Despite more electronic record use, hospitals rely on fax, mail of patient data

• Electronic availability of patient health information from outside sources increased by 10% in 2018, resulting in more than half of hospitals having EHR information available at point of care, according to a report from the Office of the National Coordinator for Health IT. But most hospitals still rely on a mix of both physical and electronic records.
• About 10% of hospitals said they exclusively use electronic methods for sending and receiving summary of care records, while almost 25% said they still rely on non-electronic methods. About 70% of hospitals surveyed said they continued to use mail or fax for sending and receiving summary of care records in 2018.
• The most frequently cited barrier among respondents was exchanging data across different EHR vendor platforms. More than 60% of hospitals reported difficulty finding providers’ addresses and more than half had trouble matching or identifying correct patients between systems.

Providers are increasingly using patient health information received electronically from outside sources, according to the ONC report, although seamlessly sharing that data remains a challenge. Cost barriers are also an issue.
In 2018, about six in 10 hospitals reported often or sometimes using patient health information they electronically received through EHRs. Among hospitals that rarely or never used electronically received information, one-third reported that information was not presented in a useful format and one-fifth said information was difficult to find.
On average, hospitals used two methods for finding patients’ health information electronically; most often through a Health Information Service Provider, through a state, regional or local health information network or through a national network.
About six in 10 hospitals reported using a Health Information Service Provider to send summary of care records, making it the most popular method for sending and receiving summary of care records electronically in 2017 and 2018.
Most hospitals participated in one national health network in 2018, and about one-third participated in more than one. These include provider portal, direct access to EHRs, and multi-EHR vendor networks to electronically find patient health information. About one-fifth participated in CommonWell Health Alliance, DirectTrust and Carequality.
Rural providers were less likely to participate in national networks, with a 14 percentage point difference in participation in national networks by medium and large hospitals compared to small hospitals with 100 beds or less.
Almost half of hospitals used state, regional or local HIOs to electronically find or query patient health information from outside sources. Use of HIOs and single EHR vendor networks for receiving summary of care records significantly increased from 2017 to 2018.
The push for interoperability, however, has proven costly for healthcare organizations, and was a frequently cited barrier among study respondents.
Spending on developing customized interfaces to electronically exchange health information and additional costs to exchange data with outside providers were cited by about four in 10 hospitals.
https://www.healthcaredive.com/news/despite-more-ehr-use-hospitals-rely-on-fax-mail-to-share-patient-records/573721/

NYC coronavirus cases rise, including Bronx girl, city worker

There are now 20 confirmed cases of the coronavirus in the city — including a 7-year-old girl from the Bronx and a city government worker, Mayor Bill de Blasio said Monday.
Hizzoner said the little girl attends the Westchester Torah Academy in White Plains, Westchester County, and is quarantined at home and doing “well.’’
She has no pre-existing conditions or a recent travel history and is showing “minimal symptoms,” de Blasio said.
The child’s mother, father and two sisters have all tested negative, he said.
A city employee also has tested positive for the potentially deadly bug, de Blasio said.
The worker, who lives in Westchester County, “was in a city office last week but only for three hours,’’ the mayor said.
The man was not symptomatic at the time and still isn’t, he said.
The patient is in quarantine, de Blasio said, adding that all of his family members tested negative for the virus.
But the mayor said a stricken 65-year-old man from Queens with diabetes is “critically ill’’ and “someone we’re very, very worried about.’’
He said the man had a fever, then developed pneumonia and shortness of breath and ended up in the ICU.
The other new coronavirus patients in the city include a 68-year-old man in Brooklyn who recently traveled, although not to any of the hot-spot countries, so it’s unclear where he contracted the virus, de Blasio said.
The man, who has diabetes and heart disease, had symptoms and was admitted to the ICU at a private hospital in Brooklyn. He is currently critical but stable, the mayor said.
A 22-year-old man in Brooklyn also had symptoms and was transported by EMS to a private hospital in the borough.
“Why is a 22-year-old man stable but hospitalized at this point?’’ de Blasio told reporters. “The one factor we know of is he is a vaper.
“We think the fact that he is a vaper is effecting this situation.’’
Hizzoner said there is at least one more case in the Bronx and related to the Westchester County cluster. Two more are in Manhattan — including Port Authority Executive Director Rick Cotton, he said.
“We’re seeing more and more cases related to community spread,’’ de Blasio said.
https://nypost.com/2020/03/09/nyc-coronavirus-cases-rise-including-bronx-girl-city-worker-de-blasio-says/

Kala Pharma’s KPI-121 successful in dry eye study; shares up

Kala Pharmaceuticals (NASDAQ:KALA) is up 13% premarket on light volume in reaction to its announcement of positive top line results from a Phase 3 clinical trial, STRIDE 3, evaluating lead candidate KPI-121 in patients with dry eye disease.

The study met the primary endpoint showing statistically significant improvements in ocular discomfort severity in both the overall intent-to-treat (ITT) population and in a predefined subgroup of ITT patients with more severe ocular discomfort. Significant results were also achieved for total corneal staining at day 15 in the ITT population.

It plans to refile its U.S. marketing application next quarter based on these data. It received a CRL in August 2019 citing the need to conduct an additional clinical trial.

The company plans to commercialize KPI-121 under the brand name EYSUVIS (loteprednol etabonate ophthalmic suspension) 0.25% with a specialty sales force of 125 reps (from 100).

https://seekingalpha.com/news/3549637-kala-pharmas-kpiminus-121-successful-in-dry-eye-study-shares-up-13-premarket

FDA OKs new use of Boehringer Ingelheim’s Ofev

Under Priority Review and Breakthrough Therapy status, the FDA approves privately held Boehringer Ingelheim’s Ofev (nintedanib) oral capsules for the treatment of patients with chronic fibrosing (scarring) interstitial lung diseases (ILD) with a progressive phenotype (trait).

Data from a pivotal study in a range of these patients showed that treatment with the kinase inhibitor slowed the rate of pulmonary function loss by 57% compared to placebo.

The FDA first approved Ofev in October 2014 for ideopathic pulmonary fibrosis followed by a second nod in September 2019 for ILD associated with systemic sclerosis or scleroderma.

ILD-related tickers: Roche (OTCQX:RHHBY -5.3%), United Therapeutics (UTHR -5.5%), aTyr Pharma (LIFE -10.2%), Bellerophon Therapeutics (BLPH -12.8%)

https://seekingalpha.com/news/3549868-fda-oks-new-use-of-boehringer-ingelheims-ofev

White House invites Wall Street executives for coronavirus meeting

The Trump administration has invited top Wall Street executives to meet at the White House on Wednesday to discuss the coronavirus, a person familiar with the plan said on Monday as stocks dropped amid concerns over the growing outbreak.
The source, who spoke on the condition of anonymity because plans were still being finalized, could not say which company executives had been invited or whether any had agreed to attend because invitations were still being extended for the meeting, which was first reported by the Washington Post.
https://www.reuters.com/article/us-health-coronavirus-usa-wallst/white-house-invites-wall-street-executives-for-coronavirus-meeting-source-idUSKBN20W2O0?il=0

Covid-19 spread could last into 2021 but impact could be blunted – CDC official

A top federal health official said Monday that the evolving coronavirus outbreak could persist in the United States into next year, while stressing that public health interventions could still reduce the spread of the virus and cases of illness and death.
“As the trajectory of the outbreak continues, many people in the U.S. will at some point, either this year or next, get exposed to this virus,” Nancy Messonnier of the Centers for Disease Control and Prevention said on a call with reporters. “And there’s a good chance many will become sick.”
Messonnier noted, however, that officials do not expect most people to suffer severe cases of Covid-19, the illness caused by the coronavirus. She pointed to data from China, where the outbreak began and thousands of cases have been reviewed, that showed that some 80% of cases were mild and only a few percent were critical.

The most common symptoms of Covid-19 include fever and cough. In more serious cases, it can cause pneumonia. There have been more than 500 confirmed cases in the United States, and more than 20 deaths.
Messonnier, the director of CDC’s National Center for Immunization and Respiratory Diseases, used the press briefing Monday to urge Americans who face higher risks of developing more severe disease, including seniors and people with underlying health conditions, to take precautions and prepare. Such steps include avoiding crowds and contact with people who are sick, and frequent hand washing.
She also said that high-risk Americans should stock up on their medications and groceries, and that family members of those high-risk people should create a plan should they get sick and they can no longer help their relatives.
“You may need to identify backups,” Messonnier said.
She added: “I understand these recommendations may not be popular and that they may be difficult for some people.”
Messonnier’s suggestion that the virus could last into next year fits with the predictions of some experts that the virus will circulate for a long time, given how difficult contagious respiratory illnesses are to halt. Some experts have said they see the virus becoming endemic, that is, spreading permanently in the human population like some viruses that cause colds and the flu.
The concern with the novel coronavirus, however, is that no one had any existing immunity to it, so initial exposure is more likely to lead to more severe illnesses for some patients. The most vulnerable include seniors, those whose immune systems are suppressed, and those who are already dealing with other health conditions.
Messonnier noted that most communities in the United States are not experiencing community spread of the virus and said that people need to make decisions based on where they live and their own needs. She also advised that people who are not at high risk for severe illness, particularly those not living in places like communities in Washington state and California where the virus is known to be spreading, to act prudently. Masks, for example, should really be saved for health care workers.

“This is a time for people to prepare for what they might need to do, but not a time for people to clear out the shelves,” she said when asked about people buying household and cleaning supplies in bulk.
If people think they have been exposed to the virus, they should stay at home and alert a health provider if they become ill, particularly if they are in a high-risk group, Messonnier said.
She said that her parents, who are in their 80s, do not live in an area where the disease is known to be actively spreading, “but I’ve asked them to stick close to home.”
During the briefing, Messonnier explained that more public health response efforts, which are largely led by state and local officials, will increasingly move from containment to mitigation, but she described that transition not like an on-off switch but like a dimmer. Containment efforts, which included isolating individual cases and following their contacts to see if they develop disease, could continue even as officials implemented the broader mitigation efforts that are designed to address wider community spread.
“We can really mitigate the impact of this disease,” she said.
Wrangling the spread of the virus will require individuals to act as well, she said. People need to listen to health authorities, and protect themselves, their families, and their communities. Reducing the spread of the disease will also reduce the burden the health care system could face.
“There are personal responsibilities that we’re asking everyone in the United States to take,” she said.

Coronavirus spread could last into next year, but impact could be blunted, CDC official says

Russia vs Saudi: How much pain can they take in oil price war?

Oil titans Russia and Saudi Arabia have accumulated vast financial cushions that will help them weather a lengthy price war. It’s a battle of nerves – so who will blink first?

Global oil prices crashed by a third after Riyadh discounted its crude and signalled it would raise output. Shares in national oil champions Saudi Aramco and Rosneft tanked.
The world’s top two oil exporters each have war chests of around $500 billion to weather economic shocks and are making bullish noises about their stamina as they square up.
Moscow said on Monday it could withstand oil prices of $25-$30 per barrel for 6-10 years. Riyadh, meanwhile, can afford oil at $30 a barrel, but would have to sell more crude to soften the hit to its revenue, according to sources familiar with the matter.
A war of attrition would nonetheless be damaging and force both countries to make difficult adjustments to their economies the longer it dragged on.
“As with any war this comes down to how much pain can be absorbed by each side,” said Hasnain Malik, head of equity strategy at Tellimer.
MbS OPENS THE TAPS
In Saudi Arabia, Crown Prince Mohammed bin Salman gave the green light for the kingdom, the world’s top oil exporter, to pump at will after Russia rejected an OPEC proposal for deeper cuts to cope with the coronavirus outbreak, two sources familiar with the matter said.
The Saudi fiscal breakeven – the oil price at which it would balance its budget – is at around $80 a barrel, double that of Russia, said Malik at Tellimer.
Saudi Arabia enjoys foreign reserves of $500 billion and a low debt-to-GDP ratio of 25% that gives it ample room to borrow.
Saudi Arabia has raised over $100 billion in hard-currency debt since 2016 to offset the impact of lower oil prices.
International bonds issued by the government and its oil giant Aramco plunged in early trade on Monday, and the Saudi riyal fell sharply against the U.S. dollar in the forwards market.
Still, low global interest rates and a recent further cut by the U.S. Federal Reserve mean that despite market volatility borrowers could tap debt investors relatively cheaply.
The problem for Riyadh is that sustained low oil prices could likely constrain government spending on projects that are part of the crown prince’s drive to diversify the economy.
Monica Malik, chief economist at Abu Dhabi Commercial Bank, said that with oil prices in the low $30s, Saudi Arabia would post a double-digit deficit as percentage of GDP this year – up from Riyadh’s own 6.4% budget deficit projection.
‘TREASURE CHEST’
Under President Vladimir Putin, Russia has amassed reserves of $570 billion and the rouble has become free-floating, allowing it to swiftly adjust to market conditions and devalue.
Russia, say analysts, is much better placed to withstand an economic shock than it was in 2014 when the West imposed sanctions over its annexation of Ukraine’s Crimea, or than in 2008 when it was buffeted by the global financial crisis.
“Many people criticised us, they said this is a kind of treasure chest, that the finance ministry is sitting on gold,” Finance Minister Anton Siluanov said last week about the reserves.
“But now the situation could change and we will finance all the expenses we have undertaken and are obliged to make with this treasure chest.”
The $570 billion reserves includes the country’s National Wealth Fund, which stands at $150.1 billion or 9.2% of Russia?s GDP. The finance ministry said on Monday the fund could be used to offset lower oil revenues if necessary.
The central bank meanwhile said it was suspending foreign currency purchases for 30 days in an attempt to ease downside pressure on the rouble and would take market conditions into account when deciding whether to go ahead with future Russian rouble OFZ government bond auctions.
Still, the rouble crashed to its weakest level since early 2016 on the interbank market and shares in Russian companies fell sharply in London with oil giants Rosneft and Lukoil down 20.4% and 18.5 percent respectively.
Oleg Vyugin, head of Moscow Exchange’s Supervisory Board, said Russia would face higher inflation and interest rates as a result of the price war.
Chris Weafer, director at Macro-Advisory consultancy, said it was still possible Moscow could decide to return to cooperating with OPEC by autumn if prices remained very low.
“Putin will be reluctant to run down financial reserves too far to fund an expanding deficit,” he added.

https://www.marketscreener.com/news/Russia-vs-Saudi-How-much-pain-can-they-take-in-oil-price-war–30131339/