A perspective paper published this week in the Journal of the American Medical Informatics Association outlined barriers to health equity research serving deaf and hard-of-hearing patients, and how EHRs may be making such barriers worse.
Although EHR systems can be useful when it comes to identifying health inequities, researchers noted that they may also be interfering with efforts to improve health outcomes among deaf and hard-of-hearing American Sign Language (ASL) users.
“Due to communication barriers and discrimination, DHH ASL-users experience deleterious social determinants of health and a myriad of health inequities when compared to non-DHH English-speaking patients including poorer health literacy, worse preventive screening outcomes, and higher rates of substance use,” explained researchers.
WHY IT MATTERS
As the paper from the Journal of the American Medical Informatics Association (JAMIA) noted, 250,000 to 500,000 people are deaf and hard-of-hearing signed language users although more precise estimates for ASL user numbers are unknown.
All the same, accurate language status is not always collected and recorded in the EHR – leading to widespread data quality issues.
For instance, researchers noted, the most recent version of the National Patient-Centered Clinical Research Network Common Data Model classifies ASL as an “other” language.
“This creates an issue of misclassification within health systems and clinical research networks who have adopted PCORnet CDM, limiting the ability for health services and clinical researchers to assess health disparities impacting patients who communicate in ASL – who have been lumped into a language category representing other languages of limited diffusion,” noted researchers.
In turn, data about ASL use can be coded within patient records but unavailable to researchers without Institutional Review Board approval for protected health information – presenting an additional hurdle that may not be solvable with query tools.
Language status misclassification can have a variety of effects, as researchers explained: In a clinical setting, it can hinder patient-provider relationships and shared decision-making, as well as making it more difficult to hire an interpreter in a timely manner.
“In research, misclassification renders this population invisible, promoting the ‘no data, no problem’ problem, and hampers efforts to direct resources to promoting health equity for these priority populations,” read the paper.
Researchers offered ways of approaching the problem:
Health informatics leaders and software developers should include ASL and signed languages as options within data frameworks
Health systems should work with health informatics providers to ensure that tools available to researchers and practitioners include languages of limited diffusion and non-majority languages when querying data points
EHR users should accurately record the patient’s preferred languages within their medical record
“Given existing barriers – at all levels, from the EHR software provider to the EHR user – change agents and researchers attempting to increase uptake of patient preferred language options should consider using behavior change theories and implementation frameworks … to understand enabling and restricting factors related to uptake,” read the paper.
THE LARGER TREND
The role EHRs can play in research and care has attracted more scrutiny in recent years – particularly as patients have readier access to their records.
This, as with deaf and hard-of-hearing patients, can obfuscate meaningful information and present barriers to care.
ON THE RECORD
“We recommend intentional steps – from all stakeholders – to ensure DHH ASL-using patients’ language statuses are accurately recorded to promote health equity for this population,” wrote the researchers in the JAMIA paper.
Original Article: healthcareitnews.com
Apple Sues NSO Group, Accusing It of Spying on Users in New Lawsuit
Apple announced this week that it was suing NSO Group, an Israeli surveillance technology company, in federal court for allegedly accessing users’ devices without authorization.
In addition to damages, the tech giant is seeking to block NSO Group from accessing or using any Apple products, or developing spyware that could be used on Apple products in the future.
“State-sponsored actors like the NSO Group spend millions of dollars on sophisticated surveillance technologies without effective accountability,” said Craig Federighi, Apple’s senior vice president of software engineering, in a statement. “That needs to change.”
Apple devices are “the most secure consumer hardware on the market,” he contended, but “private companies developing state-sponsored spyware have become even more dangerous.
“While these cybersecurity threats only impact a very small number of our customers, we take any attack on our users very seriously, and we’re constantly working to strengthen the security and privacy protections in iOS to keep all our users safe,” Federighi added.
NSO Group offered a statement to Healthcare IT News in response to requests for comment.
“Thousands of lives were saved around the world thanks to NSO Group’s technologies used by its customers,” said NSO Group representatives. “Pedophiles and terrorists can freely operate in technological safe-havens, and we provide governments the lawful tools to fight it. NSO Group will continue to advocate for the truth.”
WHY IT MATTERS
NSO Group says its surveillance technology is used by government intelligence and law enforcement agencies to track criminals.
But as Apple outlines in its complaint, the company’s spyware has reportedly been used against journalists, human rights activists, dissidents, public officials and others.
This month, the U.S. Department of Commerce included the NSO Group in its Entity List for “engaging in activities that are contrary to the national security or foreign policy interests of the United States.” Specifically, the agency said that NSO Group had enabled foreign governments, via its spyware, to “maliciously target” individuals such as embassy workers and academics and to “conduct transnational repression.”
In its complaint, Apple zeroed in on “FORCEDENTRY,” an exploit for a vulnerability used to break into a victim’s device and install NSO Group’s Pegasus spyware product.
The company accused attackers of creating Apple IDs to send malicious data to a victim’s device, which then allowed NSO Group or its clients to surreptitiously deliver Pegasus.
“On information and belief, Defendants provide consulting and expert services to their clients, assist them with their deployment and use of Pegasus, and participate in their attacks on Apple devices, servers and users,” according to the complaint. Although Apple has not observed any evidence of successful remote attacks against devices running iOS 15 or later, it said that each attack carries substantial costs for the company, including the necessity to redirect resources.
“In the meantime, on information and belief, Defendants continue with their pernicious efforts to target and harm Apple and its customers by infecting, exploiting, and misusing Apple devices and software,” said the complaint.
The company also announced that it would be contributing any damages from the lawsuit, plus an extra $10 million, to organizations pursuing cybersurveillance research and advocacy.
“At Apple, we are always working to defend our users against even the most complex cyberattacks,” said Ivan Krstic, head of Apple Security Engineering and Architecture, in a statement.
“The steps we’re taking today will send a clear message: In a free society, it is unacceptable to weaponize powerful state-sponsored spyware against those who seek to make the world a better place.”
THE LARGER TREND
Nation-states have increasingly relied on sophisticated software to carry out governmental objectives.
As Errol Weiss, H-ISAC chief security officer, pointed out in an interview with Healthcare IT News earlier this month, cyber-offensive capabilities have now become the norm, not the exception.
“A few years ago, you could count maybe a few dozen countries that had a decent, offensive cyber capability. And now it’s probably the opposite,” he said. The U.S. government has raised the alarm about these developments, most recently regarding an Iran-sponsored hacker group targeting healthcare.
ON THE RECORD
“Our threat intelligence and engineering teams work around the clock to analyze new threats, rapidly patch vulnerabilities, and develop industry-leading new protections in our software and silicon,” said Apple’s Krstic in a statement.
“Apple runs one of the most sophisticated security engineering operations in the world, and we will continue to work tirelessly to protect our users from abusive state-sponsored actors like NSO Group,” he said.
French Researchers Reveal Chatbot Skills to Override Vaccine Hesitancy
A team of French cognitive scientists has addressed the urgent issue of vaccine hesitancy within many EU countries and proposes a new approach. With a study published in October this year, the researchers successfully demonstrated that the reluctance to be vaccinated could be decreased by deploying chatbot technology.
WHY IT MATTERS
The chatbot study involved researchers from the Centre National de la Recherche Scientifique (CNRS), the French National Institute of Health and Medical Research INSERM and ENS-PSL.
The study, published in the Journal of Experimental Psychology: Applied, found that interaction with a chatbot developed by CNRS, ENS-PSL and INSERM was able to reduce vaccination refusal by 20 per cent within a test group of 338 participants.
In the control group, which received only brief information about the COVID-19 vaccination, there were no comparable results in terms of general views and willingness to vaccinate.
THE LARGER TREND
Although nearly three-quarters of all adult Europeans are now fully vaccinated against COVID-19, there remain huge disparities in vaccination rates across countries.
According to the vaccine tracker of the European Centre for Disease Prevention and Control (ECDC) as of 25 November 2021, individual EU countries such as Portugal (81.5 per cent), Ireland (76.2 per cent) and Denmark (76 per cent) have already made great progress in immunising their populations with a full COVID-19 vaccination, while the vaccination rate of other countries such as Germany, France or Austria continues to stagnate at below 70 per cent.
In other parts of Europe, especially in the south-west, the vaccination rates are significantly lower than 50 per cent. In Slovakia (45.7 per cent), Romania (37.3 per cent) and Bulgaria (24.7 per cent), very few people have received the double COVID-19 vaccine dose.
These vaccination backlogs are not only due to vaccine shortages, but in many cases a result of existing scepticism of many Europeans.
The researchers from France now hope that technology-based communication, such as chatbots, could have a positive impact on these figures in the future.
ON THE RECORD
“It remains to be shown whether the effects of chatbot interaction are lasting, and whether they are the same across age groups, and among those most resistant to vaccination”, emphasised the authors of the study with predominantly young and well-educated participants.
They added: “Half of the experimental group later tried to persuade others to get vaccinated, with three-quarters of them stating they drew information provided by the chatbot to do so.”
Roundup: Medanta Adopts Qure.ai’s X-ray Software, India to Open a Medical Cobotics Centre, and More Briefs
Medanta taps Qure.ai for AI-driven chest x-ray analysis
Medanta, a multi-speciality medical group in India, has partnered with Qure.ai to implement the latter’s artificial intelligence software to enhance chest x-ray analysis.
The hospital group will be adopting the qXR software which automatically analyses chest x-rays and spots findings for better diagnosis and treatment. The AI tool can detect 30 abnormalities of the lungs, pleura, heart, bones and diaphragm.
“Medanta strives to deliver world-class healthcare through its high-end medical equipment and superior infrastructure. State-of-the-art technology is an essential aspect of healthcare delivery,” Dr Naresh Trehan, chairman and managing director of Medanta, was quoted as saying in a news report.
The Qure.ai software has also been adopted by Fujifilm Corporation for its portable X-ray FDR Xair system. Through its recent partnership with AstraZeneca Malaysia, the startup has brought its x-ray software to some primary care clinics in Malaysia to support the early detection of lung cancer there.
Medical cobotics centre to be launched in India
The I-Hub Foundation for Cobotics at the Indian Institute of Technology – Delhi (IIT Delhi) and iHub Anubhuti at the Indraprastha Institute of Information Technology – Delhi (IIITD) have signed a memorandum of understanding to set up India’s first medical cobotics centre.
The two government-backed university technology hubs have been developing advanced technologies in robotics and collaborative robots (cobotics), digital health, sensing and computing technologies for robotic-assisted surgeries, training, and medical procedures.
According to a press statement, the Medical Cobotics Centre (MCC) at IIITD will be a tech-enabled medical simulation and training facility for young resident doctors, as well as other healthcare professionals, paramedical staff, technicians, engineers, and researchers.
It will also serve as a validation centre for research outcomes in the area of healthcare cobotics and digital health. This upcoming facility will establish partnerships with companies, undertake research, and work toward the commercialisation of technologies.
MMC’s training programmes will be at multiple levels and cohort-specific, such as urology, neurology, and laparoscopy, but will be initially limited to minimally invasive surgeries. Experts from All India Institute of Medical Sciences in New Delhi and other medical colleges will be consulted for these programmes and invited as guest faculty to conduct them.
The first batch of trainees is targeted to be inducted around April-May next year. They will be initially trained with basic training simulators while advanced surgical robots will come in the next phase.
Moreover, the centre will also be a place for various technology innovation hubs under the Indian government’s National Mission on Interdisciplinary Cyber-Physical Systems to “showcase their medical-related projects and products with applications,” according to IHFC CEO Ashutosh Dutt Sharm and IHFC Project Director Subir Kumar Saha.
Philips Foundation backs cardiac rehab programme in Singapore
Philips Foundation is funding one of the centres run by social service agency Singapore Heart Foundation that provides subsidised cardiac rehabilitation services.
The year-long project of Royal Philips’ non-profit organisation aims to reduce the mortality rate of cardiac incidences and help lower a patient’s risk of hospital readmission.
Specifically, it intends to close the gap in patients’ lack of participation in rehab programmes, which is considered a huge barrier in the secondary prevention of heart diseases. It was reported that only between 6%-15% of Singaporean patients attend cardiac rehabilitation programmes.
SHF-Philips Foundation Heart Wellness Centre is one of the social services’ three centres that provide cardiac patients and at-risk individuals with access to heart health.
Philips’ support, according to SHF Heart Wellness Centres Chairman Dr Tan Yong Seng, will provide SHF with the “resources required to continue providing affordable and quality support to the patients in need, as well as give our team the capacity to focus on raising awareness on the importance of cardiac rehab[ilitation] and drive higher participation in our programmes”.
Under the partnership, 20 sites in Singapore will be equipped with the Philips HeartStart automated external defibrillators (AED) and 500 persons will be trained in giving cardiopulmonary resuscitation (CPR) and AED over a year.
“Through the heart wellness centre’s education initiatives, the AED roll-out and the CPR training, we want to equip individuals and communities with the knowledge and resources to reduce the mortality rates of cardiac incidences in Singapore,” Philips Singapore Country Manager Ivy Lai said.
Original Source: healthcareitnews.com
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