Sunday, March 1, 2015

Predictive Analytics: Mayo Clinic and Apervita

It did not take long for analytics to become commercialized as a big business. Perhaps this is the first step in developing Preferred Patterns in developing algorithms. Leaders such as the Mayo Clinic, and perhaps other university centers will have a sweepstakes of algos for outcomes and big data in health care.  That would be wonderful and would save the rest of us from pouring limited resources into Medicare’s edicts about outcomes. Who will be next ?

On Wednesday, Mayo Clinic announced it will commercialize its analytics, publishing and sharing algorithms with healthcare enterprises to improve patient outcomes. Utilizing Apervita’s secure self-service health analytics platform, healthcare enterprises can leverage Mayo Clinic’s robust portfolio of health analytics to improve patient care. Mayo Clinic will join other prominent health institutions in the growing Apervita analytics community of providers who are already utilizing the platform.

Benefits of Sharing Algorithms

Mayo Clinic’s decision to offer its algorithms through Apervita empowers health enterprises everywhere to leverage Mayo’s portfolio of algorithms, which includes a large number of specialties, such as cardiovascular, pulmonology, and oncology. “At Mayo, one of our most scalable assets is our knowledge. We have found sharing knowledge significantly improves the efficacy of care delivery, improving quality and driving down costs. Sudden cardiac arrest is a leading cause of death among adults over the age of 40,” said Paul Friedman, MD Vice-chair, Cardiovascular Medicine, and Director, Cardiac Electronic Implantable Device Lab at Mayo Clinic in a statement. For example, Mayo is sharing an algorithm that can automatically identify patients at risk for sudden cardiac arrest for an appropriate consultation.

How It Works

Apervita empowers health professionals and enterprises to capture and share health knowledge, allowing them to easily author, publish and use health analytics, such as algorithms, quality and safety measures, pathways, and protocols. The Apervita health analytics market liberates this knowledge and makes it readily accessible so that every health professional can take advantage of it. Health enterprises no longer need to hard code analytics into their existing systems or buy siloed analytic systems. By selecting trusted analytics from globally renowned institutions, health enterprises can readily improve their workflow, inserting insight where it is most needed.

Key Benefits

Example uses of Apervita’s health analytics market for providers include:
- Create a patient safety dashboard. Use your own measure data and choose public measures from the Apervita marketplace. Share it with your safety taskforce.
- Using the latest medical algorithms, providers can detect readmission risks across your populations. Monitor high risk patients at admission and discharge, by disease.
- Quickly identify outliers and deteriorating patients. Providers can choose evidence-based algorithms from the marketplace or create your own. Take action early to avoid unnecessary harm.

Other companies have taken note of opportunities for analytics in  health care.

Rock Health: How Predictive Analytics Impacts Patient Care

Rock Health’s latest report, Predictive Analytics: The Future of Personalized Health Care explores this question and how the overabundance of big data and widespread availability of tools has catalyzed the growth of predictive analytics in healthcare. The scope of the report only includes companies using algorithms to directly impact patient care such as clinical decision support, readmission prevention, adverse event avoidance, disease management and patient matching.

Key Findings

Personalizing care through predictive analytics represents a significant opportunity to reduce costs in the healthcare system. Key findings of the report include:
- Of the venture-backed companies claiming to use predictive analytics, nearly three quarters of them are focused on just healthcare professionals and practically ignore patients.
- Healthcare data is expected to exponentially grow from 500 petabytes in 2012 to 25,000 petabytes in 2020 (AMIA). That’s the equivalent of 500 billion four-drawer filing cabinets.
- Most predictive analytics companies continue to leverage clinical and claims data for their algorithms. However, there is an emerging group of companies that are using patient-generated (e.g., digital medical devices and wearables) and patient-reported data to help better predict care.
- Even if we had the technology to address interoperability issues, solve privacy concerns, and process unstructured data, hundreds of thousands of facts influence health – many of which medical science cannot explain.  

- Health outcomes are not instantaneous. Without an effective, closed-feedback loop, algorithms struggle to continue to learn and improve. – Predictive analytics has no value if providers, physicians and patients do not act on these recommendations.  

For more information, see the full report below and register for Rock Health’s live webinar on Thursday where they will explore the details of the report.
The future of algorithms may very well be standardized, so that regional
comparisons would be valid.

Saturday, February 28, 2015

Reduce IT Complexity and Improve Utilizations through Convergence

Traditional IT  operations have been historically difficult to manage and maintain. Typically viewed as an infrastructure-centric center that includes maintenance costs and complicated applications. Digital Health Space envisions the electronic  health record that enables work flow  by focusing on services that improves productivity. IT should be elastic, nimble, modular, integrated, streamlined, high-quality, automated and software-defined.

Health care providers,  hospitals, and other support personel are faced at times with overwhelming advances in technology.

This webinar has been approved by HIMSS for up to 1 contact hour of continuing education credit toward renewal of the CPHIMS credential.

Health care personel tasked with evaluating and selecting solutions must critically evaluate software that minimally disrupts established workflow. Ethnology requires further project management for modifying established workflow for change if it is determined the new application is cost-effective and improves efficiency in the long run. Disruption may decrease efficiency for three to six months depending on it's compmlexity and learning curve.

Unfortunately deficits in software do not become apparent until after implementation. Contract negotiations must include provision for software modifications (patches) and the limitations imposed by vendors. 

The Internet of Things may also provide links from the EHR or other applications as an add-on

Friday, February 27, 2015

Digital Health...What is?

What is it ?

Digital health has grown from using a simple electronic health care record into a complex set of uses.

How Millenials are re-shaping digital health. This demographic began learning how to code in elementary school. By the time they reach high school or college they are competent in many forms of digital communications.  Many are very familiar with design of computers and their use for many tasks. All have taken examinations using computer testing methods.  Millenials use computers and software just as my generation previously learned to write with a #2 Yellow pencil and a legal size pad. If a #2 Pencil was not available, the fall back was a 

Bic pen 

or a PaperMate pen

Today's millenial physicians use smartphones, tablet pc and in the near future will be using wearables and speech driven input or output. Efficiency has become as important as quality for many reasons.

In Medical School and while training,  millenials used EHRs and became famiiar with health information exchanges.

During the past decade physicians and health personell had to be trained on the job. Now they are enrolled in courses such as the UC San Diego Course on Essentials of HIE.

Those who were early adopters of HIT will bear testimony to the difficulties using immature systems which actually decreased efficiency.

Ten or more years ago there were few physicians using electronic health record systems. The number has grown exponentially in the past five years (2010-2015), fueled by federal incentive dollars. The same applies to Health Information Exchanges.

Constructing Health Information Exchanges was difficult. There were few, if any models. HIEs required legal means for sharing private and confidential patient information.

In California several organizations have grown from a mish-mash of early committees, outlined here .

Health Information exchanges are now performing essential infrastructure activity, without which quality metrics, outcome studies, and administration of accountable care organizations could not take place. Nevertheless it will take time for the system to become integrated and build health community trust.

HIEs have yet to be formally evaluated nor determining "best of breed".  There are as yet many unanswered questions.

RAND: Systematic Review of Health Information Exchange

The 'system' is still evolving, in some cases using trial and error planning.

In our next post we will discuss mobile health, telemedicine, remote monitoring and the anticipated role of the FDA and the FTC. The Federal Trade Commission pre-empted the FDA by sanctioning and filing a cease and desist order against fraudulent claims by 'MELAPP", a smartphone app claimed to be able to identify malignant melanomas.

Phil Bauman whose blog is  

                                 Health Is Social

                      Infusing Social Media into Healthcare

Thursday, February 26, 2015

Awesome Referral Trick Using Facebook and DoctorBase

Feb 24

The only way we've seen Facebook consistently work for practices is through an automated integration with your existing practice management & survey software - meaning your patient reviews don't just appear on the web - they appear automatically on Facebook as well.

Through this software based methodology, each positive patient review generated through DoctorBase has the potential to reach approximately 600 of your patient's friends and family members through their News Feed. It's an incredibly exciting way to replace your simple Facebook Fan Page with something that actually works.
We're releasing a much more advanced version of this feature soon, and a much deeper level of integration into Facebook next week. You can setup a time to go over how this would work for your practice - the consultation is absolutely free.

Click Here to Setup a Consultation Time Convenient for You

"Many thanks to all at DoctorBase, a necessary component of today's world of social media and internet presence. It has been a great addition to our group." Dr. Henry Mentz, MD, FACS
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Wednesday, February 25, 2015

The Internet of Things-The Reality of Connected Health Care

Health Care is connected. 

How will IoT be able to increase the efficiency of the system benefiting both practitioner and patient alike?

Health Information Exchange, Portals, eRX, Mobile Health Apps, Health Insurance Portals, Secure email, Telemedicine, Webinars and the Cloud  During the past decade siloes of information have diminished substantially.


While interconnectivity can be a good thing there are some precautionary tales to tell.


Privacy, and security are at risk from cyber-sleuths who attempt to financially gain by accessing data-bases such as health insurance records, EHRs, Health Information Exchanges, and government data bases to retrieve personal information such as social security numbers, driver's license numbers and other data to be used and or sold. Criminal enterprises exist with the sole purpose of stealing digital data to be sold to other parties. Many physicians are reluctant to use cloud technology for storing patient records, however this is becoming more commonplace, as it decreases capital investment and the need for onsite software upgrades.

The 2015 HIPAA Toolkit and Customizable Compliance Plan aids in minimizing these risks.

"The Internet of Things, the idea that everything will someday be totally connected, is no longer a Jetson’s era fantasy. It’s becoming closer to a reality in healthcare."
We’ve discussed IoT in healthcare and what its impact could be, but what would that look like? How can healthcare be ready for this total connectivity? Most importantly, how will IoT be able to increase the efficiency of the system benefiting both practitioner and patient alike?

For example, some hospitals have begun to use smart beds, alerting nurses when patients are trying to get up, or the bed itself can help patients get up using varying pressure and support. Devices can even help patients once they leave the hospital like smart pill bottles that know when a prescription needs to be refilled or a patient hasn’t take their medicine."
"Greater connectivity will become apparent with these new devices, but how can these technologies be incorporated into everyday practices? Take for example Google Glass. Pierre Theodore, MD talks about the possibilities that Google Glass can provide for the doctor as opposed to the consumer. "

Remote monitoring promises to be valuable as a data collection source for patients during everyday activities. These metrics will be transmited to the cloud or directly to a provider's EHR for analysis.

Wearables offer self monitoring of fitness, blood pressure, pulse and other metrics for preventive health care. The addition of cell and internet connectivity brings these metrics to the provider. AliveCor offers a smartphone ECG real-time measurement device.

About the Author: Kelley Sullivan currently resides in the Boston area and is a health IT blogger at DICOM Grid. This article was originally published on DICOM Grid and is republished here with permission.

Tuesday, February 24, 2015

Health Care Social Media in Academia

In 2010 few in academia or clinical medicine appreciated how social media would evolve, and contribute to the spread of knowledge and analytics.

Today many institutions have established formal social media departments. The Mayo Clinic was one of the first institutions to offer a social media residency program.  Lee Aase is a pioneer in this effort, offering a social media residency program which offers a formal course catalog and learning modules.

Many #hcsm efforts are those of private individuals who develop their own private network of healthcare social media enthusiasts. What began for some as a hobby has evolved into formal analytics and networks. The introduction of computer algorithms has expanded the social media niche into a rich testbed for studies of population health as well as disease.

Symplur Signals offers a launching point about health care social media analytics and Symplur hashtags is the ontologic equivalent to Webster's dictionary. Symplur also categorizes hashtags for tweetchats , conferences, diseases, ontologies, and a summary page

In addition to private social networks the true power of social media is in the proliferation of platforms such as twitter, facebook, google plus, rss feeds, blogger, wordpress.  The ease with which anyone can publish is a double edged sword. Twitter, facebook, google plus, linkedin, offer their own search capabilities and at times bypass google search, focusing on relevant health sites.

A relevant question is,

 Which social media platform should you use?"

Hospitals, Clinics, Universities all have their own Facebook page, Google plus page, Twitter, and a presence on other social media platforms.

The USC Digital Scholar Training Initiative offers courses in 

Using Social Media Data to Gain Insights into Community Trends

Calif. Bill Aims To Limit Which Rx Drugs Are Listed in High-Cost Tiers

Calif. Bill Aims To Limit Which Rx Drugs Are Listed in High-Cost Tiers

by:  California Healthline, Thursday, February 19, 2015

California lawmakers are considering a bill (AB 339) that aims to keep prescription drug costs down by limiting which medications insurers can include in the highest-cost drug tier, Capital Public Radio's "KXJZ News" reports.

Details of Bill

AB 339, by Assembly member Richard Gordon (D-Los Altos), would prevent insurers from placing all of the prescription drugs to treat a certain condition in the highest-cost tier of a drug formulary.
According to Gordon, insurers often place high-cost medications into such specialty tiers, which forces patients to pay a larger share of the prescription drug's price. For example, Gordon explained that if "all of the HIV drugs are in a very expensive top-tier category, that would appear to be discriminatory" (Bartolone, "KXJZ News," Capital Public Radio, 2/18).
In addition, the bill would require:
  • All health plans offered, renewed or amended after Jan. 1, 2016, that cover outpatient prescription drugs to offer coverage for medically necessary medications that do not have a therapeutic equivalent; and
  • The California Department of Managed Health Care and Department of Insurance to define by Jan. 1, 2017, a "specialty prescription drug" category that would be subject to limitations (AB 339, 2/13).

Health Insurer Reaction

Nicole Kasabian Evans with the California Association of Health Plans said the bill could be misleading, noting that patients pay higher shares of specialty drugs because they often are very expensive.
She said, "Bills like this give a false sense that drug costs are going to be reduced, when in reality costs are just shifted from your out-of-pocket costs to premiums."
Health insurers also contend that out-of-pocket costs already are capped under the Affordable Care Act. They say a better way to address high prescription drug costs would be to have drugmakers be more transparent about how prices are set

("KXJZ News," Capital Public Radio, 2/18).
Source: California Healthline, Thursday, February 19, 2015