February 2018 Archives


February 2018 Archives

How to reduce the risk of healthcare data loss

Feb 28, 2018


Many hackers are well-aware of the data-hungry nature of the healthcare system and subsequently, the value of that data. Recent findings suggests the average cost of a stolen healthcare record at $380, which is more than twice the global average of $141. While the healthcare sector has attempted to address security concerns, a recent report from MediaPro shows that nearly eight in 10 healthcare employees are not adequately prepared to defend against the most common security and privacy threats they regularly face.

To discuss the issues and what healthcare bodies can do to better protect themselves, Digital Journal spoke with Colleen Huber, Director of Cyber Education Strategy with MediaPro.


Clinics and hospitals are prime targets for cybercrime because they're filled with personal health information and personally identifiable information, both of which have tremendous value on the black market. Too often we hear about healthcare organizations dealing with data breaches, ransomware attacks, phishing scams and more.

Some of these organizations have invested in protecting the data in their servers but do the bare minimum when it comes to appropriately educating their employee population about proper security and privacy behaviors related to personal health information and personally identifiable information.

Education and reinforcement are two good places to start [when it comes to protecting the organization's data], but a larger initiative should be building a culture of security and privacy protection in your organization - that often starts at the top. The healthcare field is constantly learning new and improved ways of providing care; that mindset must be extended to ensuring the cybersecurity hygiene of healthcare employees also improves.

Awareness is the key [to staying up to date]. We work with a number of healthcare organizations that rely on our content libraries to react to emerging threats.

According to Colleen Huber's research:

  • 78 percent of surveyed employees are ill-prepared to handle common privacy and security awareness scenarios they were presented with. When comparing healthcare and non-healthcare employee responses, the number of healthcare respondents who had trouble identifying common signs of malware were close to double the number of their non-healthcare counterparts.
  • Out of all healthcare employees, physicians are the least prepared for cybersecurity threats, with 24 percent lacking awareness toward phishing emails, compared to 8 percent of non-providers. Ultimately, the data in our report shows how much work still needs to be done to ensure healthcare institutions are protected from cybersecurity threats.

Updating protocols and procedures, improving employee training and developing a culture of awareness are the best ways to fight cybersecurity threats, in the healthcare industry and beyond.

Source: Digital Journal (View full article)

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AI platform for hospitals and payers

Feb 28, 2018


Artificial intelligence continues to make its way into the healthcare industry. Smart Decisions brings analytics capabilities to legacy healthcare applications and combines existing data flows, predictive data gap analysis, the company said. The goal is to make it easier for hospitals and health plans to implement machine learning and AI.

Smart Decisions is integrated into Edifecs source systems such as Smart Trading and Encounter Management, which translates to reducing implementation and integration costs to gain analytics from EDI data, the company said.

Smart Decisions will be generally available in Spring 2018 and Edifecs will demonstrate the technology at HIMSS18 next week in Las Vegas.

Edifecs will be in Booth 1674.

Source: Healthcare Finance (View full article)

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CIOs Plan to Invest More in AI, Predictive Analytics, Big Data Tools

Feb 26, 2018


Healthcare IT leaders are investing more time and money in predictive analytics tools because of their potential to improve population health and reduce care costs, but they will also have to invest in artificial intelligence and big data analytics solutions to generate truly accurate clinical predictions.

As the industry shifts to value-based care and organizations seek to extract more value from their data, it's no wonder that health IT leaders are choosing to focus on predictive analytics in the coming year.

A cross-industry poll from the International Data Group (IDG) found that

  • 47 percent of CIOs plan to increase their spending on predictive analytics in the next few months.
  • In addition, 37 percent of CIOs said they are actively researching predictive analytics or have it on their radar.
  • Thirteen percent said predictive analytics are the most important tool they're working on right now.

Providers have long believed that predictive analytics are critical for successfully managing the changing healthcare landscape. In a 2017 Society of Actuaries (SOA) survey, 93 percent of respondents said that healthcare organizations will not be able to navigate future financial and clinical challenges if they do not invest in predictive analytics tools.

Past research has shown the potential for predictive analytics tools to reduce hospital readmissions, identify patients at high risk for developing sepsis, and recognize patients who are more likely to experience harmful falls, all of which can improve patient outcomes and cut unnecessary healthcare spending.

Health IT leaders also recognize that building predictive analytics capabilities requires investments in IoT, machine learning, and AI tools that can generate and filter patient data to assist in clinical decision making.

The IDG poll shows that 33 percent of respondents plan to increase spending on IoT in 2018, while 44 percent plan to spend more on machine learning and 43 percent on AI.

Organizations looking to use predictive insights to boost outcomes and reduce costs are faced with the challenge of building a comprehensive patient data portrait. A patient's complete medical history and key non-clinical data aren't always accessible, which can hinder providers from developing truly meaningful predictions.


Ultimately, the success of predictive analytics depends on the availability and accessibility of accurate big data. CIOs planning to invest in predictive capabilities may also have to invest in AI, machine learning, and big data analytics vendors to ensure they have access to the data necessary to generate truly actionable insights.

Source: Health IT Analytics (View full article)

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Increased Usage of EHR in Healthcare Centers to Boost Global PACS and RIS Market

Feb 5, 2018


Picture archiving and communication systems (PACSs) are used in medical imaging innovation for tracking radiology images storage, displaying, billing information, and the sharing of pictures. PACS is majorly used with radiology information system and has recently witnessed high adoption in healthcare IT. PACS and RIS technologies can effectively manage staggering volume of data, due to which their demand has escalated around the world. The market is expected to surge owing to the high paced development, accompanied by the developing digitalization of healthcare systems all over the world.

Transparency Market Research evaluates that the global PACS and RIS is likely to display a promising CAGR of 7.0% over the forecast period of 2016 and 2024, rising from US$2.2 bn in year 2015 to US$3.9 bn by the end of year 2024. The global market for picture archiving and communication systems (PACS) and radiology information systems (RIS) has witnessed a growth at a significant pace in the previous couple of years. This growth can be credited to the efficiency that is achieved with the help of these technology in the healthcare sector. The increase in demand for digitization in the healthcare industry will keep on driving the market in the following couple of years as well.

What are the fire-fueling factors encouraging the growth of PACs and RIS market?

The advantages of healthcare IT have been recognized with a numerous governments all across the globe, impelling industrial progressions in the sector. Therefore, the use of PACS and RIS for the exact and accurate diagnosis of patient's wellbeing has expanded. For instance, favorable policies implemented by government in the US has favored the adoption of RIS and PACS.

The use of EHR systems in clinic and office-based activities have expanded in the last few years. This is fuelling the demand for PACS and RIS globally. These PACs systems enable medical pictures to be analyzed electronically and guarantee the simple and effective availability of the pictures to caregivers. But, owing to increased cost of the gadgets come across as a major obstruction in the growth of global PACS and RIS market.

Notwithstanding the underlying cost of equipment and programming licenses, costs relating to progressing technical support and usage likewise limits the selection of PACS and RIS by human services offices.

Which segment is likely to propel the global market owing to its high paced development?

Based on product type, the oncology PACS segments is estimated to lead the market owing to its significant development over the forecast period from 2016 to 2024. The rising incidences of several types of cancers is relied upon to be the main factor to drive the expanded demand for oncology PACS. The management segment represents the predominant share in the global PACS and RIS market. The demand for PACS and RIS management has fundamentally expanded in the previous couple of years inferable from the increased requirement for the consistent maintenance and adjusting of programming and devices.

Source: TMR Research Blog (View full article)

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Improve care quality with CMS Oncology Care Model

Feb 5, 2018


The Oncology Care Model is an initiative of the Centers for Medicare and Medicaid Services to improve the value of patient care by ensuring high-quality and more coordinated patient care while lowering the cost of care to Medicare.

CMS provides financial incentives to oncology practices to enhance care coordination, patient navigation and utilization of treatment guidelines for patients undergoing chemotherapy.

Payment to practices is in two parts, with the first being a Monthly Enhanced Oncology Services payment, which is a monthly payment to help practices with patient care coordination and reduce the cost of care. The second payment is a performance-based payment, which practices receive if they achieve a lower cost of care through care coordination and improved patient care.

Oncology Hematology Associates in Pittsburgh, part of the UPMC Hillman Cancer Center, is one of only 192 physician practices selected to participate in this program.

There are several initiatives at UPMC Hillman Cancer Center, supported by analytics initiatives and population health IT, aimed at improving patient care and lowering costs.

"We strive to ensure that each patient is treated in the appropriate clinical setting," said Rushir Choksi, MD, an oncologist at UPMC Hillman Cancer Center.

"We are establishing an oncology emergency room at UPMC Shadyside Hospital where our cancer patients can be seen and cared for by oncology trained providers," he added. "When they present to the emergency room, the patients will be triaged to the appropriate clinical setting and decisions will be made to either admit to the hospital, treat in an outpatient setting and/or follow closely at home."

In the outpatient clinic, the provider has implemented other initiatives. It works with Via Oncology and uses provider-facing pathways for chemotherapy treatment decisions.

The Via Oncology tool - which just this past month was acquired by Elsevier - was developed at UPMC several years ago and it provides web-based standardization of treatment decisions, so that no matter where a patient is seen, his or her doctor knows the best standards of care.

The pathway for each disease site is updated quarterly. If there are competing therapies that are equal in efficacy and toxicity, then the system will default to the least costly. Another initiative is a nurse triage program, which provides a nurse-facing patient triage platform to standardize symptom management when a patient calls the office. This was also developed by Via Oncology and, again, standardizes symptom management, regardless of clinic location or nurse.

On another front, UPMC Hillman Cancer Center uses technology from Integra Connect, a specialty care health IT vendor, that has supported the center's success to date in value-based care in multiple ways.

"It provides a platform for unifying our disparate data - such as EHR, practice management, claims and pathways - and helps us develop a more holistic view of the patients we treat, on both a population and individual level," Choksi explained.

The technology also provides the cancer center with population health analytics so it can identify the highest-impact opportunities to further improve quality and cost in alignment with value-based care requirements.

"This is especially important for our successful participation in the Oncology Care Model program," Choksi said. "For example, Integra Connect analytics help us understand our patients' incidence of inpatient admissions, ER visits and hospice care - the three most powerful levers for managing cost of care. We are able to analyze usage by cancer type, by provider, by location, at an individual level and more."

The market for population health analytics tools is a strong one, filled with technology companies offering varying systems. Players in the space include The Advisory Board, Caradigm, IBM Watson Health, Evolent Valence, Linguamatics, Optum, Philips Wellcentive and ZeOmega.

The cancer center also is able to benchmark against peers. That way, it can better target its efforts to engage with patients and help them get the most appropriate care, he added. In addition, the center works with the technology vendor to report performance on value-based care measures to CMS.

Results to date have been positive. The most important result is that the technology has provided the center's care teams with unprecedented levels of visibility to understand their patient populations, and it has enhanced their ability to target appropriate interventions.

"We expect to see that translate into improvements in outcomes and cost of care as our value-based care efforts continue to progress," Choksi said.

Another result has been that the center successfully submitted all the required quality reporting for the Oncology Care Model without having to mine and analyze the data itself; and the center will see this repeated with each subsequent semi-annual Oncology Care Model quality reporting deadline, Choksi said.

"We are in the process of doing the same for the Merit-based Incentive Payment System," Choksi added.

Source: Healthcare IT News (View full article)

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Reshaping access to data is required for patients to be truly engaged

Feb 5, 2018


The increase in patient engagement efforts in recent years has caused some basic rethinking of long-held assumptions about how to foster wellness. Technology is a big must-have, of course. But what about the ownership of data?

Hugo Campos never thought too much about that issue until about 10 years ago, when he was equipped with an implantable cardioverter defibrillator.

"Receiving that in 2007 was the beginning of my patient advocacy," said Campos, an emeritus member of the Stanford Medicine X executive board and a self-proclaimed data liberation advocate. "My background is not in health or health IT," he said. "I worked in advertising."

But Campos' frustrations with his ICD data caused him to change his career trajectory.

"The standard of care these days is to monitor these devices remotely," he explained. "The manufacturer is usually tasked with the data collection by the hospital or the clinic."

"Patients have no access to that stream of data, that stream of information that is constantly flowing to the manufacturer and to the clinic," he said. "I find that to be an absurd obstacle to engagement."

At the HIMSS18 Patient Engagement & Experience Summit, Campos, alongside his Stanford Medicine X colleague Larry Chu, MD, professor of anesthesiology, perioperative and pain medicine, who runs the program, will explore the value of data liberation, and how a push toward more participatory medicine could lead to patients moving past mere engagement and toward more "autonomy" and better partnerships with their care teams.

More and more patients are finding themselves part of movements that they might otherwise have never considered, said Campos. "The quantified-self movement, the e-patient movement, participatory medicine, they've all started to converge, creating these really engaged people."

But for many patients, especially those with implantable devices like him, "remote monitoring is an obstacle," he said. Millions of people live with those implanted devices, but are limited in their ability to engage with their own health because "they have no access to the data."

As patients are entrusted with more responsibility for their own care, limited access to their own data is "the most obvious obstacle to engagement in my view," said Campos.

"If you want engagement, you have to design for autonomy," he said. "For me, autonomy is sort of the elephant in the room. Nobody wants to acknowledge that what people want isn't engagement with healthcare - it's engagement with life. That's what people want."

In other words: A person living with a chronic condition "doesn't want to engage with portals, with doctors, with the healthcare system," he said. "People have different needs and different desires and different goals. It should be about allowing people to use the system in the way that works for them."

That sort of autonomy and agency comes with responsibility, of course.

"You have to imbue in people the sense of responsibility and the notion that they really should be driving their healthcare as much as they drive their lives," said Campos. "It's important to make people realize that the doctor can't solve all their problems, that they really need to step up. They really need to do what they think matters to them. Help themselves, educated themselves."

Source: Healthcare IT News (View full article)

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When patients lose their way in the healthcare revenue cycle

Feb 2, 2018

Healthcare pricing: Even when patients stop and ask for directions, it's hard to get the information they need.

Most of what's available to patients, in fact, comes from insurers, apps and third party entities, and it shouldn't be that way, according to Patient Engagement Specialist Jan Oldenburg. As a result many patients are left deeply frustrated.

She's got plenty of anecdotal evidence that patients are caught in a vortex of frustration, like one story of a client who tried to simply find the cost of an ultrasound. The man carried a $6500 deductible and wanted to be prepared.

Oldenberg said it took 15 phone calls and web research to get to pricing information and what might be a reasonable price. Ultimately, he was billed the wrong amount and it took more phone calls to resolve that issue.

"Providers really need to take the high ground when it comes to informing patients. There is a real opportunity for providers to make changes themselves rather than having them forced on them," Oldenburg said.

That's just one example. But it points to why hospital finance leaders should act sooner rather than later to make pricing information more transparent to consumers.

"Without attention to this issue, changes will be mandated and not necessarily in way that makes for better care or allows providers to tell them their own story in a way they'd like to," she added.

Oldenburg is taking her message to the HIMSS18 Revenue Cycle Solutions Summit audience because she said these are the people who are in a position to inspire real change. "Consumer payment experiences are part of overall experience and if you don't pay attention to it, it can have negative consequences in how you are rated," Oldenburg said.

Source: Healthcare Finance (View full article)

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Improving Clinical Data Integrity through EHR Documentation

Feb 2, 2018


Findings from a recent EHR usability study conducted by the National Institute of Standards and Technology (NIST) once brought to the fore the problem of clinical documentation in the digital age of healthcare.

The study of EHR use, particularly copy-and-paste functionality, led to three major findings. First, clinicians participating in the study were concerned about EHR data integrity as a result of copying and pasting information. Second, clinicians identified entering the wrong information into the wrong record as a high potential risk. Third, participants reported that over documentation introduced challenges to accessing "accurate, relevant and timely information on a patient" at the point of care.

Despite its intended purpose to improve the ease and efficiency of clinical documentation, NIST concluded that the copy-and-paste functionality "has introduced overwhelming and unintended safety-related issues into the clinical environment."

Concerns about the accuracy and quality of EHR documentation are nothing new. In a 2013 update to 2007 guidance on EHR documentation integrity, a workgroup convened by the American Health Information Management Association (AHIMA) called for safeguards to ensure electronic documentation did not undermine patient care.

"Without safeguards in place, records could reflect an inaccurate picture of the patient's condition, either at admission or as it changes over time," the AHIMA workgroup wrote. "The provider must understand the necessity of reviewing and editing all defaulted data to ensure that only patient-specific data for that visit is recorded, while all other irrelevant data pulled in by the default template is removed."

What's more, the authors of the EHR documentation guidance emphasized the urgency of addressing how the use of automated EHR functions could compromise the integrity of clinical health data.

"Data quality and record integrity issues must be addressed now, before widespread deployment of health information exchange (HIE)," they maintained. "Poor data quality will be amplified with HIE if erroneous, incomplete, redundant, or untrustworthy data and records are allowed to cascade across the healthcare system."

More recently, research has pointed to a potential disconnect between patient-reported and provider-record health data. Researchers at the University of Michigan sought to investigate whether patient-reported eye symptoms were recorded as part of clinical documentation in EHR systems. Comparing eye symptom questionnaire (ESQ) and EHR documentation, Valikodath et al. found a "substantial discrepancy" between the two.

"Discordance in symptom reporting could be because of differences in terminology of symptoms between the patient and clinician or errors of omission, such as forgetting or choosing not to report or record a symptom," they wrote. "Perhaps a more bothersome symptom is the focus of the clinical encounter, and other less onerous symptoms (e.g., glare) are not discussed (or documented). However, even for the exclusive sensitivity analysis, we show that the ESQ and the EMR are inconsistently documented."

While discrepancies in patient- and provider-reported documentation were relatively harmless and did not directly impact patient safety, their existence does raise questions about data accuracy and completeness.

Source: EHR Intelligence (View full article)

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EMR vs. EHR: Electronic Medical and Health Record Differences

Feb 2, 2018


CMS provides this tidbit of insight on the subject relative to the EHR Incentive Programs:

Sometimes people use the terms "Electronic Medical Record" or "EMR" when talking about Electronic Health Record (EHR) technology. Very often an Electronic Medical Record or EMR is just another way to describe an Electronic Health Record or EHR, and both providers and vendors sometimes use the terms interchangeably. For the purposes of the Medicare and Medicaid Incentive Programs, eligible professionals, eligible hospitals and critical access hospitals (CAHs) must use certified EHR technology.

CEHRT implementation and adoption have been, are, and will be necessary for receiving incentive payments in federal quality reporting programs now that the Quality Payment Program has emerged to replace the EHR Incentive Programs, Physician Quality Reporting System (PQRS), and Value Modifier (ONC) for eligible clinicians (i.e., professionals under meaningful use).

But this explanation from CMS does not provide much in the way of a rationale other than the interchangeable use of the two terms.

However, the federal agency responsible for overseeing health IT certification -- ONC -- summed up the differences between the two as well as personal health records in response to a frequently asked question (emphasis theirs):

Electronic Medical Records

Electronic medical records (EMRs) are digital versions of the paper charts in clinician offices, clinics, and hospitals. EMRs contain notes and information collected by and for the clinicians in that office, clinic, or hospital and are mostly used by providers for diagnosis and treatment. EMRs are more valuable than paper records because they enable providers to track data over time, identify patients for preventive visits and screenings, monitor patients, and improve health care quality.

Electronic Health Records

Electronic health records (EHRs) are built to go beyond standard clinical data collected in a provider's office and are inclusive of a broader view of a patient's care. EHRs contain information from all the clinicians involved in a patient's care and all authorized clinicians involved in a patient's care can access the information to provide care to that patient. EHRs also share information with other health care providers, such as laboratories and specialists. EHRs follow patients - to the specialist, the hospital, the nursing home, or even across the country.

Personal Health Records

Personal health records (PHRs) contain the same types of information as EHRs--diagnoses, medications, immunizations, family medical histories, and provider contact information--but are designed to be set up, accessed, and managed by patients. Patients can use PHRs to maintain and manage their health information in a private, secure, and confidential environment. PHRs can include information from a variety of sources including clinicians, home monitoring devices, and patients themselves.


One size does not fit all?

Depending on the makeup of a healthcare organization, providers could be using a diversity of health IT systems to generate and manage patient data technology and coordinate care with providers in other departments using different systems. What's more, providers participating in population health management or value-based care could be partnering with members of the care team who are not clinicians.

In a patient-centered world, the term EHR appears most capable of grasping the comprehensive nature of the patient experience across the care continuum. All providers are liable for their contributions to the complete picture of a patient's health, indicating a need for EHR technology to properly track the provenance of medical data and decision-making.

"An EHR achieves a rare trifecta: It's a win for three parties. It's a win for the clinic because it saves time over the old method (attaining charts from other health care organizations, taking down verbal information from patients, and so on). Less time lost will translate into more time with patients," Dignity Health's Rami Hashish, PhD, DPT, wrote in 2015.

While the term EHR gets the nod from most of the healthcare industry, perhaps another phrase is more fitting. EHR adoption has risen significantly since the start of the EHR Incentive Programs only a handful of years ago. There are now patients whose entire medical history is digital and record will grow as they develop and mature.

Providers want a comprehensive view of a patient's health is a provider. And new sources of health data are emerging -- genomics, wearables, and patient-generated data. With healthcare moving into more settings beyond traditional brick-and-mortar settings, the industry is better suited to thinking in terms of a longitudinal health record combining the EHRs a patient is likely to contribute to the generation of over his lifetime.

For now, it appears EHR will have to suffice.

Source: EHR Intelligence (View full article)

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Research initiatives focus on blockchain tech to improve pharmacy supply chain

Feb 1, 2018


The Center for Supply Chain Studies is working on its next round of research to explore how blockchain-based distributed ledger technology can be used to enhance and improve the pharmacy supply chain.

The organization is putting together teams for two studies and is actively seeking members to participate. The two studies are "DSCSA & Blockchain: Phase 2, Proof of Concept" and "Blockchain for the Cold Chain." DSCSA stands for 2013's Drug Supply Chain Security Act.

The "DSCSA & Blockchain: Phase 2, Proof of Concept" study follows on the heels of the organization's Phase 1 research, in which supply chain stakeholders - manufacturers, wholesalers, returns processors, retail pharmacies, hospital pharmacies, track and trace system vendors, blockchain solution companies, master data management system companies and regulators - created ReferenceModels, or supply chain simulations, to explore the use of blockchain technology within the pharmaceutical supply chain for the purposes of meeting 2023 requirements of the DSCSA.


New research sought for temp-controlled environments

As for the "Blockchain for Cold Chain Study," The foundation of this study is to explore how the industry might extend the use of the architecture outlined in the DSCSA and Blockchain Phase 1 Study to manage temperature data collected from stationary or mobile temperature controlled environments, sensors, indicators and temperature controlled packaging configurations.

"We will first look to manage trading partner assertations as to whether the products have been maintained properly - or whether there is data to suggest that there has been an excursion - then we will experiment with ways of connecting temperature monitoring data with trading partners," Celeste said. "And lastly, we will explore if it's possible to coalesce this disparate data into an electronic signal or assessment of the product, from a temperature control perspective."

In the DSCSA and Blockchain Phase 1 Study, the Center for Supply Chain Studies realized that the interconnectivity, immutability and programmability of blockchain could have value beyond DSCSA. The organization polled its subscribers and a number of challenges were identified. Providing proper signals and data within the temperature sensitive (cold chain) industry was one of the highest valued concerns.

"Using ReferenceModels, simulations, we will explore the cold chain supply chain, technology and data sets and apply blockchain features to provide a common signal when excursions occur and an architecture where temperature questions can be asked and answered and temperature data can be exchanged between trading partners and solution providers," Celeste explained.

Participants in this study include the exact same kinds of participants in the "DSCA & Blockchain: Phase 2, Proof of Concept" study.

There are two challenges the organization is attempting to address the cold chain study. First, how to use blockchain technology to address the issues in cold chain operations through the supply chain. The center believes its previous studies have already shown the way and the center will be adjusting that work to address temperature data.

"The larger challenge is how to make use of disparate temperature data sets to tell the temperature story of an item as it transmits the supply chain," Celeste said. "The goal is to explore the cold chain process and demonstrate the use of industry blockchain to connect stakeholders and share alerts and data sets."

Source: Healthcare IT News (View full article)

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