Spring 2018 Medical Practice Management
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Artificial Intelligence in Health Care: the Hope, the Hype, the Promise, the Peril
Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril Michael Matheny, Sonoo Thadaney Israni, Mahnoor Ahmed, and Danielle Whicher, Editors WASHINGTON, DC NAM.EDU PREPUBLICATION COPY - Uncorrected Proofs NATIONAL ACADEMY OF MEDICINE • 500 Fifth Street, NW • WASHINGTON, DC 20001 NOTICE: This publication has undergone peer review according to procedures established by the National Academy of Medicine (NAM). Publication by the NAM worthy of public attention, but does not constitute endorsement of conclusions and recommendationssignifies that it is the by productthe NAM. of The a carefully views presented considered in processthis publication and is a contributionare those of individual contributors and do not represent formal consensus positions of the authors’ organizations; the NAM; or the National Academies of Sciences, Engineering, and Medicine. Library of Congress Cataloging-in-Publication Data to Come Copyright 2019 by the National Academy of Sciences. All rights reserved. Printed in the United States of America. Suggested citation: Matheny, M., S. Thadaney Israni, M. Ahmed, and D. Whicher, Editors. 2019. Artificial Intelligence in Health Care: The Hope, the Hype, the Promise, the Peril. NAM Special Publication. Washington, DC: National Academy of Medicine. PREPUBLICATION COPY - Uncorrected Proofs “Knowing is not enough; we must apply. Willing is not enough; we must do.” --GOETHE PREPUBLICATION COPY - Uncorrected Proofs ABOUT THE NATIONAL ACADEMY OF MEDICINE The National Academy of Medicine is one of three Academies constituting the Nation- al Academies of Sciences, Engineering, and Medicine (the National Academies). The Na- tional Academies provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. -
The Only Complete Technology Platform for Your Independent Practice
The only complete technology platform for your independent practice. Learn how Kareo helps practices thrive. What’s Inside We believe independent practices Who is Kareo? ......................................................................................................2 are in the best position to provide the personalized, results-oriented, Introducing the Kareo Platform ......................................................................3 and cost effective care that people Kareo’s Integrated Modules ..............................................................................4 demand and deserve. Kareo Clinical ........................................................................................5 Kareo Billing ..........................................................................................7 Dan Rodrigues Founder and CEO of Kareo Kareo Engage ........................................................................................9 Kareo Platform Extensions .......................................................................11 Kareo Telehealth .........................................................................................13 Kareo Analytics ............................................................................................15 Kareo Patient Collect ................................................................................17 Kareo Patient Statements ........................................................................19 Kareo Marketplace .....................................................................................21 -
Programové Vybavení Pro Provoz Nukleární Medicíny Software
ČESKÉ VYSOKÉ UČENÍ TECHNICKÉ V PRAZE FAKULTA BIOMEDICÍNSKÉHO INŽENÝRSTVÍ Katedra biomedicínské techniky Programové vybavení pro provoz nukleární medicíny Software Systems for Nuclear Medicine Diplomová práce Studijní program: Biomedicínská a klinická technika Studijní obor: Systémová integrace procesů ve zdravotnictví Autor diplomové práce: Bc. Jana Švagriková Vedoucí diplomové práce: MUDr. Jan Bruthans, Ph.D. Kladno 2018 PROHLÁŠENÍ Prohlašuji, že jsem diplomovou práci s názvem „Programové vybavení pro provoz nukleární medicíny“ vypracovala samostatně a použila k tomu úplný výčet citací použitých pramenů, které uvádím v seznamu přiloženém k diplomové práci. Nemám závažný důvod proti užití tohoto školního díla ve smyslu § 60 Zákona č. 121/2000 Sb., o právu autorském, o právech souvisejících s právem autorským a o změně některých zákonů (autorský zákon), ve znění pozdějších předpisů. V Kladně 18.05.2018 …...….………...………………... Bc. Jana Švagriková PODĚKOVÁNÍ Na tomto místě bych ráda poděkovala svému vedoucímu diplomové práce panu MUDr. Janu Bruthansovi, Ph.D. za vedení a připomínky k mé práci, jeho rady a konzultace. Dále bych chtěla poděkovat všem osloveným společnostem za jejich informace a poskytnuté materiály. Poděkování patří také všem zúčastněným odborníkům. V neposlední řadě děkuji své rodině a přátelům. ABSTRAKT Diplomová práce s názvem „Programové vybavení pro provoz nukleární medicíny“ se zaměřuje na zhodnocení existujících softwarových produktů, zejména radiologických informačních systémů pro využití v provozu nukleární medicíny. Hlavním cílem bylo zmapování současného aktuálního stavu problematiky s důrazem na Českou republiku. Vybrané systémy byly nejprve popsány pomocí deskriptivní metody. Pomocí analýzy SWOT byly zhodnoceny možnosti jednotlivých systémů. Pro výběr ideální varianty systémů byla zvolena metoda multikriteriálního rozhodování, metoda TOPSIS. Závěrem byl vytvořen návrh na doporučení pro uživatele systémů a celkové zhodnocení formou diskuse. -
High-Confidence Medical Devices: Cyber-Physical Systems for 21St Century Health Care
The NITRD Program The Networking and Information Technology Research and Development (NITRD) Program, one of the few formal interagency R&D activities within the Federal government, comprises the Government’s main unclassified R&D investments in advanced networking, computing, software, and related information technology (IT). The NITRD Program also supports research in the socioeconomic implications of IT and in development of a highly skilled IT workforce. Now in its 18th year, NITRD provides a framework and mechanisms for active coordination among 13 Federal research agencies; many other agencies with IT interests also participate in NITRD activities. NITRD is authorized by Congress through the High-Performance Computing Act of 1991 (Public Law 102-194), the Next Generation Internet Research Act of 1998 (Public Law 105-305), and the America COMPETES Act of 2007 (Public Law 110-69). The NITRD agencies work together in eight major research areas – called Program Component Areas (PCAs). In each PCA, agency program managers participate in an Interagency Working Group (IWG) or Coordinating Group (CG) that coordinates R&D activities and preparation of the annual Supplement to the President’s Budget for the NITRD Program. The PCAs are: High End Computing Infrastructure and Applications (HEC I&A), High End Computing Research and Development (HEC R&D), Cyber Security and Information Assurance (CSIA), Human Computer Interaction and Information Management (HCI&IM), Large Scale Networking (LSN), High Confidence Software and Systems (HCSS), Social, Economic, and Workforce Implications of IT and IT Workforce Development (SEW), and Software Design and Productivity (SDP). High Confidence Software and Systems R&D NITRD’s HCSS PCA supports R&D in scientific foundations and innovative and enabling software and hardware technologies for the design, control, assurance, verification and validation, and certification of complex, networked, distributed computing systems and cyber-physical (IT-enabled) systems such as aircraft and power grids. -
Achieving Safe DICOM Software in Medical Devices
Master Thesis in Software Engineering & Management REPORT NO. 2009:003 ISSN: 1651-4769 Achieving Safe DICOM Software in Medical Devices Kevin Debruyn IT University of Göteborg Chalmers University of Technology and University of Gothenburg Göteborg, Sweden 2009 Student Kevin Debruyn (820717-2795) Contact Information Phone: +46 73 7418420 / Email: [email protected] Course Supervisor Karin Wagner Course Coordinator Kari Wahll Start and End Date 21 st of February 2008 to 30 th of March 2009 Size 30 Credits Subject Achieving Safe DICOM Software in Medical Devices Overview The present document constitutes the project report that introduces, develops and presents the results of the thesis carried out by a master student of the IT University in Göteborg, Software Engineering & Management during Spring 2008 through Spring 2009 at Micropos Medical AB . Summary This paper reports on an investigation on how to produce a reliable software component to extract critical information from DICOM files. The component shall manipulate safety-critical medical information, i.e. patient demographics and data specific to radiotherapy treatments including radiation target volumes and doses intensity. Handling such sensitive data can potentially lead to medical errors, and threaten the health of patients. Hence, guaranteeing reliability and safety is an essential part of the development process. Solutions for developing the component from scratch or reusing all or parts of existing systems and libraries will be evaluated and compared. The resulting component will be tested to verify that it satisfies its reliability requirements. Subsequently, the component is to be integrated within an innovating radiotherapy positioning system developed by a Swedish start-up, Micropos . -
MDCG 2019-11 Guidance on Qualification and Classification of Software in Regulation (EU) 2017/745 – MDR and Regulation (EU) 2017/746 – IVDR
Medical Device Medical Device Coordination Group Document MDCG 2019-11 MDCG 2019-11 Guidance on Qualification and Classification of Software in Regulation (EU) 2017/745 – MDR and Regulation (EU) 2017/746 – IVDR October 2019 This document has been endorsed by the Medical Device Coordination Group (MDCG) established by Article 103 of Regulation (EU) 2017/745. The MDCG is composed of representatives of all Member States and it is chaired by a representative of the European Commission. The document is not a European Commission document and it cannot be regarded as reflecting the official position of the European Commission. Any views expressed in this document are not legally binding and only the Court of Justice of the European Union can give binding interpretations of Union law. Guidance on Qualification and Classification of Software October 2019 Guidance on Qualification and Classification of Software in Regulation (EU) 2017/745 – MDR and Regulation (EU) 2017/746 – IVDR Page 1 of 28 Table of Contents 1. Scope and purpose of this document 3 2. Definitions and abbreviations 3 3. Qualification 6 3.1. Introduction to qualification criteria 6 3.2. Medical Device Software (MDSW) 7 3.3. ‘Software driving or influencing the use of a medical device’ 8 3.4. Qualification criteria of MDSW as an in vitro diagnostic medical device 10 4. Classification of MDSW per MDR 2017/745 12 4.1. Implementing Rules 12 4.2. Classification Rules 12 5. Classification and implementing rules per IVDR 2017/746 15 5.1. Implementing Rules: 15 5.2. Classification Rules: 15 6. Considerations on placing on the market and conformity assessment of MDSW 16 6.1. -
Software & Services
SOFTWARE & SERVICES Recognizing the software and service organizations that excelled in helping providers deliver better patient care PHYSICIAN PRACTICE SOLUTIONS BEST IN KLAS AMBULATORY EMR (1–10 PHYSICIANS) HOW DO VENDOR SOLUTIONS COMPARE? WHO IS KONFIDENCE SCORE TREND LEVEL 1. Cerner PowerChart Ambulatory BEST IN KLAS? 84.3 +13% üü 2. Amazing Charts 83.3 +4% üüü 3. SRSsoft EHR 81.0 -11% üü 4. athenahealth athenaClinicals 80.9 -7% üüü 5. Greenway PrimeSUITE Chart 79.1 -2% üüü HOW DO THEY SCORE? 6. Aprima EHR IN FIVE KEY PERFORMANCE CATEGORIES 78.2 -1% üüü 100 92.4 7. ADP AdvancedMD EHR +3% üüü 90 84.9 78.0 80.6 81.7 81.2 80 8. e-MDs Chart -13% üüü 70 74.0 60 AVG. SEGMENT MKT. 9. GE Healthcare Centricity Practice Solution EMR +1% üü PHYSICIAN PRACTICE PHYSICIAN 50 73.8 40 T10. eClinicalWorks EHR 73.4 -7% üüü 30 20 T10. Henry Schein MicroMD EMR 73.4 +4% üü 10 12. NextGen Healthcare EHR 0 65.1 -3% üüü SALES & FUNCTIONALITY GENERAL CONTRACTING & UPGRADES 13. Allscripts Professional EHR 64.7 -6% üüü SERVICE & IMPLEMENTATION SUPPORT 14. McKesson Practice Partner -14% & TRAINING 48.0 üü 0 10 20 30 40 50 60 70 80 90 100 SEE HOW OTHER VENDOR SOLUTIONS SCORE AT KLASRESEARCH.COM HOW DO THE TOP THREE SOLUTIONS TREND? SOLUTIONS NOT RANKED PRELIMINARY DATA PRODUCTS CompuGroup Medical Enterprise EHR (HEHR)*..................71.0 MIE WebChart EMR* ............................................................75.7 MTBC EMR* .........................................................................82.1 Optum Physician EMR* ........................................................79.6 -
Healthcare Industry Highlight: Revenue Cycle Management
Industry Highlight: Revenue Cycle Management Q1 2019 RCM Overview Intelligent, Automated Workflow Patient Access Claims Management RCM intelligently automates the complex tasks of the front and back office, optimizing: Case Management ✓ Patient encounters and consolidation of REVENUE records Charges & CYCLE ✓ Participation in value-based programs to Reimbursement generate maximum revenue ✓ Claims management, accounts receivable and claim resubmission Clinical ✓ Medical practice workflow, reducing Documentation redundant staff effort Medical Coding Increasing complexity in medical coding and rising healthcare costs make RCM an essential tool to maintain cash flow and stay solvent 1 RCM Market Size and Outlook The global RCM market is projected to grow to $65.2BN by 2025 from $23.6BN in 2016, a nine-year CAGR of 12.0% Value of Global RCM Market ($USD in BN) $80 Facing tight margins, time-consuming 60 regulation and enormous waste in the healthcare system, medical practices 40 are looking for adaptable solutions to streamline workflow, generating 20 significant drive in the RCM market 0 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 $23.6BN $16.5BN 40% Value of global RCM market in Estimated hospital spend on Percentage of RCM end-user market 2016 external RCM by 2020 constituted by physicians’ offices 12.0% $6.7BN 3-5% CAGR through 2025 Annual provider spend on Hospitals’ lost revenues due RCM to RCM errors 2 Source: CMS NHE Projections , Grandview Research, MicroMarketMonitor, HFMA Inefficiencies RCM Can Help Solve Key Industry Trends: -
Selecting the Right EHR for Your Practice
Selecting the Right EHR for Your Practice EHR 1 EHR 2 kareo.com TheThe purchasepurchase and implementation ofof anan electronicelectronic healthhealth record record system system (EHR)(EHR) isis nono smallsmall feat—especially forfor smallsmall practices,practices, whowho frequently frequently have have limited resources, staff, and capital to invest. limited resources, staff, and capital to invest. According to a recent study conducted by AmericanEHR, nearly 40 percent of physicians would not recommend their EHR According to a recent study conducted by AmericanEHR, nearly 40 solution to another provider; only slightly fewer said they would percent of physicians would not recommend their EHR solution to not purchase the same software again. another provider; only slightly fewer said they would not purchase the “Digital“Digital technologies technologies that that enable enable same software again. real-timereal-time claims claims management management and Conversely, in a study conducted this year by an EHR vendor, payment,and payment, automate automate dictation and the approximately 60 percent of physicians who are satisfied see Conversely, in a study conducted this year by an EHR vendor, the coding,dictation and and improve coding, physicians’ and improvements to care and workflow. What makes the difference? approximately 60 percent of physicians who are satisfied see communicationimprove physicians’ with each other Those physicians who get the most out of their EHRs carefully improvements to care and workflow. What makes the difference? Those andcommunication with patients withcould each lower other physiciansconsidered who the get products, the most the out vendors, of their EHRs the implementation,carefully considered the the overheadand with costs patients and could enable lower more products,training they’d the vendors, require, the and implementation, how the EHR thewould training be used they’d on require, a efficientoverhead practice.” costs and enable andday-to-day how the basis.EHR would be used on a day-to-day basis. -
This Is the 19Th Annual Sohn Investment Conference. the First
This is the 19th Annual Sohn Investment Conference. The first time Ispoke here was in 2002. It is amazing how this great event has grown, and I am honored to be here. 1 2 A couple weeks ago, we wrote in our quarterly letter that we believe that a narrow group of cool kid stocks have disconnected from traditional valuations and formed a bubble. This got a lot of criticism. Half the critics thought we were talking our book, even though we didn’t name names. The other half were upset that we didn’t tell them which stocks we were short. Since we can’t seem to please anybody, I’ve decided to validate both criticisms. Today, I’m going to illustrate the bubble basket doing a deep dive into one of the companies, while not disclosing the others. This company is an excellent company with an excellent product, run by a well‐meaning and honest, though occasionally promotional CEO. The world may be a better place if it succeeds, and even though we are short, I am in no way rooting for it to fail. Its main problem is that it isn’t positioned to succeed the way the bulls hope, as the assumptions the bulls are making are not plausible. The stock is simply at the wrong price. It’s caught up in a bubble and could easily fall 80% or more from its recent peak. Let me introduce you to athenahealth. 3 I think athena deserves a smaller capitalization, and I’m not just referring to how it fails to capitalize the first letter of its name. -
Electronic Medical Records Software January 2019
ELECTRONIC MEDICAL RECORDS SOFTWARE JANUARY 2019 Powered by Methodology CONTENTS 3 Introduction 5 Defining Electronic Medical Records Software 6 FrontRunners (Small Vendors) 8 FrontRunners (Enterprise Vendors) 10 Runners Up 16 Methodology Basics 2 INTRODUCTION his FrontRunners analysis Enterprise Vendor graphic had a Tis a data-driven assessment minimum qualifying score of 3.51 identifying products in the for Usability and 3.50 for User Electronic Medical Records Recommended, while the Small software market that offer the Vendor graphic had a minimum best capability and value for small qualifying score of 3.21 for Usability businesses. For a given market, and 3.25 for User Recommended. products are evaluated and given a score for Usability (x-axis) and To be considered for the Electronic User Recommended (y-axis). Medical Records FrontRunners, a FrontRunners then plots 10-15 product needed a minimum of 20 products each on a Small Vendor user reviews published within 18 and an Enterprise Vendor graphic, months of the evaluation period. based on vendor business size, per Products needed a minimum user category. rating score of 3.0 for both Usability and User Recommended in both the In the Electronic Medical Records Small and Enterprise graphics. FrontRunners infographic, the 3 INTRODUCTION The minimum score cutoff to be included in the FrontRunners graphic varies by category, depending on the range of scores in each category. No product with a score less than 3.0 in either dimension is included in any FrontRunners graphic. For products included, the Usability and User Recommended scores determine their positions on the FrontRunners graphic. -
Kareo User Manual
Kareo User Manual Table Of Contents 1. GET STARTED ............................................................................................................................................................................................. 1 1.1 Installation ................................................................................................................................................................................... 1 1.1.1 System Requirements .........................................................................................................................................................................1 1.1.2 Download and Install Kareo ............................................................................................................................................................. 2 1.1.3 Software Updates ............................................................................................................................................................................... 2 1.2 User Login .................................................................................................................................................................................... 3 1.2.1 Kareo Login with User ID/Password ............................................................................................................................................... 3 1.2.2 Password Change ...............................................................................................................................................................................