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A Weekly Compilation of Clinical Laboratory and Related Information From The Division Of Laboratory Systems ► DLS|HEALTHCARE NEWS|December 03, 2015

DLS|HEALTHCARE NEWS|December 03, 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


December 03, 2015


News Highlights

  • CDC Director: A Global Plan to Prevent, Detect, and Respond to the Next Killer Disease
  • New CDC Estimates Underscore the Need to Increase Awareness of a Daily Pill That Can Prevent HIV Infection
  • Why Some Children Get Cancer: Germline Mutations Found
  • Developing the Next Generation of Laboratory Leaders
  • FDA Commits to Moving Forward with Laboratory Developed Tests Regulation
  • 10-Minute Test That Detects a Stroke from a Few Drops of Blood Is a 'Game-Changer', Scientists Say
  • New Model for Prostate Cancer Screening Reduces Biopsies
  • Blood Test Results Vary from Drop to Drop in Finger Prick Tests
  • New Treatment for Type 1 Diabetes Shows Early Promise
  • Diabetes among Asians and Native Hawaiians or Other Pacific Islanders — United States, 2011–2014
  • No Mother-to-Child HIV Transmissions for First Time, New York State Reports 
  • WHO Records Highest-Ever Number of New HIV Cases in Its European Region
  • The Nationwide Readmissions Database
  • How Big Data Will Cause an Evolution in Medicine
  • Patient Ability to Access, Transmit Health Data Surged Last Year, ONC Reports
  

View Previous Issues - Healthcare News Archive


Leading News

CDC Director: A Global Plan to Prevent, Detect, and Respond to the Next Killer Disease
Can the nations of the world work together to stop the next deadly pandemic – before it happens? Is it possible to make the world safe and secure from infectious disease threats, whether natural or man-made? Yes, it’s not only possible – it’s underway. A coalition of 48 member countries have now committed to the Global Health Security Agenda (GHSA), originally launched in February 2014. The GHSA provides a framework to ensure that all nations are able to prevent, detect, and rapidly respond to infectious disease threats – protecting these countries and protecting Americans from deadly, global outbreaks. U.S. announced the full 30-country commitment for GHSA. As part of this effort, CDC has already begun expanding the number of disease detectives on the ground, establishing safe and secure lab networks to find deadly microbes, strengthening response to public health emergencies and upgrading systems to track health threats. http://www.cdc.gov/about/cdcdirector/

New CDC Estimates Underscore the Need to Increase Awareness of a Daily Pill That Can Prevent HIV Infection
A new Vital Signs report published today estimates that 25 percent of sexually active gay and bisexual adult men, nearly 20 percent of adults who inject drugs, and less than 1 percent of heterosexually active adults are at substantial risk for HIV infection and should be counseled about PrEP, a daily pill for HIV prevention.
PrEP for HIV prevention was approved by the Food and Drug Administration in 2012. When taken daily, it can reduce the risk of sexually acquired HIV by more than 90 percent. Daily PrEP can also reduce the risk of HIV infection among people who inject drugs by more than 70 percent. However, according to recent studies, some primary health care providers have never heard of PrEP. Increasing awareness of PrEP and counseling for those at substantial risk for HIV infection is critical to realizing the full prevention potential of PrEP.
“PrEP isn’t reaching many people who could benefit from it, and many providers remain unaware of its promise,” said CDC Director Tom Frieden, M.D., M.P.H. “With about 40,000 HIV infections newly diagnosed each year in the U.S., we need to use all available prevention strategies.”

Why Some Children Get Cancer: Germline Mutations Found
Testing of children and adolescents with cancer revealed that 8.5% had germline mutations in cancer-predisposing genes, according to a reportpublished online November 18 in the New England Journal of Medicine. Some were commonly mutated genes, such as TP53, seen in some pediatric cancers; others were new and were not yet associated with malignancies, such as Ewing's sarcoma. "This clinically significant study increases the awareness of the fact that childhood cancers do not develop by chance and there are genetic factors that will have an impact on the clinical management of these patients, and ultimately of their families," John M. Maris, MD, Giulio D'Angio Endowed Professor of Pediatric Oncology at the Children's Hospital of Philadelphia, in Pennsylvania, who authored an accompanying editorial, told Medscape Medical News. "This is a foundational study and for the first time provides an estimate of children who have a hereditary predisposition of cancer," corresponding author James R. Downing, MD, president and CEO of St. Jude Children's Research Hospital, Memphis, Tennessee, told Medscape Medical News.

Antibiotic Resistance: World on Cusp of 'Post-Antibiotic Era'
The world is on the cusp of a "post-antibiotic era", scientists have warned after finding bacteria resistant to drugs used when all other treatments have failed. They identified bacteria able to shrug off the drug of last resort - colistin - in patients and livestock in China. They said that resistance would spread around the world and raised the spectre of untreatable infections. It is likely resistance emerged after colistin was overused in farm animals. Bacteria becoming completely resistant to treatment - also known as the antibiotic apocalypse - could plunge medicine back into the dark ages. Common infections would kill once again, while surgery and cancer therapies, which are reliant on antibiotics, would be under threat. Chinese scientists identified a new mutation, dubbed the MCR-1 gene that prevented colistin from killing bacteria. Prof Timothy Walsh, who collaborated on the study, from the University of Cardiff, told the BBC News website: "All the key players are now in place to make the post-antibiotic world a reality.

Global Response to Ebola Outbreak Slammed by Independent Panel
The Harvard Global Health Institute and the UK's London School of Hygiene & Tropical Medicine recently convened an independent group of 20 experts to discuss and pick apart the global reaction to the recent Ebola outbreak. Consisting of members drawn from academia, think tanks and civil society, the group collectively reviewed the worldwide response and combined their findings. Published in The Lancet, the report pulls no punches and sets out a 10-point proposed plan to improve future reactions to similar emergencies. The report's 10 recommendations hope to give stronger guidance and bolster global systems in preparation for future outbreaks:
  1. A global strategy should be constructed to fund, observe and maintain each nation's ability to prevent major outbreaks. It is essential that poorer countries are provided with the funding and support necessary for such strategies
  2. Incentivize early flagging of outbreaks. On the other side of the coin, countries that are late to report cases should be published publicly
  3. Create a separately governed WHO department with clear accountability for outbreak response
  4. Construct a politically-protected Standing Emergency Committee within WHO that has the responsibility of declaring public health emergencies
  5. Design an independent UN body responsible for disease outbreak prevention and response within each country
  6. Develop a method to guarantee accelerated research when an emergency occurs including swift access to the benefits of that research for all
  7. Creation of a globally held finance facility in order to fund research, and for essential drugs, diagnostics, vaccines, and relevant non-pharmaceutical supplies
  8. Create a Global Health Committee as part of the UN Security Council that will elevate health issues and ensure swift actions in times of need
  9. WHO should scale back non-essential activities and focus on their core responsibilities
  10. A restructure of WHO to refocus and sharpen their abilities, including installation of leadership willing to challenge even the most powerful nation's governments.

Laboratory Testing / Diagnostics

Developing the Next Generation of Laboratory Leaders
Effective leadership and management skills are crucial for any high functioning work unit, and laboratory medicine is no exception. The two skill sets are distinct, but linked; management skills help maintain control and proper function, while leadership skills motivate and inspire.  Historically, the standard approach to selecting new laboratory leaders has been to promote high performing line staff. The problem with this strategy is that the skills and knowledge that make an effective bench technologist are quite different from those that make an effective leader. To deal with this challenge, the division of anatomic pathology at Mayo Clinic created a 12-month program to identify and train high performing staff interested in future leadership roles, called Leadership Exploration in Anatomic Pathology (LEAP). This program is intended for allied health staff who have not yet stepped into a formal leadership or management role and serves two purposes: 1) train allied health staff on basic leadership skills, and 2) identify those with the talent to manage others. It is critical to identify the strengths of prospective leaders early in order to prepare them to take the next step—something every laboratory should make a priority.

FDA Commits to Moving Forward with Laboratory Developed Tests Regulation
Dr. Jeffrey Shuren, director of the Food and Drug Administration’s Center for Devices and Radiological Health, announced at a hearing before the House Energy and Commerce Committee’s Subcommittee on Health that FDA would move forward with finalizing its plan to regulate laboratory developed tests (LDTs) sometime in 2016.  FDA provided notice of its intent to take action on LDTs when it published a draft guidance document in October 2014, setting forth the agency’s plan for regulatory oversight of LDTs. FDA’s decision to regulate LDTs would be a significant policy shift in this area because, historically, the agency has chosen not to exercise its enforcement power over LDTs.  FDA cites the increased complexity and higher patient risks involved with more modern LDTs as the impetus for its decision. Despite pushback from clinical laboratories and some other stakeholders, Shuren’s statements during House hearing demonstrate that the agency is committed to finalizing and implementing a new regulatory framework for LDTs.

F.D.A. Targets Inaccurate Medical Tests, Citing Dangers and Costs
Inaccurate and unreliable medical tests are prompting abortions, promoting unnecessary surgeries, putting tens of thousands of people on unneeded drugs and raising medical costs, the Food and Drug Administration has concluded. Life-threatening diseases go undetected in some cases. In others, patients are treated for conditions they do not have. “Patients have been demonstrably harmed or may have been harmed by tests that did not meet F.D.A. requirements,” federal investigators concluded in a report to Congress.

10-Minute Test That Detects a Stroke from a Few Drops of Blood Is a 'Game-Changer', Scientists Say
The brainchild of scientists at Cornell University in the U.S., it uses plates coated with enzymes to detect chemicals that rise in the blood after a stroke. When the enzymes bind to the chemicals, they trigger a chain reaction that leads to the emission of light. Blood tests have been developed for stroke in the past but typically take several hours, meaning they are not widely used. The combination of technology in the Cornell test gives results in under ten minutes and uses just a few drops of blood. Currently, it can pick up a chemical known to be made when the brain is damaged by stroke and other illness. It is hoped that by adapting it to detect several key chemicals, it will be able to zero in on strokes and distinguish between the two types. It may even be suitable for a paramedic to administer in the back of an ambulance, the journal PLOS ONE reports.

Novel Platelet RNA Test Finds Cancer in Single Drop of Blood
A blood-based platelet RNA test that uses the equivalent of one drop of blood can identify patients with cancer, differentiate between cancer types, and even pick out mutant biomarkers, say European researchers. In a study published online November 9 in Cancer Cell, the team reports that RNA from "tumor-educated" platelets containing tumor-associated biomolecules could distinguish cancer patients from healthy individuals with an accuracy of 96%. Furthermore, the test, which may eventually help in cancer diagnosis and guide treatment selection, could differentiate six primary tumor types with an accuracy of 71%, as well as identify specific breast and lung cancer mutant biomarkers. Coauthor R Jonas A Nilsson, PhD, department of radiation sciences, oncology, Umea University, Sweden, told Medscape Medical News: "Earlier and better diagnosis is a crucial element in curing patients or turning the disease into a manageable, more chronic disease."

Circulogene Releases Dipstick Test for Tumor Analysis
Circulogene Theranostics has released a finger-stick test that allows clinicians to monitor the progression of cancer with just a drop or so of blood. The assay will analyze 10 kinds of cancer: breast, colorectal, lung, gastric, gastrointestinal stromal, hematological, melanoma, ovarian, pancreatic and thyroid. It focuses primarily on cell-free DNA. The test can be performed with as little as 20 microliters of blood. The test turnaround time is about one week. The results include a personalized patient report that can be used to guide treatments or drug regimens.

Volitionrx Demonstrates NUQ Blood Test Detects Lung Cancers with More Than 90% Accuracy
VolitionRx Limited has announced interim data demonstrating its NuQ® blood tests have accurately detected more than 90% of lung cancer cases in a study of 73 patients. The clinical study is part of an ongoing larger prospective study of 240 subjects conducted with the Liege University Hospital (Belgium). The results were the outcome of an interim analysis of the first subjects recruited, including 29 subjects diagnosed with Non-Small Cell Lung Cancer, 22 diagnosed with another pulmonary disease (COPD) and 22 with healthy lungs. The analysis revealed that, when combined with details of smoking history, a panel of four NuQ® biomarker assays detected 93% of lung cancer cases (27 of 29), with 91% specificity (2 false positive results among 22 healthy subjects).

Sonora Quest Laboratories Offers Convenient Laboratory Services to Arizona Consumers in Select Safeway Locations
Sonora Quest Laboratories announced a collaboration with Safeway to open Sonora Quest Laboratories Patient Service Centers within select Safeway stores in Arizona, with the first now open in north Scottsdale. The Patient Service Centers will provide consumers access to convenient lab testing inside Safeway stores, directly next to the pharmacy. This retail collaboration will offer Arizona residents increased convenience with the same quality patient care they would receive at any one of Sonora Quest Laboratories' 70 Patient Service Centers, with or without a doctor's order.

FDA Raises Questions over DTC Genetic Tests Offered at Rite Aid
The U.S. Food and Drug Administration (FDA) called out another direct-to-consumer (DTC) genetic testing company over an unapproved test, this time going after one recently made available at the drugstore chain Rite Aid. According to the letter from FDA, the swab tests from Tennessee-based Harmonyx, a College of American Pathologists-accredited and Clinical Laboratory Improvement Act-certified genetic testing laboratory, are meant to help patients determine if they can safely continue taking their prescription antiplatelet, statin, ADHD or pain medications based on their genetic makeup. FDA says the tests meet the definition of a medical device and the company needs to seek approval for them. “We request that you provide us with the FDA clearance number for the Harmonyx tests. If you do not believe that you are required to obtain FDA clearance for Harmonyx tests, please provide us with the basis for that determination,” the letter says.

DNA4Life Is Latest DTC Genetic Test Company to Receive FDA Letter
Direct-to-consumer startup DNA4Life (Mandeville, La.) is the latest recipient of a letter from the U.S. Food and Drug Administration (FDA) questioning the company’s marketing of an unapproved genetic test. The test, which predicts response to 120 commonly prescribed medications based on analysis of 12 genes tied to drug metabolism, is being marketed as an unapproved medical device, the FDA says. The agency said it is unable to identify any FDA clearance for the company’s test and requested either a clearance number or the reasons DNA4Life believes that FDA clearance is not required for its test.

Research and Development

New Model for Prostate Cancer Screening Reduces Biopsies
A new model for prostate cancer screening can significantly reduce the number of unnecessary biopsies and minimize detection of clinically insignificant disease in comparison with standard screening using prostate specific antigen (PSA) alone, the Stockholm 3 (STHLM3) study indicates. "We have shown that a combination of plasma protein biomarkers, genetic polymorphisms, and clinical variables can improve the specificity of prostate cancer screening significantly compared with PSA in men aged 50 - 69 years," write the authors, led by Henrik Grönberg, MD, Karolinksa Institute, Stockholm, Sweden. The study was published online November 9 in the Lancet Oncology.

Blood Test Results Vary from Drop to Drop in Finger Prick Tests
When it comes to needles and drawing blood, most patients agree that bigger is not better. But in the first study of its kind, Rice University bioengineers have found results from a single drop of blood are highly variable, and as many as six to nine drops must be combined to achieve consistent results. The study, which appears online this week in the American Journal of Clinical Pathology, examines the variation between blood drops drawn from a single fingerprick. The results suggest that health care professionals must take care to avoid skewed results as they design new protocols and technologies that rely on fingerprick blood.

New Treatment for Type 1 Diabetes Shows Early Promise
A new form of treatment for type 1 diabetes that's based on the immune system appears safe for patients in an early trial. However, only a larger trial will show if the treatment -- which uses immune cells called regulatory T cells (Tregs) -- is effective against the illness, researchers said. If the therapy does work out, it "could be a game-changer," study first author Jeffrey Bluestone, a professor of metabolism and endocrinology at the University of California, San Francisco, said in a university news release. "For type 1 diabetes, we've traditionally given immunosuppressive drugs, but this trial gives us a new way forward. By using Tregs to 're-educate' the immune system, we may be able to really change the course of this disease," he explained. In type 1 diabetes, the immune system attacks insulin-secreting beta cells in the pancreas. Many treatments suppress the immune system, but that can lead to serious side effects, such as increasing a patient's susceptibility to infections or cancer. About 5 percent of all cases of diabetes are type 1 disease. According to the researchers, the new therapy uses a patient's own regulatory T cells to protect insulin-producing beta cells in the pancreas. The approach is designed to reduce the immune system's attack on beta cells, while still leaving the immune system strong enough to fight infections.

Researchers Find Method to Force Stem Cells to Become Bone Cells
Researchers at the University of North Carolina stumbled upon a method of forcing stem cells to become bone cells, finding a way to help replace bone in people who heal slowly. Cautioning that turning stem cells into bone cells is not a solution for osteoporosis, the researchers said stem cells could help bone fractures or hip replacement, especially for older people. "This was not what we expected. This was not what we were trying to do in the lab," said Dr. Janet Rubin, a professor of medicine at the University of North Carolina, in a press release. "But what we've found could become an amazing way to jump-start local bone formation. However, this will not address osteoporosis, which involves bone loss throughout the skeleton."

SARS-Like Virus in Bats Could Jump to Humans
A newly identified SARS-like virus in bats appears to be able to jump to humans without mutation, new research suggests. However, it's not yet clear whether it would then be able to spread from person to person, the researchers said. A worldwide outbreak of Severe Acute Respiratory Syndrome (SARS) in 2002-2003 was caused by a coronavirus that jumped from animals to humans. That outbreak resulted in 8,000 infections and nearly 800 deaths, the researchers noted. "Studies have predicted the existence of nearly 5,000 coronaviruses in bat populations, and some of these have the potential to emerge as human pathogens," senior study author Ralph Baric, from the University of North Carolina at Chapel Hill, said in a university news release.

Alzheimer's: Newly Identified Molecular Mechanism Could Lead to Treatment
During the early stages of Alzheimer's disease, when individuals appear to be free of symptoms, toxic changes are nevertheless taking place in the brain - including synapse loss. Though scientists do not yet fully know what causes this form of dementia, researchers have found how brain cell connections are destroyed in early stages of the disease. The researchers, led by scientists at the University of New South Wales (UNSW) in Australia, say their findings could lead to more research into possible treatments. They publish their work the journal Nature Communications.

Engineering Mosquitoes’ Genes to Resist Malaria
In a basement on the Irvine campus of the University of California, behind a series of five protective doors, two teams of biologists have created a novel breed of mosquito that they hope will help eradicate malaria from the world. The mosquito has been engineered to carry two ingenious genetic modifications. One is a set of genes that spew out antibodies to the malarial parasite harbored by the mosquito. Mosquitoes with these genes are rendered resistant to the parasite and so cannot spread malaria. The other modification is a set of genetic elements known as a gene drive that should propel the malaria-resistance genes throughout a natural mosquito population. When a malaria-resistant male mosquito mates with a wild female, the gene drive copies both itself and the resistance genes over from the male chromosome to its female counterpart.

Public Health and Patient Safety

Diabetes among Asians and Native Hawaiians or Other Pacific Islanders — United States, 2011–2014
Effective interventions and policies might reverse the large diabetes burden in Asians and Native Hawaiians or other Pacific Islanders (NHPIs). People with diabetes can take steps to control the disease and prevent complications, and those with prediabetes can prevent or delay the onset of type 2 diabetes through weight loss, healthy eating, and physical activity. Asians and (NHPIs) are fast-growing U.S. minority populations at high risk for type 2 diabetes. This report is the first to provide state-specific estimates of self-reported diagnosed diabetes prevalence among Asians and NHPIs in the United States. In 2011–2014, age-adjusted prevalence of diagnosed diabetes among Asians varied widely across states, with approximately a threefold difference between the state with the highest prevalence (New York, 15.3 percent) and the state with the lowest (Arizona, 4.9 percent).

No Mother-to-Child HIV Transmissions for First Time, New York State Reports 
For the first time since records started being kept, no mom delivered a baby who tested positive for the virus that causes AIDS officials said at a Nov. 19 meeting of the state's Drug Utilization Board. This is a huge victory in the war against HIV in New York State, which had one of the highest numbers of maternal transmission rates two decades ago. In 1990, for instance, nearly 1,900 HIV-positive moms delivered babies — 700 of which also tested positive for the virus.

WHO Records Highest-Ever Number of New HIV Cases in Its European Region
The World Health Organisation (WHO) said that in 2014 it had recorded the highest number of new HIV cases in its European Region, which also includes Central Asia, since the start of reporting in the 1980s. WHO and the European Centre for Disease Prevention and Control (ECDC) said in a statement that more than 142,000 people in WHO's European Region were diagnosed with HIV last year with the increase coming from its eastern sector which comprises 15 countries including Russia, Ukraine and Central Asia. The statement followed publication of findings by the United Nations AIDS programme which showed that new HIV infections overall had fallen by 35 percent since the peak of the three-decade-old pandemic in 2000.

Spike Seen in Reported Cases of Sexually Transmitted Diseases
Syphilis, gonorrhea and chlamydia are rising at alarming rates, according to figures released by the Centers for Disease Control and Prevention. Syphilis infections reported by doctors rose 15 percent from 2013 to 2014; cases of gonorrhea increased 5 percent, and chlamydia 3 percent. The agency called the diseases “a substantial health challenge.” Syphilis cases have more than tripled since 2000, and 91 percent are in men — mostly gay and bisexual men. Dr. Gail Bolan, the agency’s director of prevention of sexually transmitted disease, said there was “no single answer” for the increase, but noted several factors.

Toward Eliminating Poliovirus—In the Lab
In September, the Global Polio Eradication Initiative (GPEI) declared type 2 poliovirus eradicated. This long-awaited statement officially confirmed what polio researchers and global public health officials had known for more than a decade: one of the triumvirate of polioviruses was no longer a threat. The last case of type 2 poliovirus was diagnosed in Northern India in 1999. The announcement also set in motion a critical component of the GPEI’s Poliovirus Eradication Endgame Strategic Plan. Among other things, public health officials are planning to stop using oral polio vaccine against type 2 poliovirus in April 2016. To reduce risk of accidental release, all laboratories that stock type 2 poliovirus—both the wild-type and vaccine virus—will need to destroy the virus soon after that date, or adopt stricter standards for handling it.

BYU Researchers Speeding Up Process of Making Vaccines
Researchers at BYU have devised a system to speed up the process of making life-saving vaccines for new viruses. Their concept is to create the biological machinery for vaccine production en masse, put it in a freeze-dried state and stockpile it around the country. Then, when a new virus hits, labs can simply add water to a “kit” to rapidly produce vaccines. “You could just pull it off the shelf and make it,” said senior author Brad Bundy, associate professor of chemical engineering. “We could make the vaccine and be ready for distribution in a day.” The research, published in Biotechnology Journal, demonstrates the ability to store the drug and vaccine-making machinery for more than a year.

Physicians Discuss Medical Errors
What helps physicians after committing a serious medical error? Researchers recently asked 61 physicians the same question and distilled their words of wisdom into a must-have list of recommendations for physician training programs to consider. Here’s how experienced physicians have learned to cope with medical errors and to grow professionally despite challenging experiences in practice. Among the themes they identified as beneficial to physicians learning and healing after committing medical errors were these seven steps:
  1. Talking about the medical error.
  2. Forgiveness.
  3. Having a moral context to help them “do the right thing.”
  4. Learning how to deal with imperfection.
  5. Becoming an expert on their mistakes.
  6. Preventing recurring mistakes and improving teamwork.
  7. Helping others and teaching about it.
Want more tips on medical errors? Read the full study, which features additional recommendations for peer support programs and health care institutions on how to foster productive responses to medical errors.

Airborne Ebola Threat Analyzed by Scientists
The cross-ocean panic that accompanied the spread of Ebola in Western Africa was fueled by the unthinkable: the worst-case scenario that the dreaded virus could go airborne. No need to worry, according to a team of University of Florida researchers, who have analyzed decades of the virus’s known evolution. Ebola is only spread through direct contact with bodily fluids – a factor that has mostly prevented its spread in places with modern medical precautions and hygiene. The good news about Ebola’s stability is not only for people who may have had fears that an airborne variant could bring the contagion to parts of the world outside its normal epidemic spots – but also for drug and vaccine manufacturers who are attempting to create therapies, the University of Florida team concluded. However, not all scientists agree. In February, a researcher from the University of Minnesota concluded that some airborne transmission of Ebola was very likely, in a study published in a journal of the American Society of Microbiology.

Brazil Links Zika Fever to Birth Defects
The Brazilian health ministry has confirmed a link between a mosquito-borne virus from Africa, Zika Fever, and a high incidence of birth defects. The fever, it said, is behind a spike in cases of micro-encephalitis - an inflammation of the brain contracted in the first months of pregnancy. It has recorded two adult deaths and 739 cases of the disease, which can stunt the growth of the foetus's head. A World Health Organization team arrives in Brazil next week.


Health IT

The Nationwide Readmissions Database
The Nationwide Readmissions Database (NRD) is part of a family of databases and software tools developed for the Healthcare Cost and Utilization Project (HCUP). The NRD is a unique and powerful database designed to support various types of analyses of national readmission rates for all payers and the uninsured. This database addresses a large gap in health care data - the lack of nationally representative information on hospital readmissions for all ages. Unweighted, the NRD contains data from approximately 14 million discharges each year. Weighted, it estimates roughly 36 million discharges. Developed through a Federal-State-Industry partnership sponsored by the Agency for Healthcare Research and Quality, HCUP data inform decisionmaking at the national, State, and community levels.

How Big Data Will Cause an Evolution in Medicine
The use of big data in healthcare will not be like flipping a switch. Rather the use of data will inform models of our understanding of disease that will evolve as they're tested and applied to individuals, according to Eric Schadt, M.D., founding director of the Icahn Institute for Genomics and Multiscale Biology at New York's Mount Sinai Health System. In an interview at McKinsey & Co., Schadt says questions will become easier to answer as more data is pulled together. "We are at the very beginning stages of this revolution, but I think it's going to go very fast, because there's great maturity in the information sciences beyond medicine," he says.

Patient Ability to Access, Transmit Health Data Surged Last Year, ONC Reports
In a brief released last month, ONC reviewed the progress among non-federal acute-care hospitals in the U.S. from 2012 to 2014 in providing electronic capabilities for patient engagement. Among the findings:
  • In 2014, nearly two-thirds of hospitals (64%) enabled patients to electronically view, download, and transmit their health information, up from 10% in 2013.
  • The vast majority of hospitals (91%) allowed patients to view their health information electronically in 2014, up from 40% in the previous year and 24% in 2012.
  • More than four out of five hospitals (82%) let patients download their health information, up from 28% in 2013 and 14% in 2012.
  • Two-thirds of hospitals (66%) allowed patients to transmit their health information last year, up from only 12% in 2013.

Pentagon Ready to Certify Health Records Interoperability with VA 
The Defense Department notified lawmakers that it has met congressionally mandated requirements for health records interoperability requirements with the Department of Veterans Affairs. “With this letter, we are certifying that we have not merely met this requirement, but have gone even further to integrate data from other DoD systems, including inpatient, theater and pharmacy, into this process, thereby exceeding the NDAA’s requirements,” Kendall said. VA’s effort to ensure information contained within millions of patient electronic health records is interoperable with the Pentagon’s systems – and viewable through an integrated display of data in secure systems – will come shortly, said David Waltman, senior adviser for information strategy at the Veterans Health Administration.

DHS Has Never Properly Tested Its Catastrophic Biological Attack Detection System, GAO Says
The Department of Homeland Security has failed to properly test its system to detect biological attacks capable of causing 10,000 or more casualties, according to a newly released report from the Government Accountability Office. A lack of performance requirements has prevented DHS from accurately understanding the full capabilities of its BioWatch biosurveillance system. The department said it has the capacity to promptly warn the federal government in the event of a catastrophic attack, though GAO said those assertions are based on computer modeling and simulations that don't incorporate actual tests in the field. Further, those computer models were not created with the BioWatch system in mind.

Predictive Technology Expanding Reach
As healthcare shifts from being reactive to proactive, information technology is taking that move a step further through intuitive apps and programs that anticipate patient problems before they happen. In same vein as predictive modeling for population health, predictive technology is appearing as wearable sensors and even phone apps to ascertain changes in a patient's vitals, routines and even moods.  In particular, the trend toward predictive technology is gaining traction in the long-term care sector as skilled nursing and senior living facility operators look for ways to monitor residents in an unobtrusive manner.

Other News
Doctors Could Be Penalized for Ordering Prostate Tests
Medicare officials are considering a measure that would penalize doctors who order routine prostate-cancer screening tests for their patients, as part of a federal effort to define and reward quality in health-care services. The proposal, which hasn’t been widely publicized, has prompted a flurry of last-minute comments to the Centers for Medicare and Medicaid Services. Many of those commenting said the measure would discourage doctors from discussing the pros and cons of screening for prostate-specific antigen (PSA) with their patients and allowing them to decide, as several major medical groups recommend. “PSA screening is a very controversial topic. The debate is ongoing and people feel very strongly about it, one way or another,” said David Penson, chair of public policy and practice support for the American Urological Association, which urged CMS to reject the proposal. “To make it a quality measure would say, ‘You’re a poor quality doctor if your patients get this test.”  The proposed measure is part of continuing federal efforts to develop ways to identify and reward value in health care.

Uber Delivers Flu Shots in 36 Cities, in One-Day Experiment
For four hours, people in Boston and 35 other cities had the opportunity to summon a nurse to their doorstep to give them a flu shot. This experiment in “on-demand health care,” which involved the use of hundreds of Uber drivers, heralds what some consider the wave of the future: bringing health care to the people, instead of waiting for them to come and get it. The project, dubbed UberHEALTH, was the brainchild of John S. Brownstein, a researcher at Boston Children’s Hospital and Harvard Medical School who develops technologies that track and promote public health.

Survey Shows Americans Have Favorable Impressions of Many Federal Agencies
A new national survey by the Pew Research Center indicates that many federal agencies are regarded favorably by majorities of the public, even amid a growing distrust of government and significant partisan differences. A new 198-page report on the results of the survey—which polled public attitudes about government and politics—is based on more than 6,000 interviews conducted between Aug. 27 and Oct. 4, 2015, Pew said. A majority of respondents overall said they had a favorable view of 13 of the 17 agencies and departments tested in the survey. The U.S. Postal Service led the way, with 84 percent of respondents saying they had a favorable view of USPS, and 14 percent saying they had an unfavorable view. Next up were the National Park Service (75 percent favorable), Centers for Disease Control and Prevention (71 percent), NASA (70 percent), and FBI (68 percent).
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