genome editing with research on stem cells. The findings of the study, featured in the journal Cell Stem Cell, suggest that the breakthrough procedure could provide a cost-effective way to produce red blood cells, which would benefit patients who cannot use blood available in blood banks. Dr. Vijay Sankaran, a pediatric hematologist at the center, led a team of researchers in identifying a specific gene known as SH2B3 that contains naturally occurring variations of its sequence. Analysis of data from the GWAS has shown that the gene's sequence is capable of reducing its activity, leading to an increase production of red blood cells. "There's a variation in SH2B3 found in about 40 percent of people that leads to modestly higher red blood cell counts," Sankaran explained. "But if you look at people with really high red blood cell levels, they often have rare SH2B3 mutations." "That said to us that here is a target where you can partially or completely eliminate its function as a way of increasing red blood cells robustly," he added.

Microfluidic Device Measures Critical Patient Metabolites and Ions in Real Time
Researchers at École polytechnique fédérale de Lausanne (EPFL) have developed a microfluidic device that’s able to measure glucose, lactate, bilirubin, calcium, and potassium in real time directly from a drainage tube. Embedded with a Bluetooth radio, the device streams readings to a nearby tablet or smartphone for live review at any time, hopefully making regular manual draws a thing of the past. The team EPFL team claims that the technology can measure up to 40 different molecules at the same time. If true and the technology proves itself in clinical trials, management of patients in the ICU and others bedridden in the hospital should be considerably easier on the nurses and lead to quicker reaction when levels of various substances change abruptly.

Humacyte Lands $150M Series B for Phase 3 Study of Lab-Grown Veins
Humacyte has developed a way to make blood vessels in a lab intended to be an alternative to the synthetic implants now used to treat patients with a blood flow problem, such as a blocked blood vessel in a limb. First, it takes smooth muscle cells from humans and grows them on a scaffold in the shape of a tube. After this structure forms, the human cells are washed away, leaving a collagen structure that forms the engineered vein. Because those human cells are gone, it’s less likely a patient’s body would reject the engineered vein after it’s transplanted. The company says a patient’s own tissue can then grow into the new vein, enabling it to perform more like a human’s own blood vessel. The technology, originally developed at Duke University, is intended to produce “off-the-shelf blood vessels” that can be produced and implanted in any patient. The new funding supports a late-stage trial of Humacyte’s technology, called Humacyl, in patients with kidney failure who require hemodialysis.

Formaldehyde Fears
Data on the links between ALS and the chemical have been contradictory, but the latest study suggests undertakers are at risk. In April 2009, epidemiologist Marc Weisskopf of the Harvard T.H. Chan School of Public Health and colleagues came across a puzzling correlation as they were looking for links between the neurodegenerative disease known as amyotrophic lateral sclerosis (ALS) and exposure to 11 different chemical classes. They analyzed mortality data from a sample of more than 1 million people involved in the American Cancer Society’s Cancer Prevention Study II. While the researchers found little evidence of a link between ALS and most of the chemicals they examined, one did raise a red flag: formaldehyde, a compound commonly used in funeral homes and medical laboratories. Those participants who reported being regularly exposed to the chemical were more than twice as likely to die from ALS, compared to people with no exposures (J Neurol Neurosurg Psychiatry, 80:558-61).

 

Public Health and Patient Safety

2015 Sexually Transmitted Diseases Treatment Guidelines
These guidelines for the treatment of persons who have or are at risk for sexually transmitted diseases (STDs) were updated by CDC after consultation with a group of professionals knowledgeable in the field of STDs who met in Atlanta on April 30–May 2, 2013. The information in this report updates theSexually Transmitted Diseases Treatment Guidelines, 2010 (http://www.cdc.gov/std/treatment/2010/default.htm) (MMWR Recomm Rep 2010;59 [No. RR–12]). These updated guidelines discuss 1) alternative treatment regimens for Neisseria gonorrhoeae; 2) the use of nucleic acid amplification tests for the diagnosis of trichomoniasis; 3) alternative treatment options for genital warts; 4) the role of Mycoplasma genitalium in urethritis/cervicitis and treatment-related implications; 5) updated HPV vaccine recommendations and counseling messages; 6) the management of persons who are transgender; 7) annual testing for hepatitis C in persons with HIV infection; 8) updated recommendations for diagnostic evaluation of urethritis; and 9) retesting to detect repeat infection. Physicians and other health-care providers can use these guidelines to assist in the prevention and treatment of STDs.

Doctors, Not Parents, Are the Biggest Obstacle to the HPV Vaccine
Vaccination rates against human papillomavirus have remained far lower than rates for other routine childhood and teen immunizations. But a big reason for those low rates comes from a surprising source. It's not hesitant parents refusing the vaccine. Rather, primary care doctors treat the HPV vaccine differently from other routinely recommended immunizations, hesitating to recommend it fully and on time and approaching their discussions with parents differently, a study finds. "The single biggest barrier to increasing HPV vaccination is not receiving a health care provider's recommendation," said lead study author Melissa Gilkey, an assistant professor of population medicine at Harvard Medical School. That's more of an issue, she says, than parents' decisions to refuse or delay HPV vaccination. The problem? HPV infections are most commonly — though not always — transmitted sexually. "These findings add to a growing literature that suggests that some providers find the interpersonal environment to be challenging when it comes to talking about HPV vaccination," said Gilkey. "Discomfort talking about sex appears to be a more salient factor" than safety concerns about the vaccine.

Nobel-Winning Drug 'Tackles Malaria'
A parasitic-worm-killing drug, whose discovery won the Nobel Prize, may also cut cases of malaria, say researchers. Early data coming out of trials of ivermectin in Burkina Faso suggest it leads to 16% fewer cases of childhood malaria. Scientists at the American Society of Tropical Medicine and Hygiene's conference, said the drug was toxic to blood-drinking mosquitoes. They said their findings were pretty exciting, but still at an early stage. Ivermectin is already used to kill parasitic worms, which affect a third of the world's population and cause illnesses including river blindness and lymphatic filariasis. Its discovery won this year's Nobel Prize for Physiology or Medicine.

Leading Malaria Vaccine Gets Mixed Reviews
The leading candidate for a malaria vaccine suffered some setbacks even as two World Health Organization expert panels recommended going ahead with pilot projects to test it further. The vaccine, known as RTS, S or Mosquirix, has been in development for nearly 30 years, and is further along in the approval process than any other candidate. But it is no panacea. In clinical trials, it was less than 40 percent effective even after four shots. But because malaria kills more than 400,000 children a year and no defense against it is perfect, the vaccine is being considered as an addition to current defenses: insecticide-impregnated nets, indoor DDT spraying and rapid treatment of outbreaks before they can spread. The W.H.O.’s Strategic Advisory Group of Experts and Malaria Policy Advisory Committee recommended that several pilot projects be carried out in Africa to make sure the vaccine is not even less effective in real-world settings than it has been in carefully monitored clinical trials.

Genetics Help Explain Poor Showing for GSK Malaria Vaccine
Scientists have found a genetic explanation for why the world's first malaria vaccine is not very effective in protecting some African children against the deadly mosquito-borne disease. The analysis, published in the New England Journal of Medicine, comes at a critical time for the experimental shot from GlaxoSmithKline, when global experts are assessing how it might be deployed. GSK's Mosquirix, also known as RTS,S, is specifically designed for use by African babies and toddlers. While it has the potential to help prevent many cases of malaria, researchers have been disappointed by its limited efficacy. Now scientists have discovered that genetic variability in a protein found on the surface of malaria parasites may help explain the patchy response because, while the protein comes in different forms, GSK's vaccine incorporates only one variant.

Cutting Sugar Improves Children’s Health in Just 10 Days
Obese children who cut back on their sugar intake see improvements in their blood pressure, cholesterol readings and other markers of health after just 10 days, a rigorous new study found. The new research may help shed light on a question scientists have long debated: Is sugar itself harming health, or is the weight gain that comes from consuming sugary drinks and foods mainly what contributes to illness over the long term? The new study was financed by the National Institutes of Health.

Choose Hospitals on Performance Data, Report Suggests
Healthgrades is urging consumers to "do their homework" before choosing a hospital. Healthgrades 2016 Report to the Nation, notes that since 2011, one-in-six Medicare patients got their care from a hospital that had earned a one-star designation from Healthgrades. Had many of these patients done some research, they probably could have found a higher-rated hospital nearby for their particular procedure, says Evan Marks, chief strategy officer at Denver-based Healthgrades. When compared with one-star hospitals, which have higher risk-adjusted complication and mortality rates, Marks says patients at hospitals with a five-star rating have a 71% lower chance of dying, and a 65% lower change of experiencing complications during their stay. If all hospitals met the five-star ranking, Marks says, more than 222,000 lives potentially could have been saved since 2011.

Why Don't Doctors and Nurses Have More Healthy Lifestyles?
Doctors and nurses suffer from obesity, diabetes and heart disease only slightly less than the general population, according to a study published in theMayo Clinic Proceedings. Researchers found the same societal and environmental factors that have contributed to a rise of chronic disease in the general population affect healthcare workers. "This highlights the notion that nobody is fully immune to the factors that promote unhealthy lifestyle behaviors," lead study author Anupam B. Jena, M.D, Ph.D., of Harvard Medical School told Reuters.

Sitting Time Not Associated with Risk of Death?
Sitting per se, whether during leisure time, watching TV, or at work, irrespective of physical activity, is not associated with risk of death, shows a new study of 5000 participants published online October 9 in the International Journal of Epidemiology by Richard Pulsford, PhD, from sport and health sciences at the University of Exeter, United Kingdom, and colleagues. The study tested the hypothesis that sitting time would predict all-cause mortality risk independently of moderate to vigorous physical activity and associations would vary by type of sitting. Prior research has suggested that spending extended periods of time sitting down, either at work or during leisure time, is detrimental and contributes to mortality risk regardless of how much physical activity an individual undertakes, explained Dr Pulsford. Sitting has even been dubbed "the new smoking."


Health IT

Industry Must Address Access to, Security of Genomic Data
As the Workgroup for Electronic Data Interchange sets its sights on exchange of genomic data, one of the main issues to address is security of the information. Last week, WEDI announced it is forming a workgroup that will focus on genomic data exchange and the integration of genomic data within the U.S. healthcare system. In a recent interview with HealthcareInfoSecurity, WEDI CEO Devin Jopp said one of the big issues when it comes to genomics is data ownership.

KLAS: Top EHR Executives Agree to Publish Interoperability Metrics
To help resolve some of the key interoperability challenges in the health IT industry, several key EHR and provider stakeholders are collaborating to finally make interoperability a viable measurement tool. Convened during the KLAS Keystone Summit in Midway, Utah, Micky Tripathi, President and CEO of Massachusetts eHealth Collaborative, led and moderated the summit with EHR stakeholders on how KLAS will publish objective measures of interoperability and ongoing reporting. Leaders of 12 different EHR vendor companies proactively stepped forward to have an independent entity publish transparent measures of health information exchange that can serve as the basis for understanding our current position and trajectory. Vendors and providers willingly committed to go arm in arm to work closely with Washington to help alleviate the interoperability-measurement burden faced by the government.” The next step is to put a cohesive plan in place to launch and monitor the measurement. This plan will include continued involvement from those participating in the summit as they lock arms to make a difference.

HHS Moves Forward with Healthcare IT Interoperability Road Map
The Department of Health and Human Services took another step in its efforts to streamline healthcare IT this month, releasing its final roadmap for connecting health information systems over the next decade. The strategy, devised by Office of the National Coordinator for Health Information Technology, seeks to make it easier to share healthcare information across a wide network, but secure enough to ensure privacy from would-be hackers. In September, ONCHIT released a health IT strategic plan that covers the next five years.

5 Trends Advancing the Health IT Cause
  1. The rise of the hyper quantified self: There's no shortage of new technologies designed to engage patients.
  2. Big Data: No IT trend list – for any industry – is complete without the mention of Big Data.
  3. Into the clouds: The benefits of the cloud – flexibility, scalability, lower costs to name a few – are spurring on cloud adoption.
  4. Improved collaboration between pharma and healthcare: The benefits of collaboration between pharma and healthcare have long been recognized by both industries.
  1. Advanced interoperability: In compliance with the Medicare and Medicaid EHR incentive program's proposed rules for Stage 3 meaningful use, organizations must put significant efforts into securely connecting with external entities and systems.

5 Big Data Tips for a Risk Analysis Strategy
Regardless of industry, companies perform better by incorporating big data and analytics. An MIT study found that companies, which included healthcare organizations that were in the top third of their industry in the use of data-driven decision making, were five percent more productive and six percent more profitable than competitors.
Therefore, the following are five steps to consider when developing and executing a risk analytics strategy:
Step 1: Identify the best internal resources.
Step 2: Augment internal resources as needed.
Step 3: Allocate a reasonable budget.
Step 4: Focus.
Step 5: Improve.

3 Upgrades EHRs Need to Integrate CDS, Streamline Workflow
Electronic health record systems currently can leave much to be desired when it comes to integrating clinical decision support [CDS] and streamlining workflows, and there are many enhancements needed for the next generation of EHRs, according to a recent research paper. "The vast amount of information and clinical choices demands that we provide better supports for making decisions and effectively documenting them," according to the authors of the paper, published in the Journal of Medical Internet Research (JMIR).
Three of the upgrades that should be included in future EHR systems, according to the authors from Beth Israel Deaconess Medical Center, Yale University, New York-based Center for Urban Science and Progress and University of Virginia's Center for Wireless Health, are:
  1. Data incorporation
  2. Monitoring systems
  3. Formulation of the note in real-time

 
Other News
The Plague's Deadly Pedigree Goes Back 3,000 Years Earlier Than Thought
Turns out the plague was, er, plaguing humans far earlier than once thought. A study of ancient DNA pulled from human teeth in Asia and Europe finds that the bacteria Yersinia pestis had infected humans as far back as 2,800 to 5,000 years ago – perhaps three millenniums earlier than expected. The finding, published in the journal Cell, pushes back the long and unhappy history between humans and the disease – and points to genetic changes that later may have helped the pathogen turn massively deadly. "Our results show that plague infection was endemic in the human populations of Eurasia at least 3,000 years before any historical recordings of pandemics," the study authors wrote.

Med School Enrollment Hits New High
The number of people applying to medical school increased by 6.2% for 2015, which followed a 3.1% jump the previous year, the Association of American Medical Colleges (AAMC) announced. A total of 52,550 people applied to medical school in 2014 for enrollment in 2015; of those, 38,460 were first-time applicants, an increase of 4.8% from the previous year, the AAMC said. Medical school enrollment for 2015 was 20,630, an all-time high and an increase of 25% since 2002, the association reported. Just over half of med school students were men (52%), a ratio that was unchanged from the previous year. Overall, the starting class for 2015 was 57% white, 22% Asian, 10% Hispanic or Latino, and 8% African-American, according to the AAMC.

A 'Leap' in the Right Direction
As healthcare costs began to spiral upward in the 1990s, employers became increasingly concerned that although they were spending billions of dollars on employee health benefits, they had no objective way to assess the quality of the care delivered. Determined to use their purchasing power to influence healthcare quality and affordability, a group of large employers joined forces to form The Leapfrog Group. "To Err Is Human," the 1999 seminal report from the Institute of Medicine, prompted them to focus on reducing preventable medical errors. On average, Leapfrog estimates that purchasers pay $8,768 in hidden surcharges due to medical errors for a patient admitted to a hospital with a grade of "C" or lower on its Hospital Safety Score – a compelling case for employers to steer employees toward safer hospitals.


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