Tag: electronic health records

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Product Managers Look To Patient Records For Treatment Solutions

Patient medical records may be a new product area
Patient medical records may be a new product area
Image Credit: Kevin Spencer

Nobody ever wants to go to the hospital. However, if we do find ourselves there, we would like to think that the doctors know exactly what is wrong with us and that they have a way to fix us. However, let’s face it – the human body is really, really complex and often doctors are just guessing at what ails us. Product managers believe that that they may have an opportunity to fix this problem. They are taking a look at all of the patient records that exist and are trying to determine if they can be used to improve how patients are cared for.

The Power Of Medical Records

Product managers think that they may have discovered a new source of valuable products. Just imagine this scenario: you have just been diagnosed with diabetes. Your doctor opens your electronic medical record, which of course includes your latest test results, your DNA sequence, your history of arthritis, your smoking status, your prior Covid-19 infection and your age, gender, body-mass index and race. He then updates it as necessary and clicks a button on his tablet. Moments later, a report comes back to him summarizing how thousands of patients just like you were treated in the past. In this scenario, your doctor would draw on the volume of prior cases to come up with the best treatment for you.

Let’s face it: details on the medical care of hundreds of millions of patients are piling up in electronic health records in clinics and hospitals around the world. Product managers have realized that this comprises a growing treasure trove of real-world data on the daily practice of medicine. It includes patient diagnoses, treatments and outcomes. What product managers realize is that to date hardly anyone has sought to tap the knowledge sequestered in those digital vaults that might benefit future patient care.

Aided by advances in artificial intelligence, search capabilities and other analytics, product managers are now probing the huge databases for rapid insights into the performance of the healthcare system. Product managers have an ambitious vision for this data: to help guide how doctors treat individual patients in real time. The evidence from real-world data is a different and exciting new path. Doctors can get a lot of outcome information from medical records that can help change care for individual patients. For almost any patient that a doctor sees today – whether for high cholesterol, asthma, or sepsis – hundreds or perhaps tens of thousands of similar patients have already had the care and have had outcomes, good or bad.

Harnessing Medical Records

Product managers need to realize that patient records are observational, and thus subject to misdiagnosis and other shortcomings that can undercut their reliability in pointing to treatment options. But today’s gold standard has its own issues. Randomized clinical trials, which control for differences in patient health status and other variables, are currently the preferred evidence to inform patient care. Yet such trials generally exclude an especially common group of patients -those who have multiple ailments. Additionally, the elderly, children, women, minority groups and people who live far from medical research centers have long been underrepresented in these studies.

As a result of these gaps, the highest-quality evidence that medicine produces doesn’t apply to most patients doctors see in daily practice. It is known that there are many clinical situations where the evidence that is needed does not exist. Product managers have believed for at least a half-century that data in patient medical records could help fill the gaps. However, until the last decade, most of it was stored in manila folders that lined shelves in doctors’ offices and hospital record rooms. Not having the ability to digitally organize and analyze these records, they have had little value for patient care. Thanks to a massive government investment and regulatory push during the Obama administration, well over 80% of U.S. hospitals and physician practices now maintain computerized patient records.

There are a number of issues with these records. Electronic health records are a currently hodgepodge of data because few standards exist for entering patient variables. There are more than 60 different versions of how white blood cells are counted – a fundamental biomarker for cancer patients. Without standardized reporting, you have a question of quality and accuracy that potentially could follow you forever. Controversies over privacy and ownership of patient data could also hinder product manager’s use of the information. Especially important will be the need to minimize biases inherent in observational data and to select the most meaningful variables for a patient’s condition. Doctors will need to know they can trust the information and that it can provide useful advice in the clinic or at a patient’s bedside.

What All Of This Means For You

Product managers are excited. They think that they may have discovered a gold mine of data that they can use to create a host of new products. Patient medical records contain a great deal of information on how medical conditions have been treated in the past. If product managers can get their hands on these records, they think that they can transform them into powerful tools that doctors and hospitals would be willing to purchase.

The power of medical records comes from its size. For every medical condition, there are hundreds if not thousands of other patients who have been treated with the same conditions. Allowing doctors to draw on these past cases to find out what treatments work could be very valuable. This medical data is now becoming available because product managers now have the ability to process large quantities of medical records electronically. Product managers realize that medical records only hold the observations made by doctors, but they are still valuable. The way that treatments are generally created are based on studies that only deal with small groups of healthy people – not like the people who come to doctors seeking help. Product managers have to be aware of data privacy issues and data formatting concerns.

There is no doubt that patient medical records contain a great deal of valuable information. If product managers want to be able to tap into this data store, they are going to have to first get permission. Next they are going to have to find a way to sort out all of the information so that they can understand what they have. If they can do this, then perhaps the next time that we go to the doctor, they will have seen what we have got already and have a solution to our issue waiting for us!


– Dr. Jim Anderson Blue Elephant Consulting –
Your Source For Real World Product Management Skills™


Question For You: Do you think that people should be involved in the digitizing of medical records in order to sort out the differences?


Click here to get automatic updates when The Accidental Product Manager Blog is updated.
P.S.: Free subscriptions to The Accidental Product Manager Newsletter are now available. It’s your product – it’s your career. Subscribe now: Click Here!

What We’ll Be Talking About Next Time

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US hospital chain CommonSpirit Health says ‘IT security issue’ is disrupting services

CommonSpirit, the second-largest nonprofit hospital chain in the U.S., has confirmed a cybersecurity incident that is disrupting medical services across the country.

In a brief statement, Chicago-based CommonSpirit said the “IT security issue” is impacting some of CommonSpirit’s facilities and some patient appointments have been rescheduled as a result.

“CommonSpirit Health is managing an IT security issue that is impacting some of our facilities,” said the hospital giant, which operates more than 700 care sites and 142 hospitals in 21 states. “As a precautionary step, we have taken certain IT systems offline, which may include electronic health record and other systems.”

“Our facilities are following existing protocols for system outages and taking steps to minimize the disruption. We take our responsibility to ensure the security of our IT systems very seriously. As a result of this issue, we have rescheduled some patient appointments. Patients will be contacted directly by their provider and/or care facility if their appointment is impacted.”

CommonSpirit has yet to confirm the nature of the security incident, and it is unknown if patient information or health data was compromised. When reached, CommonSpirit spokesperson Chad Burns declined to comment beyond the organization’s statement.

The extent of the disruption caused by the issue is emerging. CommonSpirit’s Nebraska-based subsidiary, CHI Health, reported outages across its Omaha hospitals, and MercyOne Des Moines Medical Center has shut down some of its IT systems, including access to its electronic health records.

In July, U.S. cybersecurity agency CISA, the FBI and the U.S. Treasury warned in a joint statement that North Korea-backed hackers were targeting healthcare and public health sector organizations across the U.S. with ransomware.

The warning followed a spate of high-profile attacks on U.S. healthcare systems, including University Medical Center Southern Nevada, Eskenazi Health, and Kaiser Permanente. According to Brett Callow, threat analyst at Emsisoft, at least 15 U.S. health systems operating 61 hospitals across the country have been impacted by ransomware so far in 2022. In at least 12 of these incidents, sensitive data including personal health information (PHI) was compromised.

US government says North Korean hackers are targeting American healthcare organizations with ransomware

US hospital chain CommonSpirit Health says ‘IT security issue’ is disrupting services by Carly Page originally published on TechCrunch

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Health startup myNurse to shut down after data breach exposed health records

myNurse, a healthcare startup that provides chronic care management and remote patient monitoring services, said it will shut down at the end of the month after reporting a data breach that exposed personal health information of its users.

The startup, which launched as Salusive Health, said in a data breach notice filed with the California attorney general’s office that it discovered a breach on March 7 during which an unauthorized individual accessed the company’s protected health data. The data breach notice warned that patients’ demographic, health, and financial information was accessed, including names, phone numbers, dates of birth, but also medical histories, diagnoses, treatments, lab test results, prescriptions, and health insurance information.

myNurse said in the data breach notice that its decision to shutter its business “is unrelated to the data security incident,” but did not provide a reason for the unexpected shutdown. The company said it began notifying affected patients on April 29, the same date as its data breach notification, more than seven weeks after the breach was discovered.

myNurse co-founder and chief executive Waleed Mohsen provided TechCrunch with a short statement saying the company was considering “how best to adjust our business model amid a changing healthcare landscape,” but declined to answer any of our questions about the data breach, including why it took the company seven weeks to notify affected patients or if myNurse had carried out a third-party security audit of its systems prior to the breach.

Mohsen also declined to say how many patients are affected in total. Under the law of California, where myNurse is headquartered, companies must notify the attorney general’s office if more than 500 people are affected.

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Why focusing on holistic care helped Kindbody triple its revenue in 2021

One story from The Verge referred to Kindbody as the “SoulCycle” of fertility, pointing out that it sells fertility services and “empowerment” to 25-year-olds. It’s kind of a stretch, but I can see how the company could be compared to the aesthetic-driven facade of The Wing.

Kindbody isn’t solely selling a dream of belonging, however — there is a large focus on the consumerism of patient care. By concentrating on helping its patients feel like they have agency over their fertility journeys, Kindbody is trying to fit into the lives of those wanting to get pregnant.

“When you build businesses you have to think about how consumers behave today and what’s changed in the last five years or 10 years or 15 years,” Kindbody founder and chairwoman Gina Bartasi said. “And consumers crave and receive content.”

She recognizes how different the space is now compared to when she went through her own fertility journey.

“I think the hardest part is adapting, whether it’s adapting the media or adapting to healthcare,” she said. “You constantly have to have this circle and loop back with your customer and customer behavior and how that’s changed. And in healthcare, of course, your customer is the patient.”

Over the last decade, our lives have changed exponentially due to the easy access to information via social media platforms, and the COVID-19 pandemic only added a feeling of perpetual uncertainty. Businesses shut down for months at the top of 2020, schools have oscillated between mandating physical attendance and holding virtual classes nationwide, and offices that once forbade remote work have been introduced to hybrid setups like “hoteling.”

“The majority of patients need flexibility in their calendars,” Bartasi said. “I think, historically speaking, in health care, the patient did whatever the doctor did, whatever the doctor told them to do, and at Kindbody the patient is in charge, not necessarily the doctor.”

You can see this approach in nearly all of Kindbody’s services. Not only does Kindbody want to cater to how its potential patients carry on their lives, it wants them to have a familiar experience as well. Open Kindbody’s website, and you’ll find a templatized, user-friendly landing page with photos of well-designed offices and links to its social media. It’s a familiar look for the 2020s at this point, and that’s intentional.

At the end of the day, you can have the best technology and the best data, but [patients] are still at home crying; it sucks and [they] can’t get out of bed in the morning. Barbara Collura, president of Resolve

With both B2B and B2C income streams, this company is trying to significantly disrupt the women’s healthcare space by focusing on educating, helping patients feel cared for and offering solutions to major pain points through employer-provided benefits.

As Bartasi mentioned in part 1 of this TC-1, she felt like she was treated as the subordinate to the doctor throughout her fertility journey, and her team at Kindbody has put in a lot of work to avoid that.

“It’s really a broken system”

Thanks to the nature of their relationships with the space, both Bartasi and Dr. Fahimeh Sasan, Kindbody’s current chief innovation officer and an experienced board-certified OBGYN, are familiar with the challenges of the fertility journey from two different perspectives — the patient and the provider. They found that the overarching challenge, which ultimately makes every step of this process more difficult, is the fragmentation of care.

Dr. Fahimeh Sasan, Kindbody’s current chief innovation officer

Dr. Fahimeh Sasan, Kindbody’s chief innovation officer. Image Credits: Kindbody

“It’s really a broken system, and it’s a system that in no way, shape or form is based on proven human health nor on being proactive,” said Dr. Sasan. “It’s a 100% reactionary system. I was taught that you wait for a woman to prove that she’s not fertile and she has to prove her infertility diagnosis before you start doing testing and see if that’s what the problem may be.”

This reactionary approach is something she’s always felt needed to be corrected. She offers examples of how other ailments or potential health problems are addressed with the aim to prevent rather than cure.

“You do stress tests so that someone doesn’t have a heart attack. We do mammograms to detect breast changes before someone has breast cancer.” But when it comes to infertility, patients have to prove they are experiencing it before it can be addressed. She believes that the teaching and, subsequently, the care, have not caught up with the technology available for patients.

“If you think about the advancements that have been in this field, whether it’s the first egg-freezing or hormone-testing, like for the Anti-Müllerian hormone, and even the capabilities of ultrasound and sonogram, the teachings haven’t changed.”

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Verana Health closes $150M to glean more detail from electronic health records

Verana Health, a company focused on collecting and organizing troves of medical data, announced a $150 million Series E funding round on Friday. This round comes as the company sets its sights on new types of medical data, invests in organizing traditionally messy forms of information (like physician notes) and aims to extract more usable insights from Electronic Health Records (EHRs). 

Verana Health organizes and analyzes electronic health record systems run by three professional organizations: The American Academy of Ophthalmology, The American Academy of Neurology, and The American Urological Association. Then, it delivers insight back to practitioners, researchers, and life sciences companies. Since its founding in 2018, Verana has become an exclusive data management partner for these professional networks, CEO Sujay Jadhav tells TechCrunch. 

This current round was led by Johnson & Johnson Innovation, and Novo Growth. Existing investors GV (formerly Google Ventures), Casdin Capital, and Brook Byers joined the round. New investors include Merck Global Health Innovation Fund, THVC, and Breyer Capital. 

At the moment, Verana focuses on three major disease areas: ophthalmology, neurology, and urology. From there, says Jadhav, Verana provides two pillar products. There’s VeraQ a “population health engine” encompassing 90 million patients and data spanning seven years and Qdata, which can link existing data with information from other sources (like insurance claims or medical imaging, more on that later), and provide data sets designed for specific, observational studies. 

A fair question to ask of any company looking to provide data-driven insights is: What insights are you providing, exactly? Jadhav provides a few examples. 

For instance, the company recently worked with a startup looking to conduct a study on a rare disease not typically captured in ICD-10 billing codes. Verana used natural language processing and manual curation to scan through patient symptoms and procedure history to help identify clinics that might have enough patients with the condition to participate. 

On the commercial side of things, another client has used Verana to monitor the post-approval safety and uptake of medical products. Verana helped by analyzing treatment patterns and the demographics of who used the product, looking for safety signals. 

Whenever health records are in the picture patient privacy is paramount. Jadhav notes that all patient information is de-identified. “We have a very clear delineation internally. So, 27 people have access to identifiable data, we then we de-identify it and whatever we provide to the pharma sector etc is always de-identified as well,” he said. 

De-identified health records are already used to conduct research. EHR analysis, for instance, has facilitated studies on the real-world safety and effectiveness of COVID-19 vaccines extremely quickly. However, experts have also raised concerns that de-identified data could be “re-identified” through a combination of machine learning or combination with other datasets. For instance, a 2018 study in JAMA Health Policy argued that this was possible with physical activity data. 

Jadhav says that patients can opt-out of data sharing at any point in the process. Though, the most straightforward approach seems to be at the doctor’s office level. For instance, you can ask your ophthalmologist, in writing, to not share EHR data with IRIS (the dataset provided by the American Academy of Ophthalmology), if you choose. 

At the moment, Verana’s dataset is largely centered around these patient registries. However, the company is already investing in both gleaning more from these records, and integrating other types of data. 

For instance, Verana is using natural language processing techniques to extract themes from physician notes that don’t fit into most data structures. (Keep in mind de-identifying textual data in EHR records is an area of active reach in and of itself.) But for certain disease areas, Jadhav notes that these physician notes are a big untapped resource: 

“In certain therapeutic areas, such as urology, we are finding that there is some structured data there. [But] a lot of the value is around unstructured data. More specifically around physician notes.” 

The company has also integrated insurance claims data, and has developed a technique to integrate imaging data. For instance, the company published an abstract on an algorithm that was able to match IRIS EHRs and imaging data with 83 percent accuracy. 

With this current round Verana is aiming to “fuel current growth” using their current business model, per Jadhav. But it also has some specific plans laid out. The company aims to enhance the quality of analysis they can already provide, scale-up clinical trial insights, as well as fund natural language processing projects. 

This round brings the company’s total funding to $280 million. 

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When Product Managers Do Bad Things

Product managers can do bad things too
Product managers can do bad things too
Image Credit: Photo by Alex Block on Unsplash

I’d like to tell you that the calling to become a product manager is only received by those of us with the highest morals. However, I really can’t say that. What this means is that in the world of product managers, there are the good ones and the not so good ones. I like to spend my time talking about what the goods ones are able to accomplish. However, every so often the bad ones do something that is so clearly bad that I feel compelled to talk about it. It turns out that some of the bad ones work for Greenway Health and they have done some bad things.


What Greenway Health Did

The reason that I know about the bad things that the Greenway Health product managers did is because I read about it in the newspaper. Yep, this is public knowledge. What it means is that both the company, Greenway Health, and the software product that they sell, Prime Suite, are now known for dishonesty. As product managers, we work very hard to attract new customers and to retain the ones that we have. I believe that Greenway Health may have some problems doing this in the future.

What the newspaper told me was that Greenway Health had agreed to pay US$57.25M in a settlement with the U.S. Department of Justice. This is not going to look good on anyone’s product manager resume. What they had been accused of doing was being involved in fraud of the U.S. Medicare system. Medicare is a national health insurance program in the United States. It provides health insurance for Americans aged 65 and older. What Greenway Health did was to lie to both their customers and to the U.S. Government about what was in their product development definition. They told them that their product, records management software, met standards that would allow customers to qualify for payments through a Medicare and Medicaid incentive program.

So what did the Greenway Health product managers do that was so wrong? Simple – they modified their product. They made changes to their product so that it would pass the Department of Health and Human Services certification. The software that the Greenway Health product managers presented for certification was made to look as though it met the qualifications.


Why This Was A Bad Thing

So what’s the big deal you say? It’s a given that the Greenway Health product managers would want to pass the government’s certification test. You might be able to see yourself doing a little bit of modifications if this needed to be done in order to not mess up some ongoing sales. This is where you’d be wrong. The changes were not just made to pass the certification program, they were made so that customers would buy the product because it was certified.

The problem that all of this caused was that customers thought that since the product had passed the government’s certification program they could use it to become eligible for incentive payments. The result of this is that Greenway Health’s customers used the program to collect payments though the incentive program falsely believing that they were eligible. In fact, Greenway Health did a lot of work to attract new customers by touting the incentives that they could get from the government if they used the Greenway software.

The Greenway Health product managers made changes to their program so that they could sneak though the certification process. This allowed them to keep selling their software to unsuspecting customers. It was only after these customers tried to get incentive payments from the government that they discovered that they had been cheated. Yes, there is a good chance that many different people at Greenway Health participated in this deception. However, in the end it was the product managers who knew what they were doing and went ahead and did it anyway.


What All Of This Means For You

When customers purchase products from our company, they do it because they believe that the product will allow them to do something that they currently can’t do. Over at Greenway Health, their product managers were forgetting about their product manager job description and making promises about their product that were simply false in order to get people to buy it. The U.S. Government found out about this and now Greenway Health has to pay $57.25M in fines.

The bad things that Greenway Health did attracted some attention. They got written up in the newspaper for everyone to see. This will make getting future business that much harder. Greenway Health has agreed to pay fines for defrauding the Medicare program. Customers who used their software thought that they could qualify for payments though a Medicare and Medicaid incentive program. The Greenway Health product managers made changes to their program so that it would appear to pass the government’s certification program. After they did this, customers were convinced to buy the program because they thought that by using it they could participate in the Medicare initiative program and collect initiatives. However, they could not. A lot of people participated in this deception, but the Greenway Health product managers were the ones who fully knew what was going on.

Product manager are the ones who are responsible for the products that the company sells. We are the ones who both create and maintain the relationship between the company and its customers. Over at Greenway Health it’s pretty clear that the product managers panicked when they realized that their product was not going to be able to become certified and they then made a series of bad decisions. The rest of us need to learn from this. The customer always comes first – do no harm!


– Dr. Jim Anderson Blue Elephant Consulting –
Your Source For Real World Product Management Skills™


Question For You: What could the Greenway Health product managers have done when they realized that they had a problem?


Click here to get automatic updates when The Accidental Product Manager Blog is updated.
P.S.: Free subscriptions to The Accidental Product Manager Newsletter are now available. It’s your product – it’s your career. Subscribe now: Click Here!

What We’ll Be Talking About Next Time

Let’s face it, today when you see a car on the road you expect to see a person sitting behind the wheel. However, if some very smart product managers have their way, in the future you might be seeing driverless cars whizzing around. This is all brand new stuff, but there have been a number of very large investments being made in companies that make robotic delivery vehicles that are driverless. Will their product managers be able to solve all of the challenges that will be coming with this new technology?

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EHR startup Canvas Medical raises $17M and partners with insurance heavyweight Anthem

Canvas Medical, an electronic health records (EHR) startup, today announced their $17 million Series A and a new partnership with Anthem, one of the biggest health insurance companies in the country.

The round was co-led by Inspired Capital and IA Ventures, with participation from Upfront Ventures. This round brings the company’s total funding to date to $20 million. 

The San Francisco-based company, which launched in 2015, aims to help doctors experience a more efficient — and painless — approach to delivering value-based care by offering an EHR platform that promises “80% fewer clicks, 3x faster workflows, and the ability to truly work on one screen,” said Andrew Hines, the company’s CEO and founder.

Andrew Hines

Andrew Hines. Image Credits: Canvas Medical

Value-based care is a delivery model where providers are paid based on patient health outcomes as opposed to the traditional pay-per-service model where doctors are reimbursed per visit.

We’ve seen a transition in the U.S. toward value-based care over the last several years, and that shift is also being reflected in how doctors are getting reimbursed. As a result, existing EHR companies find themselves having to add bells and whistles to their platforms, which in turn has compromised the doctor’s workflow experience.

“What has happened over time is we have asked our clinicians to become sophisticated coders. They are clicking through screens that are cluttered, that are not designed with human factors in mind,” said Steve Strongwater in Catalyst, a journal on innovation in care delivery published by the New England Journal of Medicine. Strongwater is a physician and the CEO of Atrius Health in Boston.

“Current EHRs are a workplace hazard from an ergonomics perspective,” said Hines. “It’s like if you sit in the wrong chair day in and day out, your back is going to hurt.” 

While technology has made many people’s jobs easier, that’s not the case for doctors. Studies have shown that EHRs are actually a source of physician burnout in the U.S., which is in and of itself a problem of national concern. 

The EHR market is extremely fragmented (there are several hundred EHR companies in the U.S.) which makes sharing medical records between physicians a challenge. Because health insurance claims contain significant medical information, insurance companies are a reliable alternative source for a lot of the important data about their members. But if a doctor needs to access that information for treatment purposes – which they have to do regularly – they have to log into a different portal or access a different report depending on each patient’s insurance. That’s one of the problems Canvas aims to solve, and their partnership with Anthem is just the beginning.

While there’s often a major amount of inertia — and associated cost — with changing EHRs, Hines, a data scientist-turned-entrepreneur, says the company assuages these concerns by leading its sale efforts with its numbers.

“Doctors who use Canvas experience 30% more productivity in the first month and are able to save 1-2 hours a day charting — which allows them to see more patients or go home early,” he added.

8 VCs agree: Behavioral support and remote visits make digital health a strong bet for 2021

 

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Thousands of U.S. lab results and medical records spilled online after a security lapse

NTreatment, a technology company that manages electronic health and patient records for doctors and psychiatrists, left thousands of sensitive health records exposed to the internet because one of its cloud servers wasn’t protected with a password.

The cloud storage server server was hosted on Microsoft Azure and contained 109,000 files, a large portion of which contained lab test results from third-party providers like LabCorp, medical records, doctor’s notes, insurance claims, and other sensitive health data for patients across the U.S., a class of data considered protected health information under the Health Insurance Portability and Accountability Act (HIPAA). Running afoul of HIPAA can result in steep fines.

None of the data was encrypted, and nearly all of the sensitive files were viewable in the browser. Some of the medical records belonged to children.

TechCrunch found the exposed data as part of a separate investigation. It wasn’t initially clear who owned the storage server, but many of the electronic health records that TechCrunch reviewed in an effort to trace the source of the data spillage were tied to doctors and psychiatrists and healthcare workers working at hospitals or networks known to use nTreatment. The storage server also contained some internal company documents, including a non-disclosure agreement with a major prescriptions provider.

The data was secured on Monday after TechCrunch contacted the company. In an email, NTreatment co-founder Gregory Katz said the server was “used as a general purpose storage,” but did not say how long the server was exposed.

Katz said the company would notify affected providers and regulators of the incident.

It’s the latest in a series of incidents involving the exposure of medical data. Earlier this year we found a bug in LabCorp’s website that exposed thousands of lab results, and reported on the vast amounts of medical imaging floating around the web.

A billion medical images are exposed online, as doctors ignore warnings

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Thousands of U.S. lab results and medical records spilled online after a security lapse

NTreatment, a technology company that manages electronic health and patient records for doctors and psychiatrists, left thousands of sensitive health records exposed to the internet because one of its cloud servers wasn’t protected with a password.

The cloud storage server server was hosted on Microsoft Azure and contained 109,000 files, a large portion of which contained lab test results from third-party providers like LabCorp, medical records, doctor’s notes, insurance claims, and other sensitive health data for patients across the U.S., a class of data considered protected health information under the Health Insurance Portability and Accountability Act (HIPAA). Running afoul of HIPAA can result in steep fines.

None of the data was encrypted, and nearly all of the sensitive files were viewable in the browser. Some of the medical records belonged to children.

TechCrunch found the exposed data as part of a separate investigation. It wasn’t initially clear who owned the storage server, but many of the electronic health records that TechCrunch reviewed in an effort to trace the source of the data spillage were tied to doctors and psychiatrists and healthcare workers working at hospitals or networks known to use nTreatment. The storage server also contained some internal company documents, including a non-disclosure agreement with a major prescriptions provider.

The data was secured on Monday after TechCrunch contacted the company. In an email, NTreatment co-founder Gregory Katz said the server was “used as a general purpose storage,” but did not say how long the server was exposed.

Katz said the company would notify affected providers and regulators of the incident.

It’s the latest in a series of incidents involving the exposure of medical data. Earlier this year we found a bug in LabCorp’s website that exposed thousands of lab results, and reported on the vast amounts of medical imaging floating around the web.

A billion medical images are exposed online, as doctors ignore warnings

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Diagnoss launches its coding assistant for medical billing

Diagnoss, the Berkeley, Calif.-based startup backed by the machine learning-focused startup studio The House, has launched its coding assistant for medical billing, the company said.

The software provides real-time feedback on documentation and coding.

Coding problems can be the difference between success and failure for hospitals, according to Diagnoss. Healthcare providers were decimated by the COVID-19 outbreak, with hospitals operating below 60% capacity and one-fourth of them facing the potential for closing in a year if the pandemic continues to disrupt care.

The cost pressures mean that any coding error can be the financial push that forces a healthcare provider over the edge.

“For every patient encounter, a physician spends an average of 16 minutes on administration, which adds up to several hours every single day. In addition, codes entered are often wrong – up to a 30% error rate – resulting in missed or delayed reimbursements. We believe that, with the great progress we’ve seen with artificial intelligence and machine learning, we can finally address some of these inefficiencies that are leading to physician burnout and financial strain,”  said Abboud Chaballout, founder and chief executive of Diagnoss, in a statement.

Diagnoss acts like a grammar checking tool, but its natural language processing software is focused on reading doctor’s notes. The company’s tools can provide evaluation and management code for patient encounters; point out missing information in doctors’ notes; and provide predictions about the diagnosis and procedure codes that could apply after reviewing a doctor’s notes.

In a study of 39,000 de-identified EHR charts, the company found that its machine coding service was about 50% more accurate than human coders, according to a Diagnoss review.

Physician practices are already using Diagnoss’ service through a previously announced partnership with the mobile EHR vendor, DrChrono .