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Showing posts with label hit. Show all posts
Showing posts with label hit. Show all posts

Friday, May 9, 2014

Health IT Potpouri

There is an overwhelming amount of information about HIT on the web, blogs, email newsletters and a Google search will turn up literally hundreds of resources.

For this week, May 8 2014 I have compiled this list of hot topics and links:


ROI -- whether the "I" stands for innovation or for investment -- will be among the many topics up for discussion at the National Healthcare Innovation Summit, which kicks off May 13 in Boston. The organizers promise "the kinds of innovations that people can take home and use tomorrow."

Among the healthcare developers workshopping better approaches to technology design at HxRefactored in Brooklyn next week will be Stephen Buck, who'll offer some "lessons learned" from looking closely at leading EHRs -- specifically, how not to design a user interface.

More than 370,000 Medicare and Medicaid eligible providers have earned an EHR incentive payment so far, with 64,000 new participants attesting to meaningful use for the 2013 reporting year.

The Defense Health Agency has put a foot forward with revamping its clinical information systems after it inked a bridged contract with a Reston, Va.-based technology and defense company.
The current landscape of data exchange networks is disjointed, with health care systems scrambling to uncover sustainable business models. The need for interoperability is greater than ever. What will the model look like in the future and what are organizations doing to move toward more valuable data exchange? Ashish Shah, Medicity’s CTO, and I recently discussed these industry drivers with Anthony Brino, editor of Government Health IT. Read the article HIE at a Crossroads.
Carolinas HealthCare System CareConnect got an early start on creating a robust network for data exchange. Take a look at this recent case study highlighting Medicity’s role in connecting the health care ecosystem to enable a 360-degree view of patients across the care continuum.


Posted: 06 May 2014 10:06 PM PDT
A while back — three months, to be exact — I asked readers if they had a preferred term to describe “the application of new, personalized technologies to healthcare.” I gave you the choice of digital health, connected health, wireless … Continue reading →

HIE among U.S. non-federal acute care hospitals has been trending upward since 2008, in fact, and it took some major leaps forward in 2013.



Posted: 05 May 2014 09:01 AM PDT
Understanding that physicians require more comprehensive, flexible clinical documentation solutions that reflect the fast-paced highly mobile health care environment, M*Modal today announced enhancements to its Fluency Flex™ Mobile dictation application for iOS 6.0+ devices. Moving beyond the capture of clinical notes during … Continue reading →

More than half of people with chronic conditions say the ability to get their electronic medical records online outweighs the potential privacy risks, according to a new survey by Accenture.

New guidelines issued by the Federation of State Medical Boards could have a chilling effect on the growth of telemedicine -- especially in rural areas and among low-income patients, say some patient advocates, healthcare providers and healthcare companies.

Some analysts are predicting the next "great wave" in EHR purchasing among U.S. hospitals to be just around the corner. But do the numbers really bear that out?

The hits keep on coming for the new EHR certification criteria, as the American Medical Association and Telecommunications Industry Association send their complaints to ONC on the heels of similar criticism submitted earlier by the EHR Association.

The “unconfirmed rumor of a huge acquisition” that HIStalk (a.k.a. the National Inquirer of health IT) tweeted about on Wednesday apparently is that IBM was going to acquire Epic Systems. Mr. HIStalk on Thursday expressed some reservations.   @DaLAWon Much … Continue reading →


The hits keep on coming for the new EHR certification criteria, as the American Medical Association and Telecommunications Industry Association send their complaints to ONC on the heels of similar criticism submitted earlier by the EHR Association.


Posted: 01 May 2014 10:51 AM PDT
Nextgov has a great article up which outlines many of the details of the soon to be bid out Healthcare Management Systems Modernization contract. I’d prefer to call it the DoD EHR Contract or AHLTA replacement contract. Certainly there’s more … Continue reading →

Explore Medical Practice Insider's guide to emerging apps and devices for the medical practic

If you want to learn more about ACO formation and Operational Issues: Attend
this event either in person, or as a webinar.
Press Release: Brookings/Dartmouth Fifth ACO Summit Announces New Keynote Speakers Sean Cavanaugh & Alice Rivlin

  • A Hybrid Conference and Internet Event
  • The Leading Forum on Accountable Care Organizations (ACOs) and Related Delivery System and Payment Reform
  • Sponsored by Engelberg Center for Health Reform at the Brookings Institution and Dartmouth Institute for Health Policy and Clinical Practice
  • June 18 - 20, 2014
  • Hyatt Regency on Capitol Hill, Washington, DC
  • Online In Your Own Office or Home live via the Internet with 24/7 Access for Six Months


For Summit registration information, visit www.ACOSummit.com/registration.php, email registration@hcconferences.com, or call 800-503-3597.





Friday, February 7, 2014

Small Data

Health care and health reform are being influenced by seemingly unrelated spheres of influence. Many industries are effected by these same interactions in banking, transportation, defense, technology, basic science, education and government.

The age in which we live is both exciting and terrifying. Now that I am a septagenerian I see it is both. And somehow we will survive, grow stronger and thrive.

The catalyst is largely information technology and cyber technology, whether it is functions for gathering data, analytics,pseudo artificial intelligence, or robotics.  All of it is shaped by bits and bytes.  Even the basic materials of the integrated circuit and computer microprocessors will undergo basic changes perhaps away from silicon to carbon or even biological compounds such as the building blocks of DNA, nucleic acids.

Rather than having a simple bit or byte, nucleic acids as we know them, offer 4 different subunits that form a lexicon for building proteins from amino acids.

Big Data is often quoted in health care for analytics, for biological and research discoveries.















We in health care are now being continuously bombarded about the essentiality of gathering more and more information. Our government is underwriting some of the costs and also placing a large burden upon not only physicians but all providers, and hospitals to enter health data into the IT infrastrucure for some future use, some of which is still not defined, and some which is truly unproven.  Despite this billions of dollars have been and will be spent on this endeavor.

There have been some precautionary notes offered from other sectors:

Viewpoint: Why your company should NOT use “Big Data”


The latest trend is “Big Data”. The original concept of Big Data was the concept of using all of the information a company collect that was being thrown away due to costs and capacity constraints. With the rapidly declining cost of storage and retrieval, combined with machine learning, we should be able to find insights in all that ‘garbage data’ and use it to make better decisions in the core business. At least that’s the theory. As far as the basic theory goes it’s all true, but it’s not the full story.

Like a lot of trends, the drive to mastering Big Data has gone a little overboard. Google searches for the term “Big Data” has grown from practically nothing in 2010 to almost 200,000 searches a month by the end of 2013

It has become so ingrained in company cultures that to say you don’t want to use Big Data is a bit like saying you are against data-driven decision making. It would be career suicide to say Big Data is a waste of company time and resources.

The graph below depicts the exponential growth of big data over time.












The details can be found at the original article on ViewPoint

Friday, January 3, 2014

Looking Back at 2013

This report is somewhat late due to last minute projects at the end of 2013 and the confusion about the individual mandate, the botched launching of health benefit exchanges and some other unexpected tasks

We reviewed the 'best"  Health Train Express posts of 2013 as measured by the number of comments and our analytics.













There were many more 'favorites".  The highest number of page views was in the category of the Affordable Care Act. This was to be expected, given the high ranking of the ACA for search engines.

Visit the sites on Health Train Express for many more interesting topics. Health Train Express has archived our posts dating back to 2005.  The focus of posts has changed over the  years, and reveals the dynamism of health care and reform.






Saturday, December 21, 2013

mHealth----More Necessary Regulations


Much of the big news in health IT this year came out of the Office of the National Coordinator for Health IT. ONC -- along with CMS -- is in charge of overseeing the widespread adoption of EHRs through the meaningful use program. After years in the works, the first phase of that program is wrapping up right now.

The past several years were almost frantic for HIT and ONC, with meaningful use standards, interoperability standards, incentive funding and a succession of creative and dynamic national coordinators, each with their own focus on what needed to be accomplished.

Unlike other Executive departments, Medicine has been fortunate to have a clear path, relatively clear goals, and minimal political divisiveness......all to the benefit of our patients.

mHealth has had an explosive growth in mobile applications for iOS and Android.  The hardware form factors are multiple with stiff competition and new hardware offerings almost monthly.

Growth and competition are plentiful and numerous manufacturers (Nokia, Windows, Google, Motorola,iPhone) in smartphone or pc tablet form.  In many cases EHR vendors have rapidly developed a mobile app portal.  The acceptance rate has been high for those who are tech savy.  Despite the potential vulnerability to a security breech and all that HIPAA stands by on the sidelines ready to pounce with a hefty penalty. The plain truth is that these applications and hardware offer so much to efficiency a way needs to be found quickly to certify HIPAA compliance for each application and device.

Not withstanding this urgent need there have been several attempts to regulate this market. FDA, FTC, FCC,  and HHS have all been mentioned. Suffice it to say that regulatory agencies are pressed to stay current with new hardware and devices.

Why, How and Which  Mobile Health applications need regulation?

In an article (blog post) in June 20012 I discussed  Five Reasons Why Digital Health Technologies Need FDA Oversight   Now the FDA is in the process of forming a mobile health division to study, certify and authenticate applications.  A new workgroup in HHS has been formed,

According to mobiHealthNews;

"The workgroup’s efforts will likely end up affecting the regulation of mobile health and health IT. According to HHS, FDASIA requires Sibelius, with the ONC and the FCC, to “develop a report that contains a proposed strategy and recommendations on an appropriate, risk-based regulatory framework for health IT, including medical mobile applications, that promotes innovation, protects patient safety, and avoids regulatory duplication.”  The new workgroup’s input will feed into that report.

According to Brian Ahier,

"As a general matter FDA regulates all medical devices and FCC regulates devices that utilize electromagnetic spectrum - i.e. broadcast devices. So with regard to mobile health devices - sensors, applications, systems - FDA regulates any given device as a medical device while FCC regulates the device as a communications device. 

Recognizing the potentially overlapping jurisdiction in digital health, in 2010 the agencies entered into a Memorandum of Understanding "to promote collaboration and ultimately to improve the efficiency of the regulatory processes applicable to broadband and wireless enabled medical devices."

Last month FCC announced its mobile body area network (MBAN) proposal, which would allocate electromagnetic spectrum for personal medical devices (see link below). The allocated spectrum would be used to form a personal wireless network, within which data from numerous body sensors could be aggregated and transmitted in real time."


Representative Marsha Blackburn (R-TN) and others introduced The Software Act.which will act to build a cohesive multi-agency over view of mHealth.











Thursday, December 19, 2013

Health Benefit Exchange

Has health care improved since the ACO went into effect??  We have been told that already the ACA has saved millions and perhaps billions of dollars. How is that so?  Where are the details?

I have an open mind and I am willing to consider the facts....so just show me the numbers. How is it that the government has infused billions of dollars into health IT and providers must now support it operationally ? Given the lifetime of IT hardware and software obsolescence in five years at the most it will all have to be upgraded and/or replaced with a second generation of sofware that has real meaningful usability, not the garbage that HHS is insisting we use to accomodate the "quants" at HHS who massage the information spewing out of their machines.

Health care now supports an industry of high tech that has nothing to do with patient care. Vendors of hardware, software, consultants, IT consultants, a stream of auditors, review firms, outcome studies. What idiots think we are saving money?  The money in health care no longer is going to patient care......it is going to many parasitic organizations.  The only good thing about it is that unemployment would be much worse than it is already.

How long will  health benefit exchanges  be useful after the initial period of signing up the uninsured. Surely it will cost a great deal to fix it, and maintain it.

If the affordable care act continues to roll out the next five years will be a financial and health disaster.

For all the details on Health Benefit Exchanges and which insurance companies have signed up here is the list. It does not mean your doctor will accept these plans since the reimbursement rates in the Affordable Care Act will be very low compared to the current rates.

Stay tuned.




NIH Leader Calls for Evidence on mHealth

Only about 20 randomized clinical trials involving mHealth tools or services have been conducted in the United States since 2008 under the auspices of the National Institutes for Health. And more than half of them have failed to document clear evidence of improved outcomes.

 Francis Collins, MD, the NIH's director, delivered the message to attendess at the 2012 mHealth Summit in his closing keynote on Dec. 5. Collins pointed out that the lack of trial-based evidence is hindering acceptance of the technology by a healthcare industry that could really use these tools.
Dr. Collins also noted that controlled trials often are diffiicult to design in the real world by saying,
"The mHealth field is evolving so rapidly that oftentimes the technology used in trials is outdated by the time the trials are completed. For that reason, he said, the scientific and healthcare communities have to work together to fine-tune the process, producing viable results in a timely manner.
The alternative? Forge ahead with mHealth without evidence that mHealth is improving healthcare."
This viewpoint may be highly biased as to the cohort and demographics of such a study.  Presently there are thousands of mobile apps in development, most stimulated by public perception and enthusiasm from the HIT community. The feeding frenzy for profit is dynamic with the federal stimulus packages.
Many vendors in mHealth would argue differently. Hopefully some of them will comment here.