Give Me My Dam Big Data

 

Just as many patient advocates and community groups are saying about their personal stored electronic medical records, so too are others very interested in studying the warehouses of information:

What kind of data and what type of analytics are in the offing?

Four types of data analytics that providers are using to improve population health

The push by the government to reduce healthcare costs and the increased liability providers have is forcing them to more easily identify and help chronic care patients to better manage their conditions.
 

Healthcare IT vendors are expanding their big data armories to help providers, particularly accountable care organizations mine claims and clinical data to get a better sense of patient outcomes, performance and how  they can reduce costs

Dr. Anil Jain, the CMIO of Explorys, a spinout from the Cleveland Clinic, highlighted some of the different analytics approaches it is offering clients as they get more involved in population health.

Descriptive Analytics  This accounts for the biggest chunk of big data across industries and it tends to focus on what went wrong or assessing why outcomes are more or less than what was expected. . In other words, what is happening now.
 

Predictive Analytics  Big data is chiefly being used to identify patterns, predict how to predict future outcomes, and avoid preventable events as a way to reduce healthcare costs.

Prescriptive Analytics Prescriptive analytics involves helping a provider measure and manage a patient population. (Obesity, Diabetes, Hypertension.

Comparative Analytics   One of the most interesting ways providers can use big data is to compare their performance to other healthcare facilities.

This big data analytics is only possible now at large institutional providers and integrated health systems, such as Kaiser, Cleveland Clinic, or the  Mayo Clinic.

Data from small hospitals, providers and even University Medical Centers would be so disparate as to defy meaningful analysis.

Technorati Tags: big data,analytics,kaiser,cleveland clinic,mayo clinic,explorys

FDA and Mobile Health Apps

 

The Sprawling leviathon Food and Drug Administration Complex is struggling to keep up with drug review, and is now facing additional challenge of mobile health regulations in the face of  [Governmental Sequestration.]    [Washington Post Opinions]

Sprawling leviathon Food and Drug Administration Complex struggling to keep up with drug review, now facing additional challenge of mobile health regulations in the face of Governmental Sequestration.

Three days of congressional hearing with the FDA concluded with discussions about the FDA’s role in monitoring and producing guidelines for mhealtlh applications. There were no specific guidelines, nor binding regulations forthcoming at this time.

 

iHealthbeat reported this yesterday, along with other topics.

Telehealth

Flawed HER Designs

Lag of Long Term Facilities in HER adoption

 

HIMSS Hot Topics:

 

 

HIMSS13: Mostashari Says Data & Incentives Matter

HIMSS13: Federal Officials Stress Commitment to Health IT

HIMSS13: Sequester Will Affect Medicare EHR Pay, ONC Budget

11 Experts on Health IT Progress, Frustrations and Hopes for 2013

With 2012 now behind us, we asked 11 leaders in the health IT field to reflect on the progress and missed opportunities of the past year, as well as their hopes for health IT in 2013.

The meeting at HIMSS 2013 produced an intense focused forum for discussions about the progress of digitizing health information.  Most leaders in HIT were present, and many vendors were present on the meeting floor.

Unable to attend in person Digital Health Space monitored several live twitter streams, and also video live streams.  Microsoft’s health division and Dell Systems sponsored an evening meeting for a roundtable discussion of some high points of the meeting.

Hashtags from Dell's HIMSS Meeting:

You can  follow the tweets via the hashtag #DoMoreHIT or the participating tweeps in the conversation: @drandylitt, @ahier, @egpierro, @techguy, @lsaldanamd, @cthielst,@2healthguru, @jloveloc, @norabelcher, @boltyboy, @shahidnshah and @healthcarewen.

Implementation of HIT is turning out to be a “Big Bang”, an issue which challenges our ability to get our hands around it.

Presenters indicated how costly the effort has become, estimating that about $ 25 billion USD is the annual HIT budget at present, just to maintain current systems. At the same time most indicated that this offered employment security for many people at that meeting.  In the midst of the economic crisis it is not yet apparent what or if any of the HIT federal incentives will suffer.  Health now provides employment for a large segment of the U.S. Economy and reductions in health expenditures may be felt in the unemployment rates.

The topic of ‘BIG DATA” emerged as to how it would enter into the equation. Attendees at the Dell sponsored forum were sure Big Data would play a major role. The theory is that analysis of this forthcoming tool will improve outcomes and reduce costs.  The Kaiser model seems to bear that out, but it will take immense effort to convert the rest of American Health Care.  Other countries in Asia, and Europe are significantly ahead of the United States.

Big Data was vaguely defined. It was unclear if analytic systems were really in place to understand it, although it was mentioned that some large integrated systems such as Kaiser were already utilizing “Big Data”.  Most participants agreed that most hospitals and providers were not at all prepared for “Big Data”, that a large challenge is to educate 800.000 providers, and several thousand hospitals.

What organizations can encompass this ? State, county, Public Health, Health Information Exchanges.  The ‘baby” is still in the womb….what will emerge is still unknown.

Finally the topic of personalized medicine was discussed, in connection with advances in genomics. Exponential decreases in the cost of analyzing one genome have occurred due to immense increases in computer power.   We will be discussing personalized medicine and genomic in one of our next blog posts.

At times there are more questions than answers, a good sign of interest in solving our health challenges. 

The choices for organizational hierarchy changes, rapidly expand in number and perhaps we need an IBM Watson to analyze our organizational structures of health care to prepare a diagnosis and then a treatment plan  for our health system ills. How about several second opinions before the operation?

Technorati Tags: ibm watson,big data,kaiser,dell health,microsoft health,himss,fda,mobile health,mhealth,mostashari,ihealthbeat,sequestration

Heavy Weight in the Mobile Health Zone

 

Several years ago Google Health was developing  a personal health record. It failed to attract much interest  due to consumer apathy and  lack of interoperability with electronic medical records and an inability to download information from the clinic EMR.

About the same time, Microsoft developed Microsoft Health Vault. It has languished in a torpor and now that Microsoft has entered the mhealth zone, with ‘Surface”, “Windows Phone” and Windows 8 Microsoft.  These are all based upon Windows 8 GUI, which features large icons, a simple main menu and touch screen functionality.

The early edition of Microsoft Health Vault was tied to the desktop or laptop until very recently.

Microsoft has correctly read the marketplace, albeit very late. They finally came to the table with Windows 8RT, and Windows 8 Professional as well as a well designed tablet, Surface.

Microsoft also recognized the  exit from desktop and fixed locations. The transition to mobile should empower and engage patients to  get their healthcare from where they are, at work, in the car, or even outside.

Health Vault in the past several years has attracted many to the platform, laboratories, pharmacies, health and wellness, remote monitoring and more.

What can you do with HealthVault?

Microsoft HealthVault  is a free web-based platform that enables patients to collect, store, and share their health information, without charge.

Take the Tour

Prepare for an emergency

Use HealthVault to make your most important health info available

Browse the App Directory

Browse the Device Directory

Pulmonary Flo-meter        Pulse Oximeter

Examples:

 Discover apps & devices

There are now several hundred mobile and remote sensing devices which interface directly with Microsoft’s Health Vault.  There is easy access to information and the ability to purchase apps and devices. All of this is designed to be patient-centric and user friendly, HIPAA compliant and requires authentication for secure transmission of data.

Microsoft Health Vault SDK  provides  a software developers toolkit for developing applications.

HealthVault-connected apps are websites, computer software, and mobile apps that can help you get more out of—and put more into—HealthVault.
You can choose apps to help you stay motivated, analyze trends, and receive education and recommendations to keep you at your best. And it is designed for the rapidly growing niche of mobile applications, available almost anywhere.

It is a welcome addition to the PHR market.

The most interesting part is the list of devices for remote monitoring and health and wellness .

Microsoft even has social media engagement for many of their products.

Twitter            Facebook       

YouTube     

Empowering Patients

   

Health Vault in Action

If you’re like most people you just don’t want to sit there and enter your health records into a personal health records..Well, now there is a cure for that as well. Unival PHR  is a service for obtaining your records from wherever they may be.

yourPHR, part of the yourHealth suite of services, offers three solutions for getting your medical information into HealthVault. Choose one or all of the following:

• Full data conversion of your medical records by a trained, experienced nurse abstractor
• Direct import of organized, scanned documents
• An online interface to complete specific aspects of your personal health record such as demographics, insurance information, etc.

Fifteen Influencers Shaping Digital Health

 

The digital health ecosystem is advancing at a rapid pace and it’s an exciting time to be on the cusp of a health revolution.

Many of the innovative ideas in health regarding HIT now have to do with measuring, collecting and analyzing reams of data being produced, as well as exploring new methods of remote monitoring, health improvement applications, entrepreneurship. venture capital and kick starters.  Information technology has metastasized from the Silicon Valley to Austin, TX Boston, New York and beyond.

Health IT is making a major impact on the general IT space and is even showing up at such events as the Austin, TX SXSW. I will be reviewing this year’s SXSW13 which took place simultaneously with HIMSS13. Unfortunately they were in two different cities.

Like all revolutions, a revolutionary – or revolutionaries – are required to challenge the status quo and bring about change to the system either through brute force or, in digital health’s case, doing things better, cheaper and more innovatively. While the list below is totally subjective it’s a good start to identify those that are making a difference in health by merging the worlds of biology and technology together.

The top 15, In no particular order.

1. Eric Topol M.D.

American cardiologist, geneticist, and researcher but perhaps more importantly Topol is the author of The Creative Destruction of Medicine:

2. Paul Sonnier

Head of Digital Health Strategy at life science consulting firm, Popper & Co., Sonnier’s influence in digital health lies in the 15,000+ member LinkedIn group he created.

3. Halle Tecco

Founder and CEO of Rock Health, the startup incubator for digital health and healthcare technology startups.

4. John Nosta

Nosta probably knows more about the digital health ecosystem than anyone else. The HEALTH Critical columnist for Forbes and employee atOgilvy CommonHealth,

5. Walter De Brouwer

Belgian entrepreneur and founder ofScanadu, a company which is soon to be launching the SCOUT, a self diagnostic device which will allow users to monitor several of their own health statistics including heart and respiration rate, blood oxygenation, pulse transit time and temperature without a Dr or nurse.

6. Ray Kurzweil

7. Martin Blinder

8. Anne Wojcicki

10. Larry Smarr

11. Dave Asprey

More…………………at Bionc.ly

Technorati Tags: kurzweil,dave asprey,larry smarr,anne wojcicki,martin blinder,eric topol,paul sonnier,halle tecco,john nosta,walter de brouwer

,

Office of National Coordinator seeks to enable HIE Adoption

 

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

 

 

Farzad Mostashari - ONC press conference at #HIMSS13

The RFI calls more specifically for responses in the following ten categories:

1. What changes in payment policy would have the most impact on the electronic exchange of health information, particularly among those organizations that are market competitors? 

2. Which of the following programs are having the greatest impact on encouraging electronic health information exchange: Hospital readmission payment adjustments, value-based purchasing, bundled payments, ACOs, Medicare Advantage, Medicare and Medicaid EHR Incentive Programs (Meaningful Use), or medical/health homes? Are there any aspects of the design or implementation of these programs that are limiting their potential impact on encouraging care coordination and quality improvement across settings of care and among organizations that are market competitors?

3. To what extent do current CMS payment policies encourage or impede electronic information exchange across health care provider organizations, particularly those that may be market competitors? Furthermore, what CMS and ONC programs and policies would specifically address the cultural and economic disincentives for HIE that result in “data lock-in” or restricting consumer and provider choice in services and providers? Are there specific ways in which providers and vendors could be encouraged to send, receive, and integrate health information from other treating providers outside of their practice or system?

4. What CMS and ONC policies and programs would most impact post acute, long term care providers (institutional and HCBS) and behavioral health providers’ (for example, mental health and substance use disorders) exchange of health information, including electronic HIE, with other treating providers? How should these programs and policies be developed and/or implemented to maximize the impact on care coordination and quality improvement?

5. How could CMS and states use existing authorities to better support electronic and interoperable HIE among Medicare and Medicaid providers, including post acute, long-term care, and behavioral health providers?

6. How can CMS leverage regulatory requirements for acceptable quality in the operation of health care entities, such as conditions of participation for hospitals or requirements for SNFs, NFs, and home health to support and accelerate electronic, interoperable health information exchange? How could requirements for acceptable quality that involve health information exchange be phased in over time? How might compliance with any such regulatory requirements be best assessed and enforced, especially since specialized HIT knowledge may be required to make such assessments?

7. How could the EHR Incentives Program advance provider directories that would support exchange of health information between Eligible Professionals participating in the program. For example, could the attestation process capture provider identifiers that could be accessed to enable exchange among participating EPs?

8. How can the new authorities under the Affordable Care Act for CMS test, evaluate, and scale innovative payment and service delivery models best accelerate standards-based electronic HIE across treating providers?

9. What CMS and ONC policies and programs would most impact patient access and use of their electronic health information in the management of their care and health?
How should CMS and ONC develop, refine and/or implement policies and program to maximize beneficiary access to their health information and engagement in their care?

10. What specific HHS policy changes would significantly increase standards based electronic exchange of laboratory results?

I would encourage interested stakeholders to participate in this Government 2.0 example of crowdsourcing sub-regulatory guidance over the next six weeks (the comment period closed April 21).

David Harlow
The Harlow Group LLC
Health Care Law and Consulting

 

Technorati Tags: onchit,aca,aco,david harlow,farzad mostashari,cms,hhs,medicare advantage,ehr incentive,hit

Sequestration and Health Innovation

 

Our government has gone over the cliff and our health system and the accountable care act are about to do the same.

 

   

In a rush to adopt HIT, EMRs many clinics and hospitals have acquired expensive systems for management of clinical records. The incentivization/penalization process hastened the ill-informed to purchase non friendly software. In addition to this deficit HHS mandated meaningful use in order to be able to extract information for the purpose of measuring outcomes.

Dr Eric Topol an outspoken leader in innovation had this to say at the recent HIMSS annual carnival,

                         

Topol kicked off his talk with a bird's eye view of technology today, mentioning that less than a decade ago, everyday technologies like YouTube and Twitter didn't exist. Smartphones — a technology Topol said is expanding faster than television or even electricity once did — are especially bringing on revolutions in health care.

“Despite the existence of a wide range of health technologies, much of health care stays entrenched in old-fashioned thinking, he said.
 

Topol also discussed the mis-direction of technology to reduce costs and increase outcomes. 

He then shared or demonstrated several technologies that have the potential to save patients money, such as apps for eye exams, ear infection checks and sleep studies.

"Why go to a hospital sleep lab when you can just connect your phone and do your own sleep study?" he said. "And who can sleep normally in a hospital?"
In a theme consistent with the overall message of HIMSS13, Topol also spoke on the importance of patient involvement and a move away from physician privilege. I might mention there are already companies that will send a sleep study kit to use at home.

Sequestration will have an effect on this process. The Food and Drug Administration is in the process of measuring their effectiveness and reliability of mobile health applications. The FDA is already  tasked with the  of monitoring and regulating foods, and  drugs. Budgetary constraint will now slow down or halt the process.

The progress of patient advocacy was established by his closing remarks,

In a theme consistent with the overall message of HIMSS13, Topol also spoke on the importance of patient involvement and a move away from physician privilege.

"Nothing about me without me," he said, repeating a patient advocacy battle cry that originated from Valerie Billingham in a session at the Salzburg Global Seminar in 1998 called "Through the Patient's Eyes."

To sum up his point, at the talk's close Topol shared a video clip from the movie Jerry Maguire with his own voice dubbed over that of Tom Cruise: "Show me the data! SHOW ME THE DATA!"

 

LATE BREAKING NEWS !!!!

Sequester's Effect on EHR Incentives

Also during the HIMSS conference, Elizabeth Holland -- director of the HIT Initiatives Group in CMS' Office of E-Health Standards & Services -- said that health care providers participating in the Medicare part of the meaningful use program could see reduced EHR incentive payments as a result of the sequester.

According to Modern Healthcare, hospitals participating only in the Medicare part of the meaningful use program could lose about $37,500 in incentive payments as a result of the 2% cut to Medicare reimbursements under sequestration. Meanwhile, physicians and other eligible professionals participating in the Medicare portion of the meaningful use program could lose up to $360 in incentive payments.

Read more: http://www.ihealthbeat.org/articles/2013/3/6/cms-launches-website-experts-discuss-health-it-at-himss-conference.aspx#ixzz2MnMbiav1