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DLS|HEALTHCARE NEWS|November 19, 2015: Centers for Disease Control and Prevention (CDC) Healthcare News Update

DLS|HEALTHCARE NEWS|November 19, 2015

CDC. Centers for Disease Control and Prevention. CDC 24/7: Saving Lives. Protecting People.



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


November 19, 2015


News Highlights

  • Preventive HIV Treatment Shown Effective at Health Clinics
  • The FDA Questions Three Companies Marketing DNA Tests Directly to Consumers
  • Lab Values in Ebola Virus
  • The Public Health Evidence for FDA Oversight of Laboratory Developed Tests: 20 Case Studies
  • Canadian Guidelines for Managing Low Testosterone
  • New Diagnostic Tools Emerge in War against Superbugs
  • Toenails Stashed in Harvard Basement Could Hold Clues about Cancer
  • New Vaccine Could Offer 'Cheaper, More Effective' Treatment for High Cholesterol
  • Blood Test Picks out Prostate Cancer Drug Resistance
  • Meningitis Jab in Africa a 'Stunning Success'
  • Global Routine Vaccination Coverage, 2014
  • FDA to Examine Maternal Vaccines to Protect Infants
  • 4 Security Controls OIG Will Focus On in 2016
  • Connected Health 2015: IBM, Boston Children's Use Cognitive Computing to Tackle Pediatric Diseases
  • Health IT Experts Working to Tackle Patient Matching Problem
  

View Previous Issues - Healthcare News Archive


Leading News

Preventive HIV Treatment Shown Effective at Health Clinics
Medications taken to prevent HIV infection in high-risk people appear to work well in "real-life" use, a new study suggests. During a year of taking pre-exposure prophylaxis (PrEP), only two people out of more than 400 high-risk people became infected with HIV, the virus that causes AIDS. And it seems that those who became infected didn't take the medication properly, the study said. The new study found the HIV infection rate was as much as 20 times lower than in several previous HIV studies, background information in the current study said. But the treatment is not without problems. The most important issue is that PrEP is expensive, potentially costing about $1,300 a month, said study lead author Dr. Albert Liu, clinical research director with the San Francisco Department of Public Health. However, the treatment is covered by most insurance companies, and medication assistance programs are available, according to the U.S. Centers for Disease Control and Prevention.

The FDA Questions Three Companies Marketing DNA Tests Directly to Consumers
DNA4Life offers a $249 test to help customers understand whether their genes put them at risk of having bad reactions to more than 100 common medicines. Interleukin Genetics sells a $169 test that “may help you lose more weight by properly matching diet and exercise plans” to genetic profiles. And DNA-CardioCheck has suggested its test, at $450, is a "reliable method to determine whether or not you might be at risk for developing blood clots which might result in cardiovascular disease." All three companies got letters from the Food and Drug Administration in early November suggesting they didn’t have the proper clearance to sell medical tests to consumers. It’s the latest sign that regulators are concerned about how companies market DNA tests for health insights, sometimes bypassing doctors entirely. There’s good reason for that worry: For most people, the genetic analysis available today doesn’t provide much meaningful health information at all. DNA tests can reliably establish family ties, like paternity tests, or reveal a person’s ethnic heritage. They can also tell whether people are at risk for certain rare diseases like cystic fibrosis that are directly linked to genetic mutations, or for passing the risk on to their children. But when it comes to information relevant to people’s health, especially about common conditions like heart disease or diabetes, the value of genetics becomes much murkier.

Lab Values in Ebola Virus
A study of Ebola patients that assessed lab values for electrolytes and other body chemistry-type tests found a strong association between the deadly virus and hematological and biochemical abnormalities. Researchers and clinicians already knew that Ebola virus disease causes substantial organ dysfunction, particularly of the renal and hepatic systems. However, this study is the first to report Ebola infection-related hematological parameters and independent risk factors for mortality, according to the authors. “Ebola virus disease causes marked biochemical abnormalities, which might be amenable to simple interventions, potentially reducing the high case fatality rate,” the researchers wrote. Overall, the researchers found most patients had a “marked electrolyte imbalance in all stages of Ebola virus disease.” Patients also commonly had hematological derangements, including thrombocytopenia, lymphocytosis, and raised hematocrit levels. A majority of the patients had raised concentrations of alanine transaminase or aspartate transaminase, conditions associated with mortality.

Congressman Speaks at AMP Session on CLIA Modernization of Laboratory Developed Procedures
The Association for Molecular Pathology (AMP) held a session on CLIA modernization of laboratory developed procedures (LDPs), also known as laboratory developed tests (LDTs), at its annual meeting in Austin, Texas. The session, “Modernization of CLIA Regulations for Laboratory Developed Testing Procedures, an Update from Washington,” featured keynote speaker Congressman Michael Burgess, MD (R-TX), a member of the House Energy & Commerce Committee, who introduced legislation in 2011 to update the current CLIA regulations.

Laboratory Testing / Diagnostics

The Public Health Evidence for FDA Oversight of Laboratory Developed Tests: 20 Case Studies
Laboratory developed tests (LDTs) serve an increasingly important role in health care today. They also have become significantly more complex and higher risk, with several notable examples of inaccurate tests placing patients at otherwise avoidable risk. While laboratories that offer LDTs are subject to the Federal Food, Drug, and Cosmetic Act (FD&C Act), in addition to the Clinical Laboratory Improvement Amendments (CLIA), FDA has generally exercised enforcement discretion towards these tests (i.e., generally not enforced applicable provisions under the FD&C Act and FDA regulations). Therefore, most laboratories that offer LDTs follow only the regulatory requirements of CLIA, which are intended to regulate the operations of laboratories, but are not specifically intended to regulate in vitro diagnostic devices. Despite the contention from some that “CLIA is enough,” all of the tests described as problematic in this report were offered from laboratories following the minimum requirements of CLIA. We examined events involving 20 LDTs that illustrate, in the absence of compliance with FDA requirements, that these products may have caused or have caused actual harm to patients. In some cases, due to false-positive tests, patients were told they have conditions they do not really have, causing unnecessary distress and resulting in unneeded treatment.  In other cases, the LDTs were prone to false-negative results, in which patients’ life-threatening diseases went undetected. As a result, patients failed to receive effective treatments. Other LDTs provided information with no proven relevance to the disease or condition for which they are intended for use, while still others are linked to treatments based on disproven scientific concepts. In addition to patient harm, inaccurate or unreliable tests can be costly to society. We estimated these costs, if sufficient data were available.

Canadian Guidelines for Managing Low Testosterone
Consensus on how to properly diagnose and monitor patients with low testosterone has largely eluded the medical community, resulting in some reluctance among doctors to take on patients suffering from this syndrome. As a recent article in the Canadian Medical Association Journal (CMAJ) explains, the Canadian Men’s Health Foundation (CMHF) sought to remedy this problem by creating a multidisciplinary task force to analyze gaps in clinical practice—and develop a new set of guidelines on the topic of low testosterone management. The guideline, which aims to educate primary care physicians and other clinicians, emphasizes that successful diagnosis of testosterone deficiency syndrome depends on two elements: documentation of testosterone at levels below local laboratory ranges, and clinical evidence or manifestation of a deficiency. As part of the protocol for diagnosing patients with low testosterone, the guideline suggests that clinicians first take serum samples to measure total testosterone level. Sample collections should take place between 7 a.m. and 11 a.m., or within 3 hours after waking, for shift workers. The document also emphasizes that patients’ testosterone levels should be assessed using assays traceable to internationally recognized standardized reference material. Commercial assays in particular should have certification from the U.S. Centers for Disease Control and Prevention’s testosterone standardization program.

New Diagnostic Tools Emerge in War against Superbugs
A new front is emerging in the fight against antibiotic-resistant superbugs—one that doesn’t involve the development of new drugs. Companies are racing to develop diagnostic technologies that can be used by hospitals and clinics to pinpoint the cause of common infections quickly. That should cut down on the unnecessary prescription of antibiotics, a major driver of drug-resistance in bacteria. Traditional diagnostic testing via specialist laboratories can take several days to deliver results, so doctors who want to prescribe an immediate remedy often use a patient’s symptoms to guess what is causing an illness. More than a quarter of the time, this leads to antibiotics being prescribed unnecessarily, according to a 2013 study in the U.S. published in the Journal of Antimicrobial Chemotherapy. Now, a new market is opening up for diagnostics that can be used outside of specialist labs, and it is growing at a steady clip. Carl Heneghan, professor of evidence-based medicine at the University of Oxford, said the tool that doctors want most is one that can test for several potential culprits simultaneously.

A Treasure Trove of New Cancer Biomarkers
Biomarkers, which allow diseases to be diagnosed and staged based on relatively non-invasive blood tests, have been identified for several types of cancers, but for most cancers remain elusive. Now, research conducted at the RIKEN Center for Life Science Technologies (CLST) in Japan and the Harry Perkins Institute of Medical Research in Australia has identified a large number of genes that are upregulated in many different types of cancer, opening the door for developing biomarker tests that could be used to detect cancers early, allowing for prompt treatment. The study, published on November 9 in Cancer Research, made use of two different technologies. Based on the work, the researchers were able to identify 128 markers that were consistently perturbed in both datasets in a variety of tumor types. Some of them, such as TOP2A and MKI67, are well-known targets as potential biomarkers. But thanks to the data from FANTOM5, they were also able to find a number of new markers including non-coding RNAs, RNAs derived from repetitive elements and enhancer elements that CAGE technology can identify. In particular, they found that a little known repetitive element called REP522, was upregulated in many cancers.

Blood Test Detects When Hormone Treatment for Breast Cancer Stops Working
Scientists have developed a highly sensitive blood test that can spot when breast cancers become resistant to standard hormone treatment, and have demonstrated that this test could guide further treatment. The test gives an early warning of resistance to aromatase inhibitors, which are used to treat women with oestrogen receptor (ER)-positive breast cancer, the most common kind.
Detecting mutations in this gene from cancer DNA in the bloodstream could allow doctors to rapidly identify which patients are no longer benefiting from treatment and switch them to an alternative drug. The work is published in the journal Science Translational Medicine, and was funded by several organisations including the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), Breast Cancer Now, The Cridlan Ross Smith Charitable Trust and Cancer Research UK.

Rite Aid Adds Prescription Analysis to Genetic Test Lineup
Rite Aid is giving patients a chance to peek over their doctor's shoulder with genetic tests that help determine the effectiveness of some prescriptions. The drugstore chain said that it is selling Harmonyx testing kits at nearly all of its stores. The kits cost between $49 and $89 without a prescription, and customers can use them to learn more about the effectiveness of medicines for cardiac conditions, cholesterol and attention deficit hyperactivity disorder. But tests that explore a drug's effectiveness are more complex than those that just detect pregnancy hormones. Genetic counselor Joy Larsen Haidle says patients should talk to their doctor before buying a test kit.

Free Training Series on Syphilis Diagnostics Now Available
APHL, in collaboration with CDC, is introducing "Overview of Syphilis Diagnostics," a free three-part web series of interactive modules promoting an understanding of common serologic test methods for syphilis. The modules cover the history of testing, treponemal vs. nontreponemal tests, and diagnostic algorithms, followed by a set of case studies for users to practice lab result interpretation. Designed for all levels of experience, the modules are complemented with references and resources and available in PDF format for use in training programs. Users are encouraged to share this information with partners and colleagues.

Tricare to Cover More Lab-Developed Tests
Tricare beneficiaries will get access to 32 additional lab tests according to the Defense Health Agency. DHS added 32 tests to its Evaluation of Non-United States Food and Drug Administration Approved Laboratory Developed Tests Demonstration Project, which allows TRICARE to review tests not examined by the Food and Drug Administration to determine if they are safe and effective for use. The project covered 41 tests before the new additions.

Research and Development

Toenails Stashed in Harvard Basement Could Hold Clues about Cancer
Deep in the basement of Harvard University’s T.H. Chan School of Public Health sit more than a hundred vault-like freezers. Inside them: Toenails. A whole lot of toenails. Toenails that may hold the key to a better understanding of ovarian cancer. Harvard’s basement biorepository contains 3.5 million samples of blood, plasma, and urine from a nearly four-decade old research project known as the Nurses’ Health Study. But it’s the toenail clippings from more than 100,000 people — and a similar number of snips of hair from cut-off ponytails — that hold special promise for scientists. A blood sample only reflects what’s going on in your body in the very moment the blood is drawn. But hair and toenails harbor hormones and trace elements like arsenic and selenium, so scientists can analyze them to get an average of the levels in your body over several months. That makes the envelopes full of clippings a gold mine for researchers, who have used the samples in at least 400 research projects studying 40 diseases.

New Vaccine Could Offer 'Cheaper, More Effective' Treatment for High Cholesterol
In the journal Vaccine, study coauthor Dr. Bryce Chackerian - of the Department of Molecular Genetics and Microbiology at the University of New Mexico - and colleagues reveal how the new vaccine significantly reduced low-density lipoprotein (LDL) cholesterol in both mice and rhesus macaque monkeys. Though statins can be effective, Dr. Chackerian and colleagues note that they do not work for everyone and may cause severe side effects, including muscle pain, liver damage, digestive problems and increased diabetes risk. But the team says their vaccine - which works by inhibiting a cholesterol-regulating protein in the blood called PCSK9 (proprotein convertase subtilisin/kexin type 9) - may provide a more effective alternative to statins.

Blood Test Picks Out Prostate Cancer Drug Resistance
Researchers at The Institute of Cancer Research, London, the Royal Marsden NHS Foundation Trust, and the University of Trento, Italy, analysed 274 blood samples from 97 patients using state-of-the-art DNA sequencing techniques. They found that mutations in a gene called the androgen receptor (AR) predicted resistance to the prostate cancer drug abiraterone, and that patients with these mutations had poorer survival. The new study is published in the prestigious journal Science Translational Medicine today, and was funded by Cancer Research UK, Prostate Cancer UK, the NIHR Biomedical Research Centre at The Royal Marsden and The Institute of Cancer Research (ICR), and the University of Trento.

BioFire Defense Ebola Test Fares Well in Sierra Leone, UK Evaluation
A research team from the UK has determined that a rapid molecular Ebola assay from BioMérieux subsidiary BioFire Defense is sufficiently sensitive and specific to be an attractive option for relatively low-throughput laboratories testing for the disease. However, the assay and accompanying platform may not yet be suitable in outbreak situations or in labs with relatively high testing throughput, the researchers suggested. Rapid and specific testing is critical for patient care in suspected cases of Ebola virus infection, but rigorous evaluation of the numerous molecular diagnostics that have received Emergency Use Authorization from the U.S. Food and Drug Administration is ongoing.  

Pathophysiological Biomarkers Predict PAH Prognosis
Researchers have identified three biomarkers that signify an increased risk of death or requirement for lung transplantation in patients with pulmonary arterial hypertension (PAH). The finding is based on baseline measurement of endothelial, inflammatory and cardiac biomarkers in 65 PAH patients aged an average of 51 years enrolled in the ASA-STAT study. During 101,030 patient–days of follow-up, 17 of the patients died and two had lung transplants. The patients were more likely to succumb to one of these outcomes if they had higher plasma levels of N-terminal fragment of pro-B-type natriuretic peptide (NT-pro-BNP), lower cholesterol levels and reduced von Willebrand factor (vWF) activity.

Gene Study of Liver Tumor Reveals Versatile DNA
Tumors may have much greater genetic versatility than previously thought, and researchers say that might explain their ability to resist cancer treatments. The finding comes from extensive and rigorous genetic sequencing carried out on a single tumor. The human liver tumor that the scientists studied -- which was slightly more than 1 inch in diameter -- contained more than 100 million distinct mutations within the coding regions of its genes. That's thousands of times more than what scientists expected. "With 100 million mutations, each capable of altering a protein in some way, there is a high probability that a significant minority of tumor cells will survive, even after aggressive treatment," study director Chung-I Wu, a professor of ecology and evolution at the University of Chicago, said in a university news release. The study was published in this week's issue of the Proceedings of the National Academy of Sciences.

Renal Biomarkers Predict Diabetes Outcomes
Three renal biomarkers, acute kidney injury (AKI), albuminuria, and low estimated glomerular filtration rate (eGFR), considered separately or together, can predict adverse outcomes in diabetes, according to a study published online in Diabetes Care. Mathilde Monseu, MD, PhD, from the Université de Poitiers in France, and colleagues examined the prognostic value of AKI, albuminuria, and low eGFR considered together in patients with type 2 diabetes. "AKI, low eGFR, and elevated albuminuria, separately or together, are compelling biomarkers of major adverse outcomes and death in diabetes," the authors write.

Colour-Changing Dressing 'Fights Antibiotic Resistance'
A medical dressing that changes colour when it detects infection could cut the unnecessary use of antibiotics, say scientists at Bath University. It works by releasing fluorescent dye from tiny capsules when toxins are given out by bacteria in a wound. This allows doctors to identify bacterial infections and treat them more quickly, particularly in children with burns. Researchers said it could help to save lives.

Public Health and Patient Safety

Meningitis Jab in Africa a 'Stunning Success'
A mass vaccination programme against meningitis A in Africa has been a "stunning success", say experts. More than 220 million people were immunised across 16 countries in the continent's meningitis belt. In 2013 there were just four cases across the entire region, which once faced thousands of deaths each year. However, there are fresh warnings from the World Health Organization that "huge epidemics" could return unless a new vaccination programme is started.
Laboratory-confirmed cases of meningitis A have been falling ever since:
  • 2009 - 1,994 cases
  • 2010 - 430 cases
  • 2011 - 111 cases
  • 2012 - 49 cases
  • 2013 - four cases

Global Routine Vaccination Coverage, 2014
Improved vaccine stock management and the provision of vaccines during the second year of life are opportunities for countries to improve their vaccination coverage and ensure all children are fully protected from vaccine preventable diseases. The year 2014 marks the 40th anniversary of the World Health Organization’s (WHO) Expanded Program on Immunization, which was established to ensure equitable access to routine immunization services. Since 1974, global coverage with the four core vaccines (Bacille Calmette-Guérin vaccine [BCG; for protection against tuberculosis], diphtheria-tetanus-pertussis [DTP] vaccine, poliovirus vaccine, and measles vaccine) has increased from <5 percent to ≥85 percent, and additional vaccines have been added to the recommended schedule. However, global DTP3 coverage has remained unchanged at 86 percent since 2013, with 65 (34 percent) countries having not yet met the GVAP target of 90 percent national coverage. To reach and sustain global goals of vaccination coverage >90 percent in every country, adequate vaccine stock management and additional opportunities for immunization, such as through routine visits in the second year of life, are integral components to strengthening immunization programs and reducing morbidity and mortality from vaccine preventable diseases.

FDA to Examine Maternal Vaccines to Protect Infants
An advisory panel for the FDA will explore the development and licensing of maternal immunizations used to protect infants from disease, at a meeting. The FDA's Vaccines and Related Biological Products Advisory Committee will offer its recommendations regarding the appropriate clinical study design for assessing the safety and efficacy of both investigational and licensed vaccines given to mothers for their infants' protection. While several manufacturers have already begun clinical development of these maternal vaccines for their infants, their potential has "yet to be fully realized," noted briefing documents released prior to the meeting. (The agency also noted that the Advisory Committee on Immunization Practices has developed supportive public health policies targeting this issue.) The agency highlighted challenges specific to studying the safety of vaccines in pregnant women. While clinical studies of vaccines must establish safety in both the mother and the infant, efficacy is limited only to the infant. No specific vaccines or related product data will be discussed during the meeting.

Smoking Rates for Uninsured and Adults on Medicaid More Than Twice Those for Adults with Private Health Insurance
American adults who are uninsured or on Medicaid smoke at rates more than double those for adults with private health insurance or Medicare, according to a study published by the Centers for Disease Control and Prevention in Morbidity and Mortality Weekly Report (MMWR). Data from the 2014 National Health Interview Survey (NHIS) show that 27.9 percent of uninsured adults and 29.1 percent of Medicaid recipients currently smoke. By contrast, 12.9 percent of adults with private insurance and 12.5 percent of those on Medicare currently smoke. “Smoking kills half a million Americans each year and costs more than $300 billion,” said CDC Director Tom Frieden, M.D., M.P.H. “This report shows real progress helping American smokers quit and that more progress is possible.”

U.S. Sees Alarming Jump in Rate of Newborns with Syphilis
The rate of newborns with syphilis jumped 38 percent between 2012 and 2014 to its highest level in more than a decade, the Centers for Disease Control and Prevention reported, though the overall numbers remained small. The disease, which is transmitted from infected mothers to their fetuses, was found in 11.6 of every 100,000 births in 2014, up sharply from 8.4 in 2012 and the highest rate since 2001, researchers reported in the CDC'sMorbidity and Mortality Weekly Report.

Antibiotics May Make 'Superbug' MRSA Stronger
The antibiotic most commonly used to treat MRSA may actually make the infection worse, a new study finds. In its antibiotic-resistant form, methicillin-resistant Staphylococcus aureus, or MRSA, causes more than 80,000 infections and 11,000 deaths each year. While MRSA is resistant to many antibiotics, it does respond to others, and the infection is often treated with a combination of two or more antibiotics for this reason. But the study, which appeared in the journal Cell Host & Microbe, finds that one of the most common antibiotics used to treat the infection may inadvertently activate the body's own pathogen-defense system and worsen MRSA skin infections. Dr. George Liu, a researcher at Cedars-Sinai Medical Center in Los Angeles and one of the study's authors, said in a statement individuals infected with MRSA who receive a beta-lactam antibiotic -- a broad class of medicines that includes penicillin derivatives -- "could end up being sicker than if they received no treatment at all."

Maternal Mortality Falls by Almost 50% - UN Report
Pregnancy-related deaths have fallen by almost half in the past 25 years, according to a report by United Nations agencies published in The Lancet. Around 303,000 women died of complications during pregnancy or up to six weeks after giving birth in 2015 - down from 532,000 in 1990. Officials from the World Health Organisation (WHO) said the results showed "huge progress". However, only nine countries hit targets set by the UN. "This report will show that by the end of 2015 maternal mortality will have dropped by 44% from its levels from 1990," said Dr Lale Say, coordinator for reproductive health and research at the WHO. But she warned that the progress was "uneven" - with 99% of deaths happening in developing countries.

Reducing Misdiagnosis: Time for the Next Chapter in Improving Patient Safety
An estimated 12 million people in the United States experience diagnostic errors annually, but it’s time for a change, said researchers at Baylor College of Medicine, the Michael E. DeBakey Veterans Affairs Medical Center and RTI International in Raleigh-Durham, North Carolina in a call to action. In an opinion piece published in the New England Journal of Medicine, Dr. Hardeep Singh of Baylor and the DeBakey VA and Dr. Mark L Graber of RTI International in Raleigh-Durham, North Carolina said the recent Institute of Medicine report on “Improving Diagnosis in Health Care” requires individual and collaborative action from all health care stakeholders nationwide.
Diagnostic errors involve several types of missed opportunities to make a correct and timely diagnosis; a diagnosis may be missed completely, the wrong one may be provided, or diagnosis may be delayed, all of which can lead to harm from delayed or inappropriate treatments and tests. “Diagnosis is the foundation of medicine; without the right diagnosis, patients don’t receive the right treatment,” Singh said. “Understanding the importance of diagnostic errors has been difficult because they are difficult to detect and understand and less amenable to systems-based interventions.”
In addition to making patients a partner of the diagnostic team, the recommendations from the Institute of Medicine include:
  • Reforming the teaching of diagnosis.
  • Ensuring health information technology supports the diagnostic process.
  • Strengthening teamwork.
  • Measuring and learning from errors.
  • Promoting a culture of diagnostic safety.
  • Increasing research funding.
  • Reforming the malpractice and reimbursement systems.


Health IT

4 Security Controls OIG Will Focus On in 2016
The HHS' Office of Inspector General (OIG) has listed several new and revised security measures in its new 2016 work plan for better management of electronic health records and devices.
Here's a look at four key areas.
1. For controls over networked medical devices at hospitals, OIG will examine whether FDA's oversight of these devices is sufficient to effectively protect associated electronic protected health information (ePHI) and ensure patients' safety.
2. The OIG will also take new measures to determine the adequacy of the Office for Civil Rights (OCR) oversight over the security of electronic protected health information (ePHI).
3. Revised measures in the plan will include Center for Medicare and Medicaid Services (CMS) oversight of states' Medicaid information systems security controls.
4. Also revised will be state-based marketplaces information system security controls.

Connected Health 2015: IBM, Boston Children's Use Cognitive Computing to Tackle Pediatric Diseases
IBM Watson and Boston Children's Hospital will join forces to better understand rare pediatric diseases thanks to the power of cognitive computing. Using the Watson platform, the two organizations hope to help provider’s research diagnosis and treatment of such diseases, according to an announcement. Cognitive computing is the future of technology and will have great implications for healthcare once the systems learn and understand in a way that will also allow them to continuously be updated, Shahram Ebadollahi, vice president of innovations and chief science officer at IBM Watson, said at the HIMSS Connected Health Conference in Maryland.

Health IT Experts Working to Tackle Patient Matching Problem
Two national health information exchange organizations are soliciting input on ideas for improving how providers and others healthcare organizations match patients to their electronic medical records. And no, they're not recommending a national patient identifier. That controversial approach to patient matching was side-stepped when developing the group's 55-page white paper, “A Framework for Cross-Organizational Patient Identity Management.” The difficulty in matching patients to their records is seen by many health IT experts as a barrier to achieving full interoperability of healthcare information. It also highlights issues of patient safety and cost inefficiency. The authors of the new white paper came up with nearly two dozen recommendations that are in part gleaned from and validated by a case study of an actual patient-matching improvement project between Intermountain Healthcare, the Utah Health Information Network, a statewide health information exchange, and other local information exchange participants.

Predictive Analytics Helps Fraud Fighters Detect Sophisticated Schemes [Special Report]
Predictive analytics might be the hottest buzzword in healthcare. Over the last several months alone, data analytics have helped researchers predict where and when the flu is at its peak, allowed providers to determine what kind of care patients will need six months from now, and helped payers identify gaps in care. Now, predictive analytics is changing the way payers identify instances of fraud, waste and abuse in healthcare. Last month, the assistant inspector general and chief data officer at the Office of Inspector General, Caryl Brzymialkiewicz, highlighted analytics as a key tool in the largest healthcare fraud bust in U.S. history.

Does Big Data Need to be Downsized?
There used to be a certain prestige when it came to big things: big cars, big computers, and by gosh, who didn't want a Big Wheel? Today, we covet the small and personal. Yet for all our new-found love for all things small, big data is hot – as it should be, given its potential to help providers improve patient outcomes and cut costs. According to a recent Technavio report, global big data spending in healthcare is predicted to grow at a CAGR of about 42 percent from 2015 to 2019 as providers seek to derive insights from the vast amount of data generated by EHRs, bio-metric devices, social media, and other sources. However, if you are a consumer or even a physician you probably don't think too often about it, at least in terms of your health. You are likely more focused on a much smaller subset of information that directly impacts your life or your patients' lives and give little regard to the nebulous world of big data. Thus the challenge is to find ways to downsize big data and make it relevant and of value to individual patients and their physicians. Would the value of these bio-metric devices be enhanced if we could leverage big data and provide actionable insights at the patient level? Would more consumers be motivated – and remain committed – to actively monitoring their health? Would it improve physician buy-in?

Retail Clinics to Surge 47% by 2017
The prevalence of retail health clinics is expected to increase significantly by 2017, numbering more than 2,800 clinics across the U.S., according to a forecast from Chicago-based Accenture. Retail clinics first came to the U.S. market in 2001 and have historically struggled to make profits, according to the report. However, now more companies are emphasizing clinical services, investing in more advanced health IT and partnering with providers to coordinate care — all strategies that have made the retail clinic model more financially sustainable. Based on these changes, Accenture's analysis suggests retail clinics will grow 47 percent between 2014 and 2017, with numbers reaching 2,150 by the end of 2015 and roughly 2,400 in 2016. 

Vets.gov Launches in Beta
On Veterans Day, the Veterans Affairs Department unveiled vets.gov, a new website the department hopes will serve as a one-stop shop for veteran services. The website was launched in "beta," meaning additional capabilities and improvements are expected in the coming months. Launching in beta also allows VA to draw on feedback from veteran users to improve the site, said VA Secretary Robert McDonald in a Nov. 11 letter accompanying the launch. "It's still a work in progress, but it's a huge step forward in bringing veterans the online services they need and deserve," said McDonald.

Slow Telehealth Adoption Hurts Family Physicians' Ability to Compete with Retailers
One of the many ways retail health clinics are gaining market share is through telemedicine--and family physicians must adopt the technology in order to remain competitive, according to a speaker at the American Academy of Family Physicians' (AAFP) recent State Legislative Conference. But at the same time, doctors should push insurers to pay them fairly for the care they provide electronically, William Thornbury, M.D., the founder of an online appointment site called meVisit, told attendees, AAFP News reported.

Other News
World First Blood Test Reduces Risk and Increases Accuracy in Prenatal Testing
Research into a simple, accurate and low risk blood test that can detect foetal blood group, sex, and genetic conditions in unborn babies has been published in the international scientific journal, Clinical Chemistry. The research is the result of a collaboration between Plymouth Hospitals NHS Trust and Plymouth University and was conducted primarily by Plymouth University Peninsula Schools of Medicine and Dentistry PhD student, Kelly Sillence. Lead corresponding author for the study, Professor Neil Avent from Plymouth University School of Biomedical and Healthcare Sciences, explained: “Although foetal blood grouping and sexing using maternal blood has been done for over a decade, this research proves a much more accurate and sensitive method of detecting foetal DNA. This offers great opportunities to detect other conditions using this technique, but is much cheaper than current non-invasive methods. The end is now in sight for the invasive techniques of amniocentesis and chorionic villus sampling.”

Millennium Lab Files Bankruptcy after Settling with U.S.
Millennium Health LLC filed for bankruptcy after settling federal claims that it improperly billed the government for running urine tests on dead people and checking senior citizens for angel dust. The prepackaged reorganization plan filed in Delaware already has the support of key lenders. Under the proposal, Millennium, the largest U.S. drug-testing lab, will pay $256 million to settle the government claims while eliminating $1.2 billion in debt from its balance sheet
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