Tuesday, February 3, 2015
Health Information Technology Updates
While many providers are disappointed and also infuriated that the current first generation of EHRs which have been designed to meet arbitrary rules from HHS and CMS it is also obvious that the time has come for providers to play a more active role in addressing the significant shortcomings in EHRs that prevent them from playing a significant role in improving practice efficiency.
While CMS and HHS have done their 'best' to foster development with a dual system of rewards and penalties it is not enough that they totally ignored "meaningful usability". The current crop of meaningful use and EHR benefits 'pencil pushers', insurance companies, quality assurance, and others, as yet uknown who will tap into the huge data base that is developing.
One way of speeding development is to incentivize not only providers and hospitals but EHR vendors into developing more uniform standards, and common interfaces that are easily translated for physicians who often attend patients in numerous facilities, as well as their clinics. Some very large integrated health systems approach this goal successfully.
Perhaps a form of tax credits would stimulate interest in modernizing interfaces.. Microsoft is taking this approach to harmonize their desktop, tablet and smart phone GUI, making their use smooth and not requiring the learning of three separate screens. EHR vendors should follow their lead.
Our opinion here is that CMS, and HHS have rushed to force a roll out of EHRs, much as they did with the Affordable Care Act. We will be discussing the ACA in a later post.
A second generation is now becoming available, however Digital Health Space is still catching up on the older versions.
Our biggest announcement is the grand opening of our new Channel . Digital Health Space, will correlate with the blog, hopefully in a 'meaningful way'.Please subscribe.
Health blogs are ubiquitous, and we are attempting to remain relevant, creative and exciting for authors and viewers (readers) alike.
In the next several weeks a schedule will be forthcoming to be posted at Digital Health Space. The first broadcast (test) was accomplished today...it is rough, but technically it is working.
We need a video production expert to help produce the broadcast, so that do not have to multi-task. which cuts down on the professionalism, and distracts from content.
We are also recruiting providers and consultants who have opinions and can address controversy in this area.
Saturday, January 31, 2015
Barak Obama's New Phrase of the Year
"Precision Medicine"
“Precision medicine has given us one of the greatest opportunities that we have ever seen in medical research,” said Obama at a White House event kicking off the initiative. “The time's right to unleash a new wave of advances in this area.”
Medicine has always been "precise", based upon the standard of the times. However, in the past two decades mapping of the entire human genome has made it possible to locate specifc genes, including those which initiate diseases.
Modern Health reports
White House proposes $215 million, new regs for precision medicine
The White House is proposing $215 million in new funds and new regulations in a sweeping effort involving the National Institutes of Health, the Food and Drug Administration, and the Office of the National Coordinator for Health Information Technology to help fulfill the promise of what President Barack Obama has termed precision medicine.
“Precision medicine has given us one of the greatest opportunities that we have ever seen in medical research,” said Obama at a White House event kicking off the initiative. “The time's right to unleash a new wave of advances in this area.”
“Precision medicine has given us one of the greatest opportunities that we have ever seen in medical research,” said Obama at a White House event kicking off the initiative. “The time's right to unleash a new wave of advances in this area.”
The bulk of investment, $130 million, will be devoted to the NIH, which will stitch together existing cohorts of genomic database and recruit new volunteers in an effort to create a million-patient-strong cohort.
Another $70 million will go to the NIH's National Cancer Institute, to scale up current efforts to link genomic variation and cancer, along with potential treatments. The head of the NIH, Dr. Francis Collins, said during a conference call Thursday announcing the policy that the investment reflects the relative maturity of genomic efforts in cancer treatment.
The FDA would receive $10 million to hire new subject-area experts. The agency, beginning with a public meeting in February, also intends to update its regulations to deal with the peculiar challenges posed assessing the safety and efficacy of genomic sequencers and tests that analyze their data.
The ONC would receive $5 million to promulgate new interoperability standards to make genomic data more shareable. Tales of researchers mailing thumb drives and compact discs, rather than sending data electronically, are common.
“We're far from unlocking precision medicine's full potential,” Dr. Jo Handelsman, the associate director for science in the White House Office of Science and Technology Policy, said Thursday. The intention is that the initiative will build the infrastructure that will support new insights into the genome, and consequently human health.
Obama agreed, saying that basic research sometimes fails–but when it succeeds, the payoffs are large, such as with longitudinal studies discovering the risk factors for heart disease, or federal funding setting up the later success of MRI scanning.
The NIH will be placing an emphasis on uniting private sector efforts to develop genomic cohorts. “We are aware that there are something like 200 cohorts that have at least 10,000 participants. There's a wealth of potential there,” Collins said. Central to that will be ensuring the data is interoperable, and ensuring that the data is “distributed” for easy access—rather than uniting the data centrally.
Furthermore, Collins emphasized the potential gains from ensuring that patients could be recalled. For maximum potential, he said, genomic researchers need to be able to recall patients and take laboratory measurements. That ensures a tight link between the genomic data and the eventual health outcomes of the patient, rather than a snapshot in time.
For some research, he said, it's particularly vital. Some researchers have been interested in rare genomic variants that appear to provide boosts in health, rather than lead to disease. Tracking those patients closely can allow for richer knowledge of that subset.
“We would expect that [re-contact] occurs because it makes it much more powerful,” he said.
FDA's role primarily will be in modernizing its regulations. Current diagnostics, said FDA commissioner Dr. Margaret Hamburg, tend to test for one disease or condition. That makes it easy for the agency to test the link between diagnostic and disease.
Next-generation tests, on the other hand, will tend to pass verdicts on multiple diseases, and so are more complex for the agency to assess. Starting with a February public meeting, the agency intends to mull over questions related to sequencers and tests, followed by regulatory changes.
Follow Darius Tahir on Twitter: @dariustahir
The ONC would receive $5 million to promulgate new interoperability standards to make genomic data more shareable. Tales of researchers mailing thumb drives and compact discs, rather than sending data electronically, are common.
“We're far from unlocking precision medicine's full potential,” Dr. Jo Handelsman, the associate director for science in the White House Office of Science and Technology Policy, said Thursday. The intention is that the initiative will build the infrastructure that will support new insights into the genome, and consequently human health.
Obama agreed, saying that basic research sometimes fails–but when it succeeds, the payoffs are large, such as with longitudinal studies discovering the risk factors for heart disease, or federal funding setting up the later success of MRI scanning.
The NIH will be placing an emphasis on uniting private sector efforts to develop genomic cohorts. “We are aware that there are something like 200 cohorts that have at least 10,000 participants. There's a wealth of potential there,” Collins said. Central to that will be ensuring the data is interoperable, and ensuring that the data is “distributed” for easy access—rather than uniting the data centrally.
Furthermore, Collins emphasized the potential gains from ensuring that patients could be recalled. For maximum potential, he said, genomic researchers need to be able to recall patients and take laboratory measurements. That ensures a tight link between the genomic data and the eventual health outcomes of the patient, rather than a snapshot in time.
For some research, he said, it's particularly vital. Some researchers have been interested in rare genomic variants that appear to provide boosts in health, rather than lead to disease. Tracking those patients closely can allow for richer knowledge of that subset.
“We would expect that [re-contact] occurs because it makes it much more powerful,” he said.
FDA's role primarily will be in modernizing its regulations. Current diagnostics, said FDA commissioner Dr. Margaret Hamburg, tend to test for one disease or condition. That makes it easy for the agency to test the link between diagnostic and disease.
Next-generation tests, on the other hand, will tend to pass verdicts on multiple diseases, and so are more complex for the agency to assess. Starting with a February public meeting, the agency intends to mull over questions related to sequencers and tests, followed by regulatory changes.
Follow Darius Tahir on Twitter: @dariustahir
Friday, January 30, 2015
Meaningful Use Pushback
CMS announced a shortened period for attestation of Stage II of meaningful use, after the AMA and others asked for a delay in implementation and/or modify the criteria for meaningful use A large percentage of providers have not been able to certify and/or attest to Stage II of the Meaningful Use timetable. The term Meaningful use defines the ability for a provider's data to be transmitted to CMS in a format recognizable to their analytics algorighms.
to quote CMS announcement on their blog
to quote CMS announcement on their blog
We are considering proposals to:
- Realign hospital EHR reporting periods to the calendar year to allow eligible hospitals more time to incorporate 2014 Edition software into their workflows and to better align with other CMS quality programs.
- Modify other aspects of the program to match long-term goals, reduce complexity, and lessen providers’ reporting burdens.
- Shorten the EHR reporting period in 2015 to 90 days to accommodate these changes.
This shift in timing may just be a prelude for things to come.
Wednesday, January 28, 2015
Innovation....What it is NOT
Few would argue that the past ten years of the introduction of digital storage and other electronic devices has not empowered health care providers, hospitals and the health industry.
The promises have been many. Some have taken root and will become a part of the new infrastructure of how medical care is delivered.
There are those who state that HIT Venture Capital has peaked, after the Federal Funding by the HITECH Act and Federal incentives have passed. CMS Meaningful use has dampened any enthusiasm for meaningful advances in EHR since capital investment will now be diverted for a capability in which few clinicians are interested.
The fact is that most innovative ideas do not make it off the drawing board, attract capital, nor make it to a marketplace. Even after running that gauntlet the marketplace may not be favorable to develop a sustainable business model. Except for government, profit often is the measure of a successful innovator.
However even in government profit can be a motive, or at least reduce taxation and cut costs of operation. Our government functions wiith a contractual bidding system....ie, lowest bid...best product. The two are not mutually exclusive. Risk to a government is different than risk to a business innovator.
The blend for success is a mixture of creativity, scientific breakthroughs, business acumen, and timing.
Innovation can be scientific, or even new business models for health care. Certainly the Affordable Care Act is an innovation. (more later).
Here are some possibilities:
Video Teaser
Graphical Display of Innovations Innovator Gallery
Pharmaceuticals (Drug Development)
Devices
Organizations focused on Health Innovations
University of California Innovation examples
California Health Care Foundation
Digital Health Space
Center for Digital Health Innovations
Public Health Innovation
CMS Innovation Center (detailed description)
Meetings
Rock Health Summit
Blogs
HealthIT Buzz
RedBrick Health
Innovating for Value in Health Care
The Oliver Wyman Health Innovation Center
Blog « Rock Health
Center For Health Law Policy and Innovation | CHLPI Blog
Awards:
CMS
Financial
Kickstarters (While there is no specific category for Health, there is a
Technology category)
HIT Venture Capital History and Future Outlook
HIT venture capital funding jumps in 2014
Digital Health Venture Capital: 4 Areas VCs Are Betting On
Venture capital in healthcare is flowing, but how long will it ...
The impact of the Affordable Care Act,and increasing regulatory (details)
Compare Medical Devices and Equipment VC Firms
Education and MOOC Innovating in Health Care
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